Does thermotherapy lead to decreased analgesic requirement in patients with osteoarthritis of knee managed non-surgically.

Osteoarthritis knee constitutes one the most common ailments presenting to orthopaedic OPD and society in general. NSAIDs constitute the mainstay of treatment and can relieve pain effectively, but they  also have side effects. The risk of side effects depends on age and comorbidity patient may have. People who already have other illnesses, like renal,hepatic and gastrointestinal diseases, may not tolerate them well. Drug interaction is also a challenge in using NSAIDs. Thermotherapy(cold and heat) has shown effectiveness in relieving pain and discomfort of knee osteoarthritis.  In contrast to NSAIDs, no adverse effects of the thermotherapy were reported in the literature. No consideration of drug interaction and no optimization in view of comorbidity is needed.However standardized and scientific study to prove this fact is lacking.A well designed two arm study comparaing NSAIDs and thermotherapy group will be helpful in giving more insight on this issue and making thermotherapy a standard treatment modality of degenerative knee disease.