HealthDay News — A combined intervention of optimized analgesic prescription and exercise therapy is feasible and associated with significant reductions in pain and activity limitation in patients with knee osteoarthritis (OA) and severe knee pain, according to a study published in the March issue of Arthritis Care & Research.

Joyce A.C. van Tunen, PT, from the Amsterdam Rehabilitation Research Center, and colleagues examined the feasibility and outcome of a protocol for standardized optimization of analgesics in combination with exercise therapy for 49 patients with knee OA and severe knee pain. Following an incremental protocol, analgesics were prescribed; after 6 weeks, a 12-week exercise therapy program was added. At baseline and after 6 and 18 weeks, knee pain and activity limitations were assessed.

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In the intent-to-treat analysis, the researchers identified statistically significant improvements in pain and activity limitations after 6 weeks of analgesic use and at the end of the intervention. After the intervention was completed, the mean improvements from baseline were 30% for pain and 17% for activity limitation (both P < 0.001). Overall, 78% of patients were able to exercise in accordance with the protocol. In these patients, a further 10% improvement in activity limitations was seen for exercise therapy following 6 weeks of analgesic use (P = 0.004).

“Although the results are promising, they need to be confirmed in a randomized controlled trial,” the authors wrote.


van Tunen J, van der Leeden M, Bos W et al. Optimization of Analgesics for Greater Exercise Therapy Participation Among Patients With Knee Osteoarthritis and Severe Pain: A Feasibility Study. Arthritis Care Res. 2016;68(3):332-340. doi:10.1002/acr.22682.