Efficacy of modern physiotherapy in pain management for osteoarthritis of large joints in elderly patients with comorbid syndrome



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Abstract

Osteoarthritis (OA) of large joints is a common socio-economic pathology of the musculoskeletal system in the elderly, causing chronic pain and reduced work capacity. This study systematically analyzed current literature on the efficacy and safety of physiotherapy for pain management in elderly patients with OA of large joints and comorbid conditions (CC). Publications from 2019-2025 were searched in PubMed, Scopus, Ovid MEDLINE, Elibrary, and Google Scholar. Included were studies on elderly patients with OA and CC, detailing physiotherapy interventions. Randomized controlled trials, meta-analyses, systematic reviews, and prospective cohort studies were selected. The analysis revealed that modern physiotherapy methods such as therapeutic exercise (TE), shockwave therapy (SWT), transcutaneous electrical nerve stimulation (TENS), high-intensity laser therapy (HILT), and manual therapy are highly effective in reducing pain intensity and improving functional activity. A combined approach, synergizing methods (e.g., TE + SWT), enhances outcomes over monotherapy. Personalization of rehabilitation programs considering dominant comorbidities is crucial for safety and tolerability. Standard pharmacotherapy has limitations in this population due to high risks of side effects and complications from comorbidities. Integrating modern physiotherapy into comprehensive rehabilitation programs is an effective and safe strategy for managing OA and CC patients. Key success factors include method combination, personalized treatment considering comorbidity, and an interdisciplinary approach involving physiotherapists, gerontologists, cardiologists, and endocrinologists.

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About the authors

Matvey E. Fridman

Russian University of Medicine

Author for correspondence.
Email: al32752456@gmail.com
ORCID iD: 0009-0000-8447-9255

student

Russian Federation

Arina A. Kamilova

Russian University of Medicine

Email: arina.kamilova2188@mail.ru
ORCID iD: 0009-0006-4461-6378

student

Russian Federation

Milada Yu. Shadova

Russian University of Medicine

Email: mikaandlada@mail.ru
ORCID iD: 0009-0004-4351-6071

student

Russian Federation

Olga V. Vergasova

Russian University of Medicine

Email: olga.podvalnaya00@mail.ru
ORCID iD: 0009-0000-5209-9370

student

Russian Federation

Raya S. Norsoyan

Kuban State Medical University

Email: raanorsoan@gmail.com
ORCID iD: 0009-0005-5797-5460

student

Russian Federation

German S. Soglaev

Kuban State Medical University

Email: Soglaevg@mail.ru
ORCID iD: 0009-0000-2970-9644

student

Russian Federation

Alina A. Zvyagintseva

Kursk State Medical University

Email: zvyag.770@mail.ru
ORCID iD: 0009-0006-7605-0049

student

Russian Federation

Varvara A. Komarova

Ural State Medical University

Email: yeaviere@mail.ru
ORCID iD: 0009-0005-5037-7943
Russian Federation

Zaynab A. Magomedova

Dagestan State Medical University

Email: zaynab.akhmedovna@gmail.com
ORCID iD: 0009-0002-8991-7706

student

Russian Federation

Ekaterina S. Lukina

N.I. Pirogov Russian National Research Medical University

Email: katya.lukina16@yandex.ru
ORCID iD: 0009-0004-0071-3083

student

Russian Federation

Margarita A. Gerber

N.I. Pirogov Russian National Research Medical University

Email: margoritka03@gmail.com
ORCID iD: 0009-0003-3092-2313

student

Russian Federation

Renata R. Gimazetdinova

Bashkir State Medical University

Email: renagimraf@gmail.com
ORCID iD: 0009-0004-1787-2814

student

Russian Federation

Alina A. Gritsenko

Rostov State Medical University

Email: ms.alina2002gritsenko@mail.ru
ORCID iD: 0009-0006-5090-3840

student

Russian Federation

Kristina O. Voronova

Kuban State Medical University

Email: kristina_voronova_03@inbox.ru
ORCID iD: 0009-0007-8784-1978

student

Russian Federation

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80650 от 15.03.2021 г.