Spring is coming and with it comes increased outdoor activities, but millions of people are limited because of knee pain. According to the Arthritis Foundation, 21 million Americans suffer from osteoarthritis (OA), the most common form of arthritis, which is characterized by a breakdown of the cartilage and a deterioration of the fluid in a joint.
The symptoms of OA include pain and stiffness, which can range from mild to severe. While, the majority of OA sufferers are 45 years of age and older, OA can be diagnosed at any age due to knee injury and sports-related trauma.
According to Nicholas A. DiNubile, MD, a clinical assistant professor in the department of orthopedic surgery at the Hospital of the University of Pennsylvania and an orthopedic consultant to the National Basketball Association's Philadelphia 76ers and the Pennsylvania Ballet, "Genetics may play a part in the development of osteoarthritis. Some people may be born with knee alignment problems that predispose them to wear or a genetic problem with their cartilage, which causes the cartilage to break down in the joint as the person ages or in younger individuals who engage in rigorous activity."
Alternatives to Oral Pain Relievers
There are a number of FDA-approved, pill-free alternatives to COX-2 inhibitors and non-steroidal anti-inflammatory drugs (ibuprofen and naproxen) that offer OA knee pain relief with less cardiovascular and gastrointestinal side effects. There are clinically proven options, among them a treatment known as viscosupplementation, which is a series of three to five injections that can provide up to six months of pain relief.
Alternative treatments to oral pain relievers include:
* Exercise, weight loss, physical therapy
These types of treatments are usually the first step in OA therapy. Often, approaches such as exercise, weight loss, and physical therapy can be combined with other treatments to produce the best results. For example, weight loss can reduce the amount of stress on a knee joint, and physical therapy can help strengthen knee joints.
* Nutritional Supplements
Products like glucosamine and chondroitin sulfate are commonly used to treat OA knee pain. However, the clinical evidence to support the role of these supplements in helping OA knee pain sufferers is somewhat controversial.
* Corticosteroid injections
This treatment can be used to reduce local inflammation and swelling, which may in turn relieve OA knee pain. However, pain relief with these agents is usually short-term and the number of injections per year per knee may be limited.
* Viscosupplementation
In knee OA, synovial (or joint) fluid can break down and provide less cushioning and lubrication. Viscosupplementation is a treatment that replaces diseased joint fluid. Healthcare professionals inject a gel that is similar to healthy synovial fluid into a patient's knee joint, which can reduce the pain from OA of the knee. Viscosupplementation products have been proven to provide pain relief from osteoarthritis of the knee and when treatment is started early enough it might reduce the need for a total knee replacement in the future.
Currently, Synvisc (www.synvisc.com) is the top-selling viscosupplementation treatment, which can be administered by a knee pain specialist during a series of three office visits, providing relief for up to six months.
Also, in a medical study reported by Dr. J.P. Raynauld and colleagues, patients who added Synvisc to usual care such as diet, exercise and oral medications reported significantly greater pain relief than those who received usual care alone.
* Surgery
In more advanced cases of OA of the knee, surgery may be the last option. This may include arthroscopy to remove damaged cartilage and loose bodies. For some people, a complete joint replacement may be needed.
"The most important thing patients can do to determine the treatment that's right for them is talk to their doctors. Whether cases are mild, moderate or severe, OA of the knee can progress and pain may get worse over time. With the right treatment, sufferers can get the pain relief needed to lead a more active life," says Dr. DiNubile.
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