Knee Osteoarthritis – Physiotherapy vs Corticosteroid Injection     

A recent article from the New England Journal of Medicine investigated two separate treatment methods and their effects on knee osteoarthritis. The comparative effects were either injecting glucocorticoid into the knee or having Physiotherapy intervention. You may or may not be surprised to hear that Physiotherapy came out on top!

It is not as simple as Physiotherapy being a one stop intervention, there was more to it than just turning up to the clinic. Indeed, there was a few interesting points from this study.

The participants were military personnel or family members who were retired or still in active duty. You can imagine their knees would have taken a bit of loading in their lifetimes!

The Physiotherapy intervention was not solely manual hands on therapy, or exercises. Each participant in the Physiotherapy group had a customised approach based on their needs. This included stretches, strength exercises, manual therapy and massage, joint mobilisations and movement exercises which reinforced the effects of the manual techniques.

They attended Physio sessions 8 times over 4 to 6 weeks and had the option to have one to three sessions at the 4 month and 9 month follow up sessions.

The injection group had 1 ml of triamcinolone acetonide and 7 ml of 1% lidocaine in one or both knees given by a specialist. This group could have 2 more injections within the year to follow up.

At one year follow-up participants were measured using a number of methods including pain questionnaires, step tests, timed up and go test and through cost of Physio vs injection.

At one year from commencement of the trial, participants in the Physio group were significantly better off when measured on pain questionnaires and tended to be better off with functional tests. Interestingly the cost for either group was the same for physio vs steroid injection.

If you have knee issues and you would like to investigate further come in and see one of our experienced Physiotherapist here at Bend + Mend.


Deyle GD, Allen CS, Allison SC, Gill NW, Hando BR, Petersen EJ, et al. Physical therapy versus glucocorticoid injection for osteoarthritis of the knee. N Engl J Med 2020;382:1420-1429.

Campbell Hooker

About Campbell Hooker

Campbell Graduated from AUT University and has worked in private practice in both Australia and in London. Campbell has a keen interest in sporting injuries, office based injuries and the neck. He has worked at grassroots and elite levels of rugby union and league, and with surf lifesaving. He has recently taken to triathlon where he spends most of his spare time. Campbell has an interest in neurological conditions and has a Neuroanatomy degree out of Otago University. He utilises a number of methods when both analysing and treating patients, including dry needling and the Sarah Key Method.

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