Physical, functional and other nonpharmacological interventions for osteoarthritis

Non-pharmacological interventions are frequently and widely used in the man agement of patients with osteoarthritis (OA). However, there is little evid ence that most of these interventions are efficacious (i.e. that they work under ideal circumstances) owing to the paucity of research studies on thes e interventions and the fundamental methodological flaws in published studi es. Moreover, the clinical effectiveness of non-pharmacological interventio ns (i.e. their efficacy under the conditions prevailing in clinical practic e) is unknown, and cost-analysis of these interventions has not been carrie d out. If evidence-based management guidelines were to be constructed solel y from firm research studies few could be recommended. Established and deve loping research methodologies and techniques should be employed to construc t and conduct research programmes that appropriately evaluate the clinical and cost effectiveness of these complex non-pharmacological healthcare inte rventions. Establishing clinical effectiveness will ensure that we have pra ctice-based evidence and are administering relevant, effective and optimal healthcare for patients with OA, maximizing the efficient use of healthcare resources.