Analgesic effect of exercise comparable to NSAIDs and paracetamol in knee osteoarthritis

Clinical guidelines recommend exercise as a core treatment for knee or hip osteoarthritis (OA). However, how its analgesic effect compares to analgesics, for example, oral non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol—the most commonly used analgesics for OA, remains unknown.

The Design of the study was Network meta-analysis. PubMed, Embase, Scopus, Cochrane Library and Web of Science sources from database inception to January 2022 were used. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) comparing exercise therapy with oral NSAIDs and paracetamol directly or indirectly in knee or hip OA.

Results

A total of n=152 RCTs (17 431 participants) were included. For pain relief, there was no difference between exercise and oral NSAIDs and paracetamol at or nearest to 4, 8

Similarly, there was no difference between exercise and oral NSAIDs and paracetamol in functional improvement at or nearest to 4 , 8 and 24 weeks

Exercise has similar effects on pain and function to that of oral NSAIDs and paracetamol. Given its excellent safety profile, exercise should be given more prominence in clinical care, especially in older people with comorbidity or at higher risk of adverse events related to NSAIDs and paracetamol.

Reference:

Weng Q, Goh S, Wu J, et alComparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trialsBritish Journal of Sports Medicine Published Online First: 02 January 2023. doi: 10.1136/bjsports-2022-105898