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Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis

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 alle...

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Detalles Bibliográficos
Autores principales: Rice, David, McNair, Peter, Huysmans, Eva, Letzen, Janelle, Finan, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912819/
https://www.ncbi.nlm.nih.gov/pubmed/31652929
http://dx.doi.org/10.3390/jcm8111769
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author Rice, David
McNair, Peter
Huysmans, Eva
Letzen, Janelle
Finan, Patrick
author_facet Rice, David
McNair, Peter
Huysmans, Eva
Letzen, Janelle
Finan, Patrick
author_sort Rice, David
collection PubMed
description 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.
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spelling pubmed-69128192020-01-02 Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis Rice, David McNair, Peter Huysmans, Eva Letzen, Janelle Finan, Patrick J Clin Med Review 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. MDPI 2019-10-24 /pmc/articles/PMC6912819/ /pubmed/31652929 http://dx.doi.org/10.3390/jcm8111769 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rice, David
McNair, Peter
Huysmans, Eva
Letzen, Janelle
Finan, Patrick
Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title_full Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title_fullStr Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title_full_unstemmed Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title_short Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis
title_sort best evidence rehabilitation for chronic pain part 5: osteoarthritis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912819/
https://www.ncbi.nlm.nih.gov/pubmed/31652929
http://dx.doi.org/10.3390/jcm8111769
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