Key Finding
Exercise is effective for knee osteoarthritis and associated comorbidities, and acupuncture demonstrated effectiveness in a clinical trial, while digital rehabilitation programs proved equally viable as in-person care.
Researchers reviewed rehabilitation treatments for osteoarthritis published over the past year, examining what works best for joint pain and function. They analyzed 39 high-quality studies covering various non-surgical approaches including exercise, diet, digital programs, and acupuncture.
The review found that exercise effectively reduces knee osteoarthritis pain and helps manage related health conditions, though results for hip osteoarthritis were mixed. Combining diet with exercise helped people lose weight but didn't consistently reduce pain levels. Digital rehabilitation programs (online or app-based) worked as well as in-person treatment, offering a convenient alternative for many patients.
For acupuncture specifically, the researchers identified that it showed effectiveness in reducing osteoarthritis symptoms in a single clinical trial. This suggests acupuncture may be a helpful treatment option, though more research is needed to confirm these benefits across different patient populations and joint locations.
Other findings included inconsistent results for electrical therapy devices depending on which joint was treated, and that knee braces and orthotics can relieve pain when customized to individual needs. Adding psychological or behavioral treatments to standard care didn't provide extra benefits.
What this means for patients: If you have osteoarthritis, exercise remains the foundation of treatment, particularly for knee pain. Acupuncture appears promising as an additional treatment option based on emerging evidence. Digital programs can work well if you prefer remote care or have difficulty accessing in-person services.
If considering acupuncture for osteoarthritis, seek a licensed acupuncturist with experience treating musculoskeletal conditions.
This systematic review synthesized 39 moderate-to-high quality studies on non-pharmacological osteoarthritis rehabilitation published March 2024-March 2025, searching Medline, Embase, and CINAHL databases. Key findings include: exercise demonstrates efficacy for knee OA and comorbidities with varied hip OA effects; diet plus exercise achieves weight loss without consistent pain reduction; digital rehabilitation equals in-person care effectiveness; mind/behavioral interventions show no added benefit; electrotherapy effects were inconsistent and region-specific; orthoses provide pain relief when individualized.
Regarding acupuncture, one high-quality clinical trial demonstrated effectiveness for OA symptom management, suggesting its viability as an adjunctive treatment modality. Blood flow restriction training also showed promise in single trials.
Methodologically significant: only 5% of studies reported sex/gender-disaggregated results despite 59% reporting sex and 28% reporting gender; none defined these terms or justified why analyses weren't stratified. Clinical takeaway: Exercise remains first-line treatment for knee OA; acupuncture shows emerging evidence as effective adjunct therapy; clinicians should consider patient preferences when recommending orthoses and digital versus in-person delivery.
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