Whilst drugs may relieve symptoms, effect sizes are small to modest at best and their toxicity/adverse event profile is unfavourable compared to conservative non-drug interventions (Zhang et al 2007). Indeed, all clinical guidelines advocate conservative non-drug strategies for hip osteoarthritis (Conaghan et al 2008, Hochberg et al 2012, Zhang et al 2008). In particular, guidelines recommend a focus ‘on self-help and patient-driven treatments rather than on passive

therapies delivered by health professionals’ (Zhang et al 2008). Treatment should be individualised Imatinib and patient-centered, involving shared decision making between the patient and physiotherapist taking into account the patient’s preferences and wishes. Two recent systematic reviews have found that such patient-centred interaction enhances the therapeutic alliance (Pinto et al 2012a) and improves patient satisfaction with care (Oliveira et al 2012). Other aspects to consider this website in guiding treatment include: hip factors (adverse mechanical factors, impairments, obesity, physical activity, dysplasia); general factors (age, sex, co-morbidity); level of pain intensity and disability; and location and degree of structural damage (Zhang et al 2005). Given the broad impact of osteoarthritis and in accordance with a biopsychosocial approach to the management of chronic pain, it is logical that both biological

and psychosocial factors should be addressed in people with hip osteoarthritis. For hip osteoarthritis, core conservative treatments for all patients should include education and exercise. In addition, weight loss is also recommended for those with lower limb osteoarthritis who are overweight/obese (Conaghan et al 2008, Hochberg et al 2012, Zhang et al 2005, Zhang et al 2008). It is apparent that the treatments of exercise Ribonucleotide reductase and weight loss for osteoarthritis require behavioural changes and it is well known that these changes are difficult

to initiate and maintain. Therapists therefore need to assist the patient in formulating achievable shortand long-term goals and specific action plans. Patient education is a core component of hip osteoarthritis treatment as it is an indispensable element in promoting adequate self-management. Education delivery modes vary and can include informal discussion with the health care provider, provision of written materials, support groups, websites, and structured self-management programs. Self-management programs can also take various forms with differences in the content, mode of delivery (individual, group-based, telephone, internet), program length, and expertise of those delivering the material (lay leaders, health care professionals). Self-management programs typically include coping with behavioral change, educational information, and self-management techniques.