Such programmes were also cost-effective, researchers led by Associate Prof Haxby Abbott, of the Centre for Musculoskeletal Outcomes Research, have found.
The randomised clinical trial involved 207 Dunedin patients with painful osteoarthritis in knee and hip joints over one year, and used three protocols of treatment provided by physiotherapists, as well as the usual care by their GP.
One group was given seven manual physiotherapy sessions, as well as usual care, for 40-50 minutes over nine weeks, with later booster sessions. The second group undertook an exercise programme in the clinic and at home, and a third group received a combination of manual and exercise therapy.
A control group received only usual care from their GP or other health providers.
Dr Cathy Chapple, an Otago physiotherapy lecturer whose doctorate was supervised by Prof Abbott, said the study delivered some ''extremely positive'' messages not only for people with osteoarthritis, but also for health professionals.
It had often been thought that osteoarthritis involved ''an inevitable decline towards surgery and joint replacement'', Dr Chapple said.
In fact, the study showed this was was not the case and that many people could ''improve and get better'', and surgery was not necessarily required in all cases, she said.
Half of the patients treated with manual therapy and 40% of those treated with exercise therapy were ''treatment successes'' a year later, being significantly better both in terms of pain and ability to perform everyday activities.
This was a ''great result'' for a group of patients with degenerative joint disease, she said.
Karen Browne, a clinical skills administrator at the Otago faculty of medicine, had right knee replacement surgery early this year because of osteoarthritis in the joint.
Ms Browne, who was not involved with the Otago study, said the surgery had ended arthritic pain in the knee.
And physiotherapy, and a range of exercises had also significantly improved her health.
She is a member of Arthritis New Zealand and has received support both from the Otago School of Physiotherapy and Dunedin Hospital.
Her mobility and general fitness had improved, and she was continuing the increased exercise, including swimming and using an exercycle.
''It's improved my wellbeing- I can do so much more,'' she said.
A further study, published this week in the international journal Osteoarthritis and Cartilage, looked at the economics of the extra treatment in this trial. It found that both additional exercise therapy and manual therapy were more cost-effective for the health system and for individuals than just applying usual care management to osteoarthritis.
The researchers said there was quite low use of non-surgical and non-drug therapies for osteoarthritis in primary care, and these studies pointed to a way of preventing or delaying pain and disability at significant cost-effectiveness for society and the health system.
