Table 6.65Symptoms: pain

Pain outcomeReferenceInterventionAssessment timeOutcome/effect size
Knee
Brace
Pain on function (6 minute walk test, 30 second stair-climb test).1 MA (Brouwer et al. 2005) 1 RCT, N=119Knee brace vs neoprene sleeve6 monthsKnee brace better
Pain on function (6 minute walk test, 30 second stair- climb test)1 MA (Brouwer et al. 2005) 1 RCT, N=119Knee brace vs medical treatment6 monthsKnee brace better
Pain on function (6 minute walk test, 30 second stair-climb test)1 MA (Brouwer et al. 2005) 1 RCT, N=119Neoprene sleeve vs medical treatment6 monthsNeoprene sleeve better
Pain severity (VAS)1 RCT (Brouwer et al. 2006) (N-=118)Knee brace + conservative treatment vs control (conservative treatment)3 months, 6 months
12 months or overall
NS
Insoles
WOMAC pain1 MA (Brouwer et al. 2005) 1 RCT, N=147Laterally wedged insole vs neutrally wedged insole1 month, 3 months and 6 months follow-upNS
WOMAC pain; overall pain (VAS); clinical improvement in WOMAC pain (score ≥50 points); Pain improvement in patients with KL grade 4 compared with KL grade <4; pain improvement in patients with BMI <30 kg/m2 compared with patients with BMI ≥30 kg/m21 RCT (Baker et al. 2007) (N=90)Laterally wedged insole vs neutrally wedged insole6 weeks (end of treatment)NS
Pain (VAS)1 MA (Brouwer et al. 2005) 1 RCT, N=90Subtalar strapped insole vs inserted insole8 weeksNS
WOMAC pain (change from baseline)1 RCT (Pham et al. 2004) (N=156)Laterally wedged insole vs neutrally wedged insole2 years (end of treatment)NS
Taping
Daily pain, VAS1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs neutral taping4 days, end of treatmentp<0.05
Favours medial taping
Patient’s change scores (number of patients ‘better’)1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs neutral taping4 days, end of treatmentp<0.05
Favours medial taping
Pain on standing, VAS (change from baseline)1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs neutral taping6 months, end of treatment−1.2 (medial) and
−0.3 (neutral)
Medial taping better
Daily pain, VAS1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs lateral taping4 days, end of treatmentp<0.05
Favours medial taping
Patient’s change scores (number of patients ‘better’)1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs lateral taping4 days, end of treatmentp<0.05
Favours medial taping
Pain on standing, VAS (change from baseline)1 RCT (Cushnaghan et al. 1994) (N=14)Medial taping vs lateral taping6 months, end of treatment−1.2 (medial) and
−0.3 (neutral)
Medial taping better
Pain on movement, VAS (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment and 3 weeks post- treatment3 weeks: −2.1 (therapeutic) and
−0.7 (neutral)
3 weeks post-treatment
−1.9 (therapeutic) and
−1.1 (control)
Therapeutic tape better
Pain on worst activity, VAS (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment and 3 weeks post- treatment3 weeks: −2.5 (therapeutic) and
−1.1 (neutral)
3 weeks post-treatment
−2.8 (therapeutic) and
−1.4 (control)
Therapeutic tape better
WOMAC pain (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −1.8 (therapeutic) and
−1.6 (neutral)
Therapeutic tape better
Knee Pain Scale, KPS, Severity (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −2.7 (therapeutic) and
−1.9 (neutral)
Therapeutic tape better
Knee Pain Scale, KPS, Frequency (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −2.6 (therapeutic) and
−2.4 (neutral)
Therapeutic tape better
WOMAC pain (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −1.7 (therapeutic) and
−2.0 (neutral)
Control tape better
Knee Pain Scale, KPS, severity (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −2.3 (therapeutic) and
−2.9 (neutral)
Control tape better
Knee Pain Scale, KPS, Frequency (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs control tape3 weeks, end of treatment3 weeks: −2.7 (therapeutic) and
−3.3 (neutral)
Control tape better
Pain on movement, VAS (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs no tape3 weeks, end of treatment and
3 weeks post- treatment
3 weeks: −2.1 (therapeutic) and
+0.1 (no tape) 3 weeks post-treatment
−1.9 (therapeutic) and
−0.1 (none)
Therapeutic tape better
Pain on worst activity, VAS (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs no tape3 weeks, end of treatment and
3 weeks post- treatment
3 weeks: −2.5 (therapeutic) and
−0.4 (no tape)
3 weeks post-treatment
−2.8 (therapeutic) and
−0.4 (none)
Therapeutic tape better
WOMAC pain (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs no tape3 weeks, end of treatment and
3 weeks post- treatment
3 weeks: −1.8 (therapeutic) and
−0.1 (no tape)
3 weeks post-treatment
−1.7 (therapeutic) and
+0.4 (none)
Therapeutic tape better
Knee Pain Scale, KPS, Severity (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs no tape3 weeks, end of treatment and
3 weeks post- treatment
3 weeks: −2.7 (therapeutic) and
0.0 (no tape)
3 weeks post-treatment
−2.6 (therapeutic) and +0.5 (none)
Therapeutic tape better
Knee Pain Scale, KPS, Frequency (change from baseline)1 RCT (Hinman et al. 2003) (N=87)Therapeutic tape vs no tape3 weeks, end of treatment and
3 weeks post- treatment
3 weeks: −2.6 (therapeutic) and
−0.1 (no tape)
3 weeks post-treatment
−2.7 (therapeutic) and
−0.1 (none)
Therapeutic tape better
Shoes
WOMAC pain total (change from baseline)1 RCT (Nigg et al. 2006) (N=125)Masai barefoot technology (MBT) shoe vs high-end walking shoe12 weeks (end of treatment)NS
WOMAC pain walking (change from baseline)1 RCT (Nigg et al. 2006) (N=125)MBT shoe vs high-end walking shoe12 weeks (end of treatment)NS
WOMAC pain stairs (change from baseline)1 RCT (Nigg et al. 2006) (N=125)MBT shoe vs high-end walking shoe12 weeks (end of treatment)NS
Mixed
Pain, VAS (change from baseline)1 RCT (Quilty et al. 2003) (N=87)Taping + exercises + posture correction + education vs standard treatment (no experimental intervention)5 months (3 months post- treatment) and at 12 months (10 months post- treatment).NS
Pain, VAS (change from baseline)1 RCT (Toda and Tsukimura 2004) (N=66)Urethane insole + strapping
+ NSAID vs rubber insole
+ NSAID
3 months, mid-study and at 6 months, mid-study3 months: −16.4 (urethane insole) and −2.8 (rubber insole)
6 months: −17.3 (urethane insole) and −3.6 (rubber insole)
Urethane insole + strapping + NSAID better
Hand (thumb – CMC joint)
Pain, VAS (change from baseline)1 RCT (Wajon and Ada 2005) (N=40)Thumb strap splint + abduction exercises vs control (short opponens splint + pinch exercises2 weeks (mid- treatment) and at 6 weeks (end of treatmentNS
Pain, VAS (change from baseline); Splint/pinch Pain, VAS (change from baseline)1 RCT (Weiss 2000) (N=26)Short opponens splint vs long opponens splint1 week (end of treatment)NS

From: 6, Non-pharmacological management of osteoarthritis

Cover of Osteoarthritis
Osteoarthritis: National Clinical Guideline for Care and Management in Adults.
NICE Clinical Guidelines, No. 59.
National Collaborating Centre for Chronic Conditions (UK).
Copyright © 2008, Royal College of Physicians of London.

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