Physical therapy may harm hip osteoarthritis outcomes, study suggests

Though medical science relies on new research that illuminates more accurate and effective ways to treat all manner of conditions, even physicians are liable to make assumptions about the best treatments available. For example, patients with forms of osteoarthritis, particularly of the hip, are often instructed to undergo physical therapy programs in lieu of or in addition to surgery. This was traditionally thought to help regain mobility and reduce pain.

However, according to a recent study conducted by researchers at the Center for Health, Exercise and Sports Medicine at the University of Melbourne and published in the Journal of the American Medical Association, patients with hip osteoarthritis who undergo physical therapy may not get better at all. Contrary to popular medical opinions, these patients may in fact experience an increase in mild adverse symptoms directly related to physical therapy.

New data emerges
According to the U.S. Centers for Disease Control and Prevention, an estimated 52.2 million Americans – 22.7 percent of the population – have been diagnosed by a physician with some form of osteoarthritis. Moreover, the average American has a one in four chance of developing mild to severe hip osteoarthritis over the course of his or her lifetime.

With such dramatic figures, incorrect treatments for hip osteoarthritis could cause major damage. According to the University of Melbourne study, this may be happening right now.

Kim Bennell, Ph.D., director of the Center for Health, Exercise and Sports Medicine at the University of Melbourne and lead author of the study, randomly assigned 102 patients with hip osteoarthritis to different treatment groups. One group of 49 would receive an "active treatment" plan that included education about the patients' conditions and manual physical therapy, which included light exercise at home and a walking aid, if necessary. The other group of 53 were administered a "sham treatment," which consisted of a placebo-like ultrasound treatment and an inert gel application. Over the course of 24 weeks, the former group continued its assigned exercise regimen while the latter group applied the gel three times weekly.

Bennell found that at intervals of 13 and 36 weeks, the active treatment provided no greater observable benefit to patients symptoms and mobility than the sham treatment. Both populations reported an overall reduction in pain, but this appeared unrelated to the physical therapy regimens. 

In fact, 41 percent of patients in the active treatment group reported adverse effects of their treatments, as opposed to only 14 percent of the sham group.

"These results question the benefits of such a physical therapy program for this patient population," Bennell said in a statement.

While Bennell and her fellow researchers also admitted that more comprehensive studies are necessary before patients give up on physical therapy's effectiveness, they hope that their findings can inform the development of more accurate treatments for a condition that will only affect more patients in the future. Otherwise, patients may be at the mercy of, at best, ineffective or, at worst, harmful treatments.