Knee arthritis is a common condition affecting many middle to older aged adults. Its’ prevalence makes it one of the leading causes of disability in our country preventing these individuals from participating in their life, work, and recreational activities. Physical therapy including patient education, manual therapy, and exercise remains a first line treatment for this diagnosis secondary to evidence documenting significant reductions in pain and disability following treatment. In addition, prior research has shown patients who received Physical Therapy were able to postpone or prevent the need for a total knee replacement surgery. A steroid injection is another common conservative treatment offered to patients with knee arthritis. A new study compares the short and long term effectiveness of these two treatments.

Physical Therapy researchers led by Gail Deyle published their study in the New England Journal of Medicine (2020) this month. Authors randomized 156 patients (56 y.o.) to either a series of steroid injections (1 to 3 depending on MD discretion) or Physical Therapy. Each patient was seen by a fellowship trained Physical Therapist for 8 visits over a 4-6 week period. Patients could elect for additional visits if needed at the 4 and 9 month follow up. Each visit included joint mobilizations, exercise, and education. Patients were assessed for both subjective pain and function, as well as, objective functional tests. Authors reported improved outcomes at 1 year in the patients who received Physical Therapy compared to their peers who received a steroid injection(s).

Based on this and prior research steroid injections are best utilized in the short term, but should be concurrently utilized with Physical Therapy for long term relief.

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