The joint distribution indicates that weight-bearing joints present the most significant symptoms. The improvement in the mobility of the joints after physical therapy shows how these may be helped. It is reasonable to suggest that the earlier the treatment starts, the better the results will be. The benefits of treatment seem to decrease with the passage of time. It is likely that the patients who do not exercise well by themselves in order to retain movement and may need a long-term physical therapy programme.
Treatment needs to last for some time in order to ensure relief of pain.
The pain seems to increase during spring and autumn. This could simply be due to weather conditions as with osteoarthritis, or to the fact that farmers perform heavy manual work with ploughing, sowing and irrigating in the spring, and harvesting in the autumn. Treatment may therefore be required throughout the year. Progressive decrease in pain was seen in the control group. This could be due to the intake of multivitamins or to the psychological effect of enrollment into the study and regular medical review.