People who see a doctor for knee pain due to arthritis may be offered steroid shots into the joint. Other physicians might make a referral for physical therapy first. Both treatments work, but how do they compare?
Comparing Physical Therapy With Steroid Shots:
Health care providers have long wondered about this question. Now scientists have designed a study to see which of these treatments works best (NEJM, April 9, 2020). The investigators assigned 156 patients with osteoarthritis of the knee to one of the treatments. They made the assignments using randomization software, but there were no placebo treatments. All the volunteers got one active treatment or the other, and they all knew which treatment they were getting.
Which Treatment Was Better?
After one year of follow-up, the clinicians reported that people who did physical therapy had less pain and better mobility than those receiving the steroid shots. Those getting physical therapy had up to eight sessions in the first month and a half. That’s not all, though. They also had the option of a few additional sessions at the 4-month and 9-month evaluations.
The steroid shots were triamcinolone with lidocaine. These volunteers could also opt for an additional shot at the 4-month and/or 9-month reassessments.
On average, both groups got better. However, these researchers from the US military and their colleagues report that patients on physical therapy had significantly more improvement. Moreover, nearly one-fourth of those getting steroid shots reported no improvement or even worse symptoms at the end of the year. That compares with less than 10 percent of those in the physical therapy group reporting deterioration.
The investigators concluded:
“physical therapy for osteoarthritis of the knee resulted in better absolute scores on scales of pain and physical function than glucocorticoid injection at 1 year.”
If you would like to know more about managing arthritis pain, you may be interested in our eGuide to Alternatives for Arthritis. This online resource provides information on medications as well as nondrug approaches to help you with this common health problem.