Access to the PPM Journal and newsletters is FREE for clinicians.
15 Articles in Volume 16, Issue #6
Osteoarthritis and Central Pain
Uncovering the Sources of Osteoarthritis Pain
The Synergistic Effects of Mood and Sleep on Arthritis Pain
Nonsurgical Rx of OA: Analyzing the Guidelines
Osteoarthritis Disability Is Often Underestimated By Rheumatologists
10 Pain Medication Myths
The Use of Medical Marijuana for Pain in Canada
6 Common Concerns Regarding Medical Marijuana
What Pain Specialists Need to Know About Medicinal Cannabis
Applying Kinesiology as a Multipronged Approach to Pain Management: Part 2
Practical Guide to Adding Recreation Therapy Into Pain Management
A Novel Treatment for Acute Complex Regional Pain Syndrome
Genetic Testing in High-Dose Opioid Patients
No More “Fifth Vital Sign”
Letters to the Editor: Disc Herniation, SCS, Arachnoiditis, Tapering Opioids

Nonsurgical Rx of OA: Analyzing the Guidelines

See how the AAOS and VA/DoD recommendations stack up.

The National Guideline Clearinghouse recently released a comparison of the practice guidelines on nonsurgical management of knee osteoarthritis from the American Academy of Orthopaedic Surgeons (AAOS) and the Department of Veterans Affairs, Department of Defense (VA/DoD).1-3

Areas of Agreement

Everyone agrees, weight loss should be a primary intervention for obese patients with osteoarthritis.The guidelines have many similarities, including the general recommendation that nonsurgical interventions should be used before considering surgery for knee OA (Table). Both guidelines also recommend weight loss for overweight and obese patients, with the VA/DoD suggesting a goal of losing at least 5% body weight.

Use of acupuncture or chondroitin sulfate and/or glucosamine is not recommended. Both groups were unable to recommend for or against chiropractic therapy, and the VA/DoD was unable to make a recommendation for the use of dietary supplements.

Areas of Disagreement

The groups disagree on the use of manual therapy, with the VA/DoD recommending manual therapy as an adjunct to traditional physical therapy and supervised exercise, and the AAOS stating it was unable to recommend for or against manual therapy due to a lack of evidence on the topic.

Regarding pharmacotherapy, the AAOS only recommends NSAIDs (oral or topical) and tramadol, while the VA/DoD makes recommendations according to pain severity.


Last updated on: August 4, 2016
Continue Reading:
Osteoarthritis Disability Is Often Underestimated By Rheumatologists

Join The Conversation

Register or Log-in to Join the Conversation
close X