Rev Med Interne. 2003 Apr; 24(4): 243-52.

[Therapeutic management of osteoarthritis in the beginning of the third millennium. Part II: non pharmacological strategies]

Flipo RM, Conrozier T.

Service de rhumatologie, hÃ´pital Roger-Salengro, centre hospitalier et universitaire de Lille, 59037 cedex, Lille, France. rmflipo@chru.lille.fr

COMMENT: Osteoarthritis represents one of the most frequent pathologies today, and its current management requires the combination of pharmaceutical and non pharmacological strategies. Moreover, osteoarthritis constitutes one of the main diseases leading to the requirement to the alternative medicines. NEWS AND KEY POINTS: This overview resumes the main recommendations in the light of recent controlled clinical trials concerning the not medicinal coverage of osteoarthritis : importance of the information and the education of the patient, the importance of the establishment of programs of physical exercises, the need for a reduction of the weight excess for knee osteoarthitis. Some controlled studies tried to estimate the symptomatic efficiency of acupuncture, homoeopathy or the contribution of minerals, vitamins. The appeal to the alternative said medicines is approached on this review. PERSPECTIVES AND PROJECTS: If certain not medicinal strategies have a sufficient proof of efficiency today, on the other hand number of propositions still have not, at the moment, demonstrated by superiority and by efficiency versus placebo. Numerous controlled studies should be organized to confirm or exclude the place of treatments such as homoeopathy, minerals.