Elsevier

Pain Management Nursing

Volume 14, Issue 4, December 2013, Pages e274-e288
Pain Management Nursing

Review Article
Complementary Therapies for Osteoarthritis: Are They Effective?

https://doi.org/10.1016/j.pmn.2012.01.001Get rights and content

Abstract

Increasing interest has focused on complementary management modalities, including tai chi, acupuncture, yoga, and massage therapy, as treatments for osteoarthritis (OA). This review article synthesizes evidence from randomized controlled trials (RCTs) and systematic reviews (SRs) that examined one or more of the above as treatments for OA. Medline, Pubmed, and Cinahl databases were searched to identify English-language articles using an RCT design or that conducted a SR of published studies and presented data on symptom or functional outcomes. Two authors independently abstracted relevant information (e.g., study sample, intervention characteristics, treatment effects, safety data). Retained articles (n = 29) included those that evaluated tai chi (8 RCTs, 2 SRs), acupuncture (11 RCTs, 4 SRs), yoga (2 RCTs), and massage therapy (2 RCTs). Available evidence indicates that tai chi, acupuncture, yoga, and massage therapy are safe for use by individuals with OA. Positive short-term (≤6 months) effects in the form of reduced pain and improved self-reported physical functioning were found for all 4 treatments. Limited information exists regarding the relative effectiveness of the therapies (e.g., yoga vs. tai chi vs. acupuncture), as well as treatment effects in persons with joint involvement besides the knee and in distinct patient subgroups (e.g., older vs. younger adults, persons with mild vs. moderate vs. advanced disease). Complementary therapies can reduce pain and improve function in adults with OA. Research is needed to evaluate long-term benefits of the treatments, as well as their relative effects among diverse patient subgroups.

Section snippets

Methods

Medline, Pubmed, and the Cumulative Index to Nursing and Allied Health Literature (Cinahl) databases (January 1995 to April 2011) were searched using tai chi, acupuncture, yoga, and massage as MeSH terms. Additional search terms included randomized controlled trial, systematic review, and osteoarthritis. Identified abstracts were reviewed in detail by using the following inclusion criteria: 1) article published in English; 2) enrolled adults with osteoarthritis; 3) used a randomized controlled

Results

Twenty-nine articles met the inclusion criteria (23 RCTs and 6 SRs) and were retained for review. The following section is organized by treatment to include a brief description of each intervention (i.e., tai chi, acupuncture, yoga, and massage therapy), evidence regarding its efficacy and safety, and a summary of the evidence along with questions that remain unanswered regarding each treatment. Table 1 provides a brief summary of each article to include information regarding the

Discussion

Available evidence suggests that tai chi, acupuncture, yoga, and massage therapy are safe for use by persons with OA and may have beneficial effects. Many unanswered questions remain about their role as treatments for persons with OA. Studies are needed to determine the long-term effects (i.e., >6 months) of the therapies and their role in treating individuals with various types of OA (e.g., multiple vs. single joint involvement). Head-to-head comparisons (e.g., tai chi vs. yoga) are needed to

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    Supported by the National Institute on Aging (Edward R. Roybal Center grant P30AG022845) and the John A. Hartford Foundation (Center of Excellence in Geriatric Medicine award).

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