What are the ACR/Arthritis Foundation recommendations for nonpharmacologic treatment of hip osteoarthritis (OA)?

Updated: Oct 12, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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For hip osteoarthritis, the American College of Rheumatology (ACR)/Arthritis Foundation recommends the following regarding nonpharmacologic measures [154] :

  • Exercise is strongly recommended; balance exercises are conditionally recommended
  • Weight loss is strongly recommended for patients who are overweight or obese
  • Self‐efficacy and self‐management programs are strongly recommended
  • Tai chi is strongly recommended
  • Cognitive behavioral therapy is conditionally recommended
  • Cane use is strongly recommended for patients in whom disease in 1 or more joints is causing a sufficiently large impact on ambulation, joint stability, or pain to warrant use of an assistive device
  • Modified shoes and lateral and medial wedged insoles are conditionally recommended  against
  • Acupuncture is conditionally recommended
  • Thermal interventions (locally applied heat or cold) are conditionally recommended
  • Massage therapy is conditionally recommended  against
  • Manual therapy with exercise is conditionally recommended  against over exercise alone
  • Transcutaneous electrical stimulation (TENS) is strongly recommended  against

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