Physical Therapy, Lifestyle Advice Underused in Knee OA

2007 to 2015 saw increase in use of NSAID prescriptions from orthopedists, primary care doctors

FRIDAY, Oct. 18, 2019 (HealthDay News) -- For patients with knee osteoarthritis (KOA), physical therapy (PT) and lifestyle counseling seem to be underutilized, while medication use has increased, according to a study published online Oct. 8 in Arthritis Care & Research.

Samannaaz S. Khoja, P.T., Ph.D., from the University of Pittsburgh, and colleagues conducted a cross-sectional analysis examining data between 2007 and 2015 from the National Ambulatory Medical Care Survey. Visits to orthopedists and primary care physicians were identified for KOA. The authors examined triennial rates for PT referral, lifestyle counseling, and nonsteroidal anti-inflammatory drug (NSAID) and narcotic prescriptions.

The researchers identified 2,297 KOA-related physician visits. Over time, for visits to orthopedists, there was a decrease in recommendation rates for PT and lifestyle counseling and increases in NSAID and narcotic prescriptions. No significant changes in the rates of PT, lifestyle counseling, and narcotics were seen for visits to primary care physicians, while NSAID prescriptions increased. There were correlations for treatment recommendations with nonclinical factors, including practice type, location, and type of provider seen.

"Knee OA is primarily managed from a perspective of symptom control and not from the perspective of improving physical function, fitness, and overall well-being," the authors write. "If PT and lifestyle interventions were emphasized at a more optimal rate in clinical practice, reliance on pain medications (especially those that are not guideline concordant, i.e., narcotic analgesics) may reduce."

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