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Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis

Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland 1142, New Zealand
Waitemata Pain Service, Department of Anaesthesiology and Perioperative Medicine, Waitemata District Health Board, Auckland 1142, New Zealand
Pain in Motion International Research Group
Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussel, Belgium
Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
I-CHER, Interuniversity Center for Health Economics Research, 1090 Brussels, Belgium
Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
Department of Psychiatry & Behavioral Sciences, Johns Hopkins University, Baltimore, MD 21287, USA
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1769;
Received: 14 September 2019 / Accepted: 30 September 2019 / Published: 24 October 2019
(This article belongs to the Special Issue Rehabilitation for Persistent Pain Across the Lifespan)
Osteoarthritis (OA) is a leading cause of chronic pain and disability in older adults, which most commonly affects the joints of the knee, hip, and hand. To date, there are no established disease modifying interventions that can halt or reverse OA progression. Therefore, treatment is focused on alleviating pain and maintaining or improving physical and psychological function. Rehabilitation is widely recommended as first-line treatment for OA as, in many cases, it is safer and more effective than the best-established pharmacological interventions. In this article, we describe the presentation of OA pain and give an overview of its peripheral and central mechanisms. We then provide a state-of-the-art review of rehabilitation for OA pain—including self-management programs, exercise, weight loss, cognitive behavioral therapy, adjunct therapies, and the use of aids and devices. Next, we explore several promising directions for clinical practice, including novel education strategies to target unhelpful illness and treatment beliefs, methods to enhance the efficacy of exercise interventions, and innovative, brain-directed treatments. Finally, we discuss potential future research in areas, such as treatment adherence and personalized rehabilitation for OA pain. View Full-Text
Keywords: osteoarthritis; musculoskeletal pain; rehabilitation medicine; physiotherapy; psychology; non-pharmacological osteoarthritis; musculoskeletal pain; rehabilitation medicine; physiotherapy; psychology; non-pharmacological
MDPI and ACS Style

Rice, D.; McNair, P.; Huysmans, E.; Letzen, J.; Finan, P. Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis. J. Clin. Med. 2019, 8, 1769.

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