 International guidelines, 2008, on the management of hip and knee OA recommend a combination of non-pharmacological and pharmacological treatment. For years the majority of interventional research for hip and knee OA has focused on surgery and drugs. Surgery is an option, when pain and disability have reached severe levels, and an increasing group of patients are today looking for other treatment options than drug treatment pharmacological. In the last 4-6 years, new randomized controlled trials RCT have shown promising results with non-pharmacological treatment, such as exercise, patient education, manual therapy and acupuncture. 