• Gary J Macfarlane, Priya Paudyal, Michael Doherty, Edzard Ernst, George Lewith, Hugh MacPherson, Julius Sim, Gareth T Jones, and Arthritis Research UK working group on Complementary and Alternative Therapies for Management of Rheumatic Diseases.
• Musculoskeletal Research (Epidemiology Group), School of Medicine and Dentistry, University of Aberdeen, UK. g.j.macfarlane@abdn.ac.uk
• Rheumatology (Oxford). 2012 Dec 1;51(12):2224-33.

ObjectiveTo critically review the evidence on the efficacy and effectiveness of practitioner-based complementary therapies for patients with osteoarthritis. We excluded t'ai chi and acupuncture, which have been the subject of recent reviews.MethodsRandomized controlled trials, published in English up to May 2011, were identified using systematic searches of bibliographic databases and searching of reference lists. Information was extracted on outcomes, statistical significance in comparison with alternative treatments and reported side effects. The methodological quality of the identified studies was determined using the Jadad scoring system. Outcomes considered were pain and patient global assessment.ResultsIn all, 16 eligible trials were identified covering 12 therapies. Overall, there was no good evidence of the effectiveness of any of the therapies in relation to pain or global health improvement/quality of life because most therapies only had a single randomized controlled trial. Where positive results were reported, they were often comparing an active intervention with no intervention. Therapies with multiple trials either provided null (biofeedback) or inconsistent results (magnet therapy), or the trials available scored poorly for quality (chiropractic). There were few adverse events reported in the trials.ConclusionThere is not sufficient evidence to recommend any of the practitioner-based complementary therapies considered here for the management of OA, but neither is there sufficient evidence to conclude that they are not effective or efficacious.

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