Multimodal OA treatment more effective than usual care for reduction of pain-related measures

SEATTLE — A multimodal treatment consisting of neuromuscular exercise, education, diet, insoles and pain medication was more effective than usual care in reducing self-reported pain measures among patients with knee osteoarthritis, according to researchers at the Aalborg University in Denmark.

The researchers randomly assigned 100 patients with osteoarthritis (OA) who were not eligible for total knee arthroplasty (TKA) to either usual treatment or the multimodal treatment, called MEDIC. Usual care consisted of two informational leaflets provided with treatment advice. Forty-six patients completed usual care, and 43 patients completed the MEDIC treatment after 12 weeks.

At baseline and at 12 weeks, patients completed a 30-minute walking exercise and reported pain on a VAS of 0 to 100. Central and peripheral sensitization were assessed at the knee, lower leg and forearm using handheld algometry following the walking activity.

By 12 weeks, both groups of patients improved in peak pain intensity, but the MEDIC treatment group improved by 15.4 points more than the usual care group.

After 30 minutes of walking, patients in the MEDIC group reported lower pain intensity and a smaller number of body sites with pain. However, pain sensitization improved equally in both groups, suggesting that the perception of pain is related to mechanisms other than pain sensitization, according to the researchers. - by Shirley Pulawski

Reference:

Skou ST, et al. Paper #17. Presented at: Osteoarthritis Research Society International World Congress on Osteoarthritis. April 30-May 3, 2015; Seattle.

Disclosure: The researchers report no relevant financial disclosures.