In a study just published in the New England Journal of Medicine, Deyle and colleagues conducted a study to compare steroid injections with physical therapy in patients with diagnosed knee arthritis. Half of the patients were assigned to receive injections (up to a total of 3) along with physician consultations while the other half received physical therapy treatment. The therapy treatments consisted of education, manual therapy to work on joint motion and pain as well as muscle flexibility, and specific, individualized exercises. 8 sessions over 4-6 weeks were initially performed with the option to attend 1-3 more sessions at 4 and 9 months. Outcomes were measured periodically over 1 year.
As can be seen from the graph above, at all time points in which outcomes were measured, patients in the therapy group reported greater improvements than the injection group when asked about pain, physical function, and stiffness (which the WOMAC survey measures). A secondary outcome that was measured in this study was a patient's perceived improvement. The median score for therapy patients was rated as "quite a bit better" whereas the injection group was "moderately better." The authors concluded that physical therapy was more effective than injections in leading to improved outcomes at 1 year.
This study does show that injections do help, and the fact that many physicians and patients see it as a quicker and easier way to make improvement than an episode of physical therapy, may be why it is so commonly done. However, patients undergoing an injection may not be obtaining the maximum improvement that they could obtain with a quality physical therapy program.
If you have been diagnosed as having arthritis in your knee(s) and want to avoid injections and surgery, please feel free to reach out to me so we can discuss what a program would look like for you.
Thanks for reading,