Avoidance of surgical and pharmacological management of osteoarthritis is best strategy - Magaziner

Avoidance of surgical and pharmacological management of osteoarthritis is best strategy

Exercise and weight loss are very important components of treating hip osteoarthritis. For many patients this may be easier said than done because of range of motion and pain concerns.

In this article we describe non-surgical hip pain repair in conjunction with diet and exercise to help the patient lessen pain and regain mobility.

Research has shown that for people with osteoarthritis of the knee, exercise in combination with weight loss is a proven effective conservative treatment option, yet evidence is lacking for people with hip osteoarthritis.

Recently, doctors published their findings which clearly suggested that older patients are not being advised of the importance or exercise and diet and the correct diet and exercise program for their individual cases. When these patients are, they show significant improvement in their symptoms.1

In another study, doctors took thirty-five people who were 25 years or older, had clinical and radiological evidence of hip osteoarthritis, and were overweight or obese. They participated in an 8-month program of exercise in combination with weight loss.

Participation in the combination program resulted in a 32.6% improvement in self-reported physical function after 8 months, a finding that could be considered clinically relevant. Significant improvements also were seen in pain and on walking tests.2

Avoidance (if possible) of surgical and pharmacological management of osteoarthritis

A key to this and other research is the all out avoidance (if possible) of surgical and pharmacological management of osteoarthritis. In New Zealand, researchers noted in their paper:

“Non-pharmacological, non-surgical interventions are recommended as the first line of treatment for osteoarthritis  of the hip and knee.”3

What type of exercise?
Exercise and physical therapy plans should always be discussed with your doctor as hip osteoarthritis is a multi-plexed problem and the recommendations to the patient needs to be individualized.

In discussing exercise or physical therapy – the researchers added:

“There is evidence that exercise therapy is effective for reducing pain and improving function in patients with knee osteoarthritis, some evidence that exercise therapy is effective for hip osteoarthritis, and early indications that manual therapy may be efficacious for hip and knee osteoarthritis. There is little evidence as to which approach is more effective, if benefits endure, or if providing these therapies is cost-effective for the management of this disorder.” 3

Researchers in Ireland published a study in which they also found that physical therapy and exercise, when compared, delivered inconclusive results on the benefit of manual therapy on pain and function for knee or hip osteoarthritis and was basically equal to an exercise program in results. This again is a broad study and the needs of the individual patient must be addressed in designing any plan of exercise or therapy.

At the Magaziner Center for Wellness we take a holistic view of the body, even from an orthopedic standpoint. We believe it is crucial to obtain recovery from an injury or to cure chronic pain. We also look at the problems of the immune system and problems of obesity.

We bring a comprehensive understanding of thyroid, hormonal, metabolic and nutritional medicine to our treatment of our patients. Since regular exercise and a healthy diet are crucial when it comes to controlling weight, we speak to each patient about his or her lifestyle habits, as well as his or her biochemistry, in order to create a customized treatment plan.

Rather than just placing an obese patient on a restricted diet, we first analyze his or her blood to look for thyroid or endocrine problems that could have led to weight gain and may be inhibiting a patient from losing weight. We test patients’ reaction to food allergens and if a food allergy or sensitivity is discovered, we will have the patient avoid the food that may be harmful to his or her wellbeing or we work to desensitize the patient to that food. If hypothyroidism is discovered, we will utilize natural thyroid agents to stimulate the production of thyroid hormone as a first step.

For the long run, we help our patients understand food choices and their impact on the body. Our goal is to help our patients maintain their weight loss for a lifetime, by educating them on proper nutrition and changing body chemistry to reduce cravings.


Please visit our page on treating hip pain


1. Quintrec JL, Verlhac B, Cadet C, Bréville P, Vetel JM, Gauvain JB, Jeandel C, Maheu E. Physical Exercise and Weight Loss for Hip and Knee Osteoarthritis in Very Old Patients: A Systematic Review of the Literature. Open Rheumatol J. 2014 Nov 28;8:89-95. eCollection 2014.

2. Paans N, van den Akker-Scheek I, Dilling RG, Bos M, van der Meer K, Bulstra SK, Stevens M. Effect of exercise and weight loss in people who have hip osteoarthritis and are overweight or obese: a prospective cohort study. Phys Ther. 2013 Feb;93(2):137-46. doi: 10.2522/ptj.20110418. Epub 2012 Sep 27.

3. Abbott JH, Robertson MC, McKenzie JE, Baxter GD, Theis JC, Campbell AJ; MOA Trial team. Exercise therapy, manual therapy, or both, for osteoarthritis of the hip or knee: a factorial randomised controlled trial protocol. Trials. 2009 Feb 8;10:11. doi: 10.1186/1745-6215-10-11.

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