Background

Osteoarthritis (OA) is the most common form of arthritis, and it is often associated with

significant disability and an impaired quality of life ( Badley 1995; Moralestorres 1996; Scott

1993; Towheed 1998). An estimated 12.1% of Americans aged 25 years and older (nearly 21

million persons in 1990) have clinical signs and symptoms of OA (Lawrence 1998). Among US

adults aged 30 years or older, symptomatic disease in the knee occurs in approximately 6% and

symptomatic disease in the hip occurs in approximately 3% (Felson 2000). OA of the hip and

knee can be especially disabling to lower extremity functioning because the hip and knee are

large weight‐bearing joints (Liang 1984). Advanced OA of the hip or knee is the most common

reason for elective joint replacement (Hochberg 1996).

Although there are no curative therapies currently available for OA, individualized treatment

programs are available to help relieve pain and stiffness and to maintain or improve functional

status (ACR 2000; Creamer 1998; Hochberg 1995a; Hochberg 1995b). Treatment strategies for

OA have included both non‐pharmacological and pharmacological modalities ( Creamer 1997).

Non‐pharmacological therapy is considered to be the foundation for the successful medical

management of OA (Felson 1998; Puett 1994). These modalities include weight reduction (if

obese), physiotherapy (for example muscle strengthening), and occupational therapy (for

example, use of assistive devices for ambulation).

Non‐steroidal anti‐inflammatory drugs (NSAIDs) are considered by many physicians to be the

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