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![ABSTRACT Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Evidence-based guidelines and recommendations for the treatment of OA consider non-pharmacological modalities as the cornerstone of modern OA management. Nonetheless, research evidence from clinical trials on non-pharmacological interventions for the treatment of hand and hip OA is scarce and considerably less than that for knee OA. In addition, research on non-pharmacological interventions for OA appears highly on the list of patients' research priorities. Thus, there is a clear mismatch between the available research evidence for non-pharmacological interventions for hip and hand OA and both the treatment guidelines and the interests of patients. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $209.00 per year only $17.42 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS CORE AND ADJUNCTIVE INTERVENTIONS FOR OSTEOARTHRITIS: EFFICACY AND MODELS FOR IMPLEMENTATION Article 13 July 2020 EFFECTIVENESS OF INTERFERENTIAL CURRENT THERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS Article Open access 11 June 2022 A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFECT OF PHONOPHORESIS ON PATIENTS WITH KNEE OSTEOARTHRITIS Article Open access 27 July 2022 REFERENCES * Towle, A. & Godolphin, W. Framework for teaching and learning informed shared decision making. _BMJ_ 319, 766–771 (1999). Article CAS PubMed PubMed Central Google Scholar * Gøtzsche, P. C. Do patients with osteoarthritis get the clinical research they need? _Ann. Rheum. Dis._ 59, 407–408 (2000). Article PubMed PubMed Central Google Scholar * Chard, J. A., Tallon, D. & Dieppe, P. A. Epidemiology of research into interventions for the treatment of osteoarthritis of the knee joint. _Ann. Rheum. Dis._ 59, 414–418 (2000). Article CAS PubMed PubMed Central Google Scholar * Tallon, D., Chard, J. & Dieppe, P. Exploring the priorities of patients with osteoarthritis of the knee. _Arthritis Care Res._ 13, 312–319 (2000). Article CAS PubMed Google Scholar * Tallon, D., Chard, J. & Dieppe, P. Relation between agendas of the research community and the research consumer. _Lancet_ 355, 2037–2040 (2000). Article CAS PubMed Google Scholar * Jordan, K. M. _ et al_. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). _Ann. Rheum. Dis._ 62, 1145–1455 (2003). Article CAS PubMed PubMed Central Google Scholar * Murray, C. J. L. & Lopez, A. D. _The Global Burden of Disease_ (World Health Organisation, Geneva, 1997). Google Scholar * Petersson, I. F. & Jacobsson, L. T. Osteoarthritis of the peripheral joints. _Best Pract. Res. Clin. Rheumatol._ 16, 741–760 (2002). Article PubMed Google Scholar * Peat, G. _ et al_. The Knee Clinical Assessment Study—CAS(K). A prospective study of knee pain and knee osteoarthritis in the general population. _BMC Musculoskelet. Disord._ 5, 4 (2004). Article PubMed PubMed Central Google Scholar * Birrell, F., Lunt, M., Macfarlane, G. & Silman, A. Association between pain in the hip region and radiographic changes of osteoarthritis: results from a population-based study. _Rheumatology (Oxford)_ 44, 337–341 (2005). Article CAS Google Scholar * Oliveria, S. A., Felson, D. T., Reed, J. I., Cirillo, P. A. & Walker, A. M. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. _Arthritis Rheum._ 38, 1134–1141 (1995). Article CAS Google Scholar * Andrianakos, A. A. _ et al_. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study. _J. Rheumatol._ 33, 2507–2513 (2006). PubMed Google Scholar * Grotle, M., Hagen, K. B., Natvig, B., Dahl, F. A. & Kvien, T. K. Prevalence and burden of osteoarthritis: results from a population survey in Norway. _J. Rheumatol._ 35, 677–684 (2008). PubMed Google Scholar * National Institute for Health and Clinical Excellence (NICE). _Osteoarthritis: National Clinical Guideline for Care and Management in Adults_ [online], (2008). * Zhang, W. _ et al_. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). _Ann. Rheum. Dis._ 64, 669–681 (2005). Article CAS PubMed Google Scholar * Zhang, W. _ et al_. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). _Ann. Rheum. Dis._ 66, 377–388 (2007). Article CAS PubMed Google Scholar * Zhang, W. _ et al_. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. _Osteoarthritis Cartilage_ 16, 137–162 (2008). Article CAS PubMed Google Scholar * Towheed, T. E. Systematic review of therapies for osteoarthritis of the hand. _Osteoarthritis Cartilage_ 13, 455–462 (2005). Article CAS PubMed Google Scholar * Moe, R. H. _ et al_. Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: an umbrella review of high quality systematic reviews. _Phys. Ther._ 87, 1716–1727 (2007). Article PubMed Google Scholar * Atkins, D. _ et al_. Grading quality of evidence and strength of recommendations. _BMJ_ 328, 1490 (2004). Article Google Scholar * Moe, R. H., Kjeken, I., Uhlig, T. & Hagen, K. B. Very limited evidence for the effect of non-pharmacological and non-surgical interventions for hand osteoarthritis: an overview of high quality systematic reviews. _Ann. Rheum. Dis._ 68 (Suppl. 3), 774 (2009). Google Scholar * Jamtvedt, G. _ et al_. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. _Phys. Ther._ 88, 123–136 (2008). Article PubMed Google Scholar * Hewlett, S. _ et al_. Patients and professionals as research partners: challenges, practicalities, and benefits. _Arthritis Rheum._ 55, 676–680 (2006). Article PubMed Google Scholar * Kjeken, I. _ et al_. Research priorities, attitudes and experiences among persons with rheumatic diseases in Scandinavia. _Ann. Rheum. Dis._ 68 (Suppl. 3), 793 (2009). Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Kåre B. Hagen, Geir Smedslund, Rikke H. Moe, Margreth Grotle & Ingvild Kjeken * Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Tore K. Kvien Authors * Kåre B. Hagen View author publications You can also search for this author inPubMed Google Scholar * Geir Smedslund View author publications You can also search for this author inPubMed Google Scholar * Rikke H. Moe View author publications You can also search for this author inPubMed Google Scholar * Margreth Grotle View author publications You can also search for this author inPubMed Google Scholar * Ingvild Kjeken View author publications You can also search for this author inPubMed Google Scholar * Tore K. Kvien View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Kåre B. Hagen. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hagen, K., Smedslund, G., Moe, R. _et al._ The evidence for non-pharmacological therapy of hand and hip OA. _Nat Rev Rheumatol_ 5, 517–519 (2009). https://doi.org/10.1038/nrrheum.2009.158 Download citation * Issue Date: September 2009 * DOI: https://doi.org/10.1038/nrrheum.2009.158 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative](https://media.springernature.com/w215h120/springer-static/image/art%3A10.1038%2Fs41584-020-0447-8/MediaObjects/41584_2020_447_Fig1_HTML.png)
ABSTRACT Osteoarthritis (OA) is a leading cause of pain and disability worldwide. Evidence-based guidelines and recommendations for the treatment of OA consider non-pharmacological
modalities as the cornerstone of modern OA management. Nonetheless, research evidence from clinical trials on non-pharmacological interventions for the treatment of hand and hip OA is scarce
and considerably less than that for knee OA. In addition, research on non-pharmacological interventions for OA appears highly on the list of patients' research priorities. Thus, there
is a clear mismatch between the available research evidence for non-pharmacological interventions for hip and hand OA and both the treatment guidelines and the interests of patients. Access
through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal
Receive 12 print issues and online access $209.00 per year only $17.42 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices
may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support
SIMILAR CONTENT BEING VIEWED BY OTHERS CORE AND ADJUNCTIVE INTERVENTIONS FOR OSTEOARTHRITIS: EFFICACY AND MODELS FOR IMPLEMENTATION Article 13 July 2020 EFFECTIVENESS OF INTERFERENTIAL
CURRENT THERAPY IN PATIENTS WITH KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS Article Open access 11 June 2022 A SYSTEMATIC REVIEW AND
META-ANALYSIS OF THE EFFECT OF PHONOPHORESIS ON PATIENTS WITH KNEE OSTEOARTHRITIS Article Open access 27 July 2022 REFERENCES * Towle, A. & Godolphin, W. Framework for teaching and
learning informed shared decision making. _BMJ_ 319, 766–771 (1999). Article CAS PubMed PubMed Central Google Scholar * Gøtzsche, P. C. Do patients with osteoarthritis get the clinical
research they need? _Ann. Rheum. Dis._ 59, 407–408 (2000). Article PubMed PubMed Central Google Scholar * Chard, J. A., Tallon, D. & Dieppe, P. A. Epidemiology of research into
interventions for the treatment of osteoarthritis of the knee joint. _Ann. Rheum. Dis._ 59, 414–418 (2000). Article CAS PubMed PubMed Central Google Scholar * Tallon, D., Chard, J.
& Dieppe, P. Exploring the priorities of patients with osteoarthritis of the knee. _Arthritis Care Res._ 13, 312–319 (2000). Article CAS PubMed Google Scholar * Tallon, D., Chard, J.
& Dieppe, P. Relation between agendas of the research community and the research consumer. _Lancet_ 355, 2037–2040 (2000). Article CAS PubMed Google Scholar * Jordan, K. M. _ et
al_. EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Report of a Task Force of the Standing Committee for International Clinical Studies
Including Therapeutic Trials (ESCISIT). _Ann. Rheum. Dis._ 62, 1145–1455 (2003). Article CAS PubMed PubMed Central Google Scholar * Murray, C. J. L. & Lopez, A. D. _The Global
Burden of Disease_ (World Health Organisation, Geneva, 1997). Google Scholar * Petersson, I. F. & Jacobsson, L. T. Osteoarthritis of the peripheral joints. _Best Pract. Res. Clin.
Rheumatol._ 16, 741–760 (2002). Article PubMed Google Scholar * Peat, G. _ et al_. The Knee Clinical Assessment Study—CAS(K). A prospective study of knee pain and knee osteoarthritis in
the general population. _BMC Musculoskelet. Disord._ 5, 4 (2004). Article PubMed PubMed Central Google Scholar * Birrell, F., Lunt, M., Macfarlane, G. & Silman, A. Association
between pain in the hip region and radiographic changes of osteoarthritis: results from a population-based study. _Rheumatology (Oxford)_ 44, 337–341 (2005). Article CAS Google Scholar *
Oliveria, S. A., Felson, D. T., Reed, J. I., Cirillo, P. A. & Walker, A. M. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance
organization. _Arthritis Rheum._ 38, 1134–1141 (1995). Article CAS Google Scholar * Andrianakos, A. A. _ et al_. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece.
The ESORDIG study. _J. Rheumatol._ 33, 2507–2513 (2006). PubMed Google Scholar * Grotle, M., Hagen, K. B., Natvig, B., Dahl, F. A. & Kvien, T. K. Prevalence and burden of
osteoarthritis: results from a population survey in Norway. _J. Rheumatol._ 35, 677–684 (2008). PubMed Google Scholar * National Institute for Health and Clinical Excellence (NICE).
_Osteoarthritis: National Clinical Guideline for Care and Management in Adults_ [online], (2008). * Zhang, W. _ et al_. EULAR evidence based recommendations for the management of hip
osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). _Ann. Rheum. Dis._ 64, 669–681 (2005). Article
CAS PubMed Google Scholar * Zhang, W. _ et al_. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a task force of the EULAR Standing Committee for
International Clinical Studies Including Therapeutics (ESCISIT). _Ann. Rheum. Dis._ 66, 377–388 (2007). Article CAS PubMed Google Scholar * Zhang, W. _ et al_. OARSI recommendations for
the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. _Osteoarthritis Cartilage_ 16, 137–162 (2008). Article CAS PubMed Google Scholar
* Towheed, T. E. Systematic review of therapies for osteoarthritis of the hand. _Osteoarthritis Cartilage_ 13, 455–462 (2005). Article CAS PubMed Google Scholar * Moe, R. H. _ et al_.
Effectiveness of nonpharmacological and nonsurgical interventions for hip osteoarthritis: an umbrella review of high quality systematic reviews. _Phys. Ther._ 87, 1716–1727 (2007). Article
PubMed Google Scholar * Atkins, D. _ et al_. Grading quality of evidence and strength of recommendations. _BMJ_ 328, 1490 (2004). Article Google Scholar * Moe, R. H., Kjeken, I., Uhlig,
T. & Hagen, K. B. Very limited evidence for the effect of non-pharmacological and non-surgical interventions for hand osteoarthritis: an overview of high quality systematic reviews.
_Ann. Rheum. Dis._ 68 (Suppl. 3), 774 (2009). Google Scholar * Jamtvedt, G. _ et al_. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic
reviews. _Phys. Ther._ 88, 123–136 (2008). Article PubMed Google Scholar * Hewlett, S. _ et al_. Patients and professionals as research partners: challenges, practicalities, and benefits.
_Arthritis Rheum._ 55, 676–680 (2006). Article PubMed Google Scholar * Kjeken, I. _ et al_. Research priorities, attitudes and experiences among persons with rheumatic diseases in
Scandinavia. _Ann. Rheum. Dis._ 68 (Suppl. 3), 793 (2009). Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * National Resource Center for Rehabilitation in
Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Kåre B. Hagen, Geir Smedslund, Rikke H. Moe, Margreth Grotle & Ingvild Kjeken * Department of Rheumatology, Diakonhjemmet Hospital,
Oslo, Norway Tore K. Kvien Authors * Kåre B. Hagen View author publications You can also search for this author inPubMed Google Scholar * Geir Smedslund View author publications You can also
search for this author inPubMed Google Scholar * Rikke H. Moe View author publications You can also search for this author inPubMed Google Scholar * Margreth Grotle View author publications
You can also search for this author inPubMed Google Scholar * Ingvild Kjeken View author publications You can also search for this author inPubMed Google Scholar * Tore K. Kvien View author
publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Kåre B. Hagen. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no
competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Hagen, K., Smedslund, G., Moe, R. _et al._ The evidence for
non-pharmacological therapy of hand and hip OA. _Nat Rev Rheumatol_ 5, 517–519 (2009). https://doi.org/10.1038/nrrheum.2009.158 Download citation * Issue Date: September 2009 * DOI:
https://doi.org/10.1038/nrrheum.2009.158 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not
currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative