Knee Pain And Reliance On Painkillers Can Be Reduced With Help From Physiotherap

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Knee Pain And Reliance On Painkillers Can Be Reduced With Help From

Physiotherapists And Pharmacists, UK

http://www.medicalnewstoday.com/medicalnews.php?newsid=54651

Older people with knee pain who receive their main care from

physiotherapists and pharmacists are more likely to experience

improvements in pain levels and knee function, and are less likely

to need NSAIDs (non-steroidal anti-inflammatory drugs, eg asprin and

ibuprofen), according to a BMJ study.

Researchers from Keele University undertook a study involving over

300 people with knee pain. The participants (aged over 55), were

split into three groups.

The first group took part in an 'enhanced pharmacy review' with up

to 6 appointments with an experienced community pharmacist to

monitor the appropriateness and effectiveness of medication. A

second group received up to 6 sessions with a physiotherapist, which

included general aerobic exercise and specific muscle strengthening

and stretching exercises. A final 'control' group received an

information and advice leaflet - which was also issued to the other

two groups - plus a telephone call to reinforce the information in

the leaflet and address any specific concerns about putting the

advice into practice.

When compared with the control group, those in the physiotherapy

group reported a significant improvement in pain levels and in knee

function after three months of treatment. Participants in the

pharmacy group also reported improvements in pain levels.

However, in the longer term (at six months and 12 months), there

were no significant differences in pain or function between the

physiotherapy, pharmacy and control group. The researchers suggest

that this change may in part be due to a lack of adherence to the

programme - as time goes by people may not be as strict about

keeping up with their exercise programme or taking their medication.

However, there were differences between each groups' usage of NSAIDs

(non-steroidal anti-inflammatory drugs, e.g. asprin and ibuprofen).

The study found that participants in the pharmacy and physiotherapy

groups were less reliant on NSAIDs than the control group. At six

months NSAID usage was 16% lower in the pharmacy group and 15% lower

in the physiotherapy group than those in the control group, with no

increase in pain reporting and high levels of patient satisfaction.

The researchers say that this finding has 'important safety

implications' as NSAIDs can cause adverse reactions and illness, and

are not recommended for long-term use, particularly for older

people.

The study also found that physiotherapy appeared to encourage a long-

term shift in behaviour away from GP led care - with participants in

the physiotherapy group less likely to consult their GP about knee

pain than patients in the control group.

The authors conclude that further investigation is needed to how the

early clinical benefits of physiotherapy and pharmacy can be

sustained in the long-term.'