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Walk the evidence base by book and chapter — the raw source passages that ground Ask, Differential, and the rest.
2 passages
Do not routinely use imaging to diagnose osteoarthritis unless there are atypical features or features that suggest an alternative or additional diagnosis. For all people with osteoarthritis, offer therapeutic exercise tailored to their needs (for example, local muscle strengthening, general aerobic fitness). Do not offer acupuncture or dry needling to manage osteoarthritis. Do not offer electrotherapy treatments to people with osteoarthritis because there is insufficient evidence of benefit. Do not routinely offer insoles, braces, tape, splints or supports to people with osteoarthritis. Offer a topical non-steroidal anti-inflammatory drug (NSAID) to people with knee osteoarthritis. Consider any risk factors the person may have, including age, pregnancy, current medication and comorbidities. Offer a gastroprotective treatment (such as a proton pump inhibitor) for people with osteoarthritis while they are taking an oral NSAID. Do not offer glucosamine or strong opioids to people to manage osteoarthritis. Do not offer intra-articular hyaluronan injections to manage osteoarthritis. Do not routinely use imaging for follow-up or to guide non-surgical management of osteoarthritis. Do not offer arthroscopic lavage or debridement to people with osteoarthritis.
The available evidence was predominantly for knee osteoarthritis. This showed a lack of benefits of acupuncture and some evidence of harm. Economic evidence also showed that using acupuncture for osteoarthritis is not cost effective.