A Comparison of Manual Physical Therapy and Corticosteroid Injections for Knee Osteoarthritis

Inclusion Criteria: * All subjects must be eligible for care in the military health system * Meet Altman's clinical criteria for knee OA * Have English language skills sufficient to complete the WOMAC and GROC outcome instruments * Be 38 years of age or older Exclusion Criteria: * Steroid injections or physical therapy treatment for their knee in the past 12 months * Current or past history of rheumatoid arthritis or similar rheumatic condition * Current or past history of gout or pseudogout of the knee * Active infection in the knee within the past 12 months * Other physical ailment or condition that is typically more limiting or painful than their knee OA during activities such as sitting, standing, walking, or stair climbing * History of allergy or adverse effect to corticosteroids * Cannot speak/read English adequately to understand and provide consent to participate in the study * Pregnant or intending to become pregnant * Military service members pending a medical evaluation board, physical evaluation board, equivalent discharge process, or on medical hold to determine long-term disposition. For non-military personnel, anyone that is pending or undergoing any litigation for this condition. * Contraindication to receiving a corticosteroid injection (history of allergic or adverse reaction to steroid injection, history of multiple corticosteroid injections in that area even if not within last year, etc) * Unable to give informed consent to participate in the study.