Potentials and Limits of Physiotherapy in Osteoarthritis

In view of the already existing and the expected growing costs due to the pathological osteoarthritic joint alterations and the related consequences, preventive and conservative strategies which can avoid or delay osteoarthritic joint alterations are welcomed from a socioeconomical perspective. Here, it should be mentioned that corresponding primary prevention measures should take place early by already educating children about a healthy diet and motivating them to regular physical exercise. In overt or symptomatic osteoarthritis, a good joint function and reduction of disease-related pain as well as a delay in the progression of osteoarthritis should be the primary goals of non-surgical therapeutic approaches.

The current body of studies is already able to prove the effectiveness of differential indicative physiotherapeutic and physical measures and should be further developed in the future. Nevertheless, the implementation of the available knowledge from the studies under evidencebased medicine criteria proves difficult during the daily routine in clinics. On one hand, an assessment of the effectiveness of physical therapy within the framework of a multimodal treatment approach (e.g. thermotherapy in combination with manual therapy) is difficult to define.

On the other hand, an objective assessment of treatment success, owing to the heterogeneity among the patients (above all varied disease activity, functional limitations, accompanying diseases and therapy) will also remain complicated.