Although Osteoarthritis (OA) has no cure, numerous treatments are effective. Some people with severe osteoarthritis are pain-free, while others experience great pain with minor joint changes. Two people with OA in the same joint may have different results from the same treatment. Various therapies for this condition, from self-help to invasive surgery, are available.
Overweight people experience greater joint pressure, causing a faster rate of cartilage wear. Doctors should advise which exercise programs suit individual physical capabilities. Exercise, by reducing weight and increasing function, may slow the disease's progress. Low-impact aerobics, stretching, and strengthening exercises are often recommended. Several short sessions daily are preferable to a long one. Safe warm-ups and cool-downs (slow 5-minute walks) are important. Avoid jogging and tennis; exercise bikes are not advised for those with arthritic knees. Diets should include legumes, whole grains, fruit, and vegetables.
If losing weight and exercise do not relieve symptoms, medication may be recommended. No drug stalls or cures OA's progression, but several reduce joint pain. Whether obtained OTC or by prescription, drugs for this purpose often have side effects, even after taking for some time. Kidney, liver, tinnitus, and cardiovascular problems have been reported when taking large dosages long-term. Consult your doctor if you feel anything unusual when on such medications.
Acetaminophen provides pain relief but not inflammation reduction. Aspirin is effective against both, but should not be used by those with aspirin allergy or ulcers. Ibuprofen or Naproxen (Motrin, Advil) reduce pain and inflammation and are stronger by prescription. With some medications, stomach upset may occur. Antacids (Cytotec, Prilosec) may relieve symptoms while decreasing ulcer risk. Cox 2 inhibitors such as Celebrex may prevent certain side effects.
Corticosteroids may be effective when other medications are not. Side effect risks are weight gain, infection, and cataracts or osteoporosis.
Doctors may recommend antidepressants for chronic pain. Cymbalta or antidepressants affecting brain chemicals that cause pain sensation may help. Drowsiness, dry mouth, and blurred vision may result. Rarely, mood changes and suicidal thoughts occur.
Stress management techniques may be beneficial. Occupational and physical therapy, bracing, orthotics, chiropractic manipulation, massage therapy, herbs, and glucosamine/chondroitin supplements are sometimes used. Heat (soothing) or cold (numbing) applications frequently give temporary relief but should be limited to twenty minutes. Topical pain relievers are also temporarily effective, but physicians should be consulted before use by those allergic to aspirin or those taking anticoagulants. Accupuncture is a popular alternative treatment; its benefit is suggested but not conclusive.
Joint injections of corticosteroids are safer for younger people and should be administered only for occasional flareups. Joint degradation may occur if used for long periods of time, especially in older adults. Injections of hyaluronic acid, presently approved only for the knee joint, can provide a year's relief with no side effects.
Conservative methods should be the first approach to OA treatment. If no other method improves function and relieves pain, surgery may be recommended. There are several surgical procedures for osteoarthritis of the knee.
Arthroscopy incisions and instruments are small. Damaged cartilage can be trimmed, loose debris removed, and the joint cleaned in this procedure. At the same time, meniscus tears or damaged ligaments can be corrected. Arthroscopy may help those under 55 delay more invasive surgery.
An osteotomy (reshaping the bones) can restore knee function, diminish OA pain, and may stimulate new cartilage growth. However, results deteriorate over time; and many will need a full replacement eventually.
Total joint replacement (arthroplasty) is usually recommended for severe pain and limited movement. Replacement parts are made of titanium or cobalt-chrome metals and wear-resistant smooth polyethylene (plastic). Results are generally excellent, with significant pain relief and improved function. Full rehab may take 3 to 6 months. The success rate ten years after surgery is about 90%
Surgeons can permanently fuse joint bones (arthrodesis) when pain is so severe that joint immobilization is an improvement. A fused ankle joint bears weight painlessly but has no flexibility. Consequently, this procedure usually occurs on smaller (finger and toe) joints.
For successful recovery, arrange to have help at home and safe mobility, possibly with ramps or grab bars. Meal prepararation, bathroom use, and getting in/out of bed should require little effort. Stay on one floor; stairs are impossible immediately following surgery.
There are several options for osteoarthritis relief. Your physician and yourself, together, form the best decision-making team.
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