Effectiveness of Thai herb heat treatment compared to physical therapy in primary knee osteoarthritis

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Theerayut Ketmalee
Sineenart Chautrakarn


Background : Knee osteoarthritis is a major public health problem among the elderly. It is considered one of the most frequent causes of pain and physical disability in elderly which impacts on patient quality of life. Treatment includes a combination of pharmacological and non-pharmacological therapies. Physical therapy is the most widely used for non-pharmacological treatment. Another potential therapy, the Thai herb heat treatment, has not been well described and compared to other techniques.

Objective : To compare the effectiveness of the Thai herb heat treatment and physical therapy in primary knee osteoarthritis patients.

Methods : A randomized controlled trial was conducted in 54 patients with primary knee osteoarthritis. All patients were randomly allocated into two groups to receive either the Thai herb heat treatment (n = 27) or physical therapy (n = 27). Patients in the Thai herb heat treatment group were treated every 3 days for 5 times, while patients in the physical therapy group were treated weekly for 4 times. The clinical results were obtained using the Knee and Osteoarthritis Outcome Score (KOOS) before and after treatment.

Results : At the end point, statistically significant improvement was observed in both groups. The KOOS score improved significantly (P <0.001) in all subscales, i.e., pain, other symptoms, function in daily living, function in
sport and recreation, and knee-related quality of life. Having compared KOOS improvement scores between the two groups, there were no significant differences in pain, other symptoms, function in daily living, and function in sport and recreation subscales. However, patients in physical therapy group demonstrated a statistically significant superiority (P = 0.001) in the KOOS knee-related quality of life subscale over the Thai herb heat treatment group.

Conclusion : The Thai herb heat treatment is a safe alternative choice for primary knee osteoarthritis treatment. Patients treated with the Thai herb heat treatment showed prompt reduction of pain and functional improvement.

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