Osteoarthritis in Saudi Arabia: Current Evidence, Public Perceptions, and Future Research: A Narrative Review

Vollständiger Abstract

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Background and Purpose: Osteoarthritis (OA) is a leading cause of pain and disability worldwide and represents a growing public health concern in Saudi Arabia. This narrative review synthesises current evidence on OA in the Saudi context, with particular emphasis on epidemiology, risk factors, public perceptions, clinical management patterns, and the utilisation of physiotherapy and other conservative interventions. The aim is to inform clinical practice, public health strategies, and health system planning in alignment with Saudi Vision 2030.Methods: A narrative review was undertaken, drawing on evidence from PubMed/MEDLINE, Scopus, Web of Science, Saudi Digital Library, Ministry of Health (Saudi Arabia) publications from database inception to September 2025. Studies reporting OA prevalence, risk factors, public awareness, management approaches, or health service utilisation in Saudi Arabia were considered. Findings were synthesised thematically across epidemiology, risk factors, public awareness, and clinical management domains.Results: Thirty-nine studies were included. Reported knee OA prevalence ranged from 13–41% in community-based samples and exceeded 60% among older adults. Increasing age, female sex, obesity, prior joint injury, and physical inactivity consistently emerged as major risk factors. Public awareness of OA was generally limited, with widespread misconceptions regarding disease causation, prognosis, and the role of physical activity. Clinical management was predominantly pharmacological, characterised by extensive use of NSAIDs, simple analgesics, and intra-articular corticosteroid injections. Despite strong international evidence supporting physiotherapy-led education, exercise, and weight-management interventions, physiotherapy was markedly underutilised, with approximately 25% of patients reported to receive referrals and limited access within primary care. No randomised controlled trials evaluating physiotherapy or other non-pharmacological interventions in Saudi populations were identified. Key evidence gaps included the absence of national OA registries, longitudinal studies, intervention trials, and economic evaluations.Conclusion: OA constitutes a substantial and escalating health burden in Saudi Arabia. Improving public awareness, strengthening early conservative management (particularly access to physiotherapy and lifestyle-based interventions) and generating robust Saudi-specific research evidence are critical to optimising OA care pathways and supporting ongoing health system transformation under Vision 2030.