Effectiveness of Non-Pharmacological Interventions in Osteoarthritis Management
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Abstract
Background: Osteoarthritis is a major cause of chronic joint pain, stiffness, functional limitation, and reduced quality of life, particularly among middle-aged and older adults. Although pharmacological treatment may provide short-term symptom relief, long-term management requires strategies that address modifiable contributors such as muscle weakness, excess body weight, altered movement patterns, and poor self-management. Objective: This systematic review without meta-analysis aimed to synthesize national and international evidence on the effectiveness of non-pharmacological interventions, particularly exercise therapy, weight management, physical therapy, and combined rehabilitation programs, in osteoarthritis management. Methods: A structured literature search was conducted using PubMed, Google Scholar, Cochrane Library, ScienceDirect, SpringerLink, Web of Science, and selected Pakistani medical journals. Eligible evidence included randomized controlled trials, systematic reviews, meta-analyses, clinical practice guidelines, and relevant local studies involving adults with osteoarthritis and reporting pain, function, stiffness, walking ability, weight-related outcomes, or quality of life. Findings were synthesized narratively because of heterogeneity in study design, intervention content, comparator groups, and outcome measures. Results: Thirty-four studies were included. Exercise therapy was the most frequently represented intervention category and showed favorable effects on pain, stiffness, physical function, mobility, and quality of life. Weight management was most relevant for overweight and obese patients with knee osteoarthritis, while physical therapy supported improvement in pain, mobility, balance, range of motion, and functional performance. Combined lifestyle-rehabilitation programs showed broad clinical relevance. Conclusion: Non-pharmacological interventions are clinically important first-line strategies for osteoarthritis care, especially when individualized and integrated into combined rehabilitation pathways
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