Which nonpharmacologic modality should be avoided in OA?

• A. Transcutaneous electrical nerve stimulation (TENS)
• B. Bracing
• C. Tai Chi
• D. Cane

Answer: (A)

The main idea is choosing nonpharmacologic options that reliably improve OA pain and function. Transcutaneous electrical nerve stimulation delivers electrical stimulation to modulate pain, but the evidence for its benefit in OA is inconsistent and generally small in magnitude. It doesn’t address the mechanical factors driving OA symptoms as consistently as other modalities, so it isn’t a reliable frontline choice. In contrast, using a cane or bracing helps reduce joint loading and improve function, and Tai Chi offers a safe, evidence-supported way to improve strength, flexibility, balance, and pain. Because of the stronger and more consistent benefits of the latter approaches, TENS is the modality to avoid as a primary nonpharmacologic option in OA.