Osteoarthritis

Alternative Names

Treatment

The goals of treatment are to:

• Increase the strength of the joints
• Maintain or improve joint movement
• Reduce the disabling affects of the disease
• Relieve pain

The treatment depends on which joints are involved.

MEDICATIONS

The most common medications used to treat osteoarthritis are nonsteroidal anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen, and naproxen.

Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. Manufacturers of NSAIDs include a warning label on their products that alerts users to an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Other medications used to treat OA include:

• COX-2 inhibitors (coxibs). Coxibs block a substance called COX-2 that causes swelling. This class of drugs was first thought to work as well as other NSAIDs, but with fewer stomach problems. However, reports of heart attacks and stroke have led the FDA to re-evaluate the risks and benefits of the COX-2s. Celecoxib (Celebrex) is still available at the time of this report, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest possible period of time. Ask your doctor whether the drug is right and safe for you.
• Steroids. These medications are injected right into the joint. They can also be used to reduce inflammation and pain.
• Supplements. Many people are helped by over-the-counter remedies such as glucosamine and chondroitin sulfate. There is some evidence that these supplements can help control pain, although they do not seem to grow new cartilage.
• Artificial joint fluid (Synvisc, Hyalgan). These medications can be injected into the knee. They may relieve pain for up to 6 months.

LIFESTYLE CHANGES

Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.

Other lifestyle recommendations include:

• Applying heat and cold
• Eating a healthy balanced diet
• Getting rest
• Losing weight if you are overweight
• Protecting the joints

PHYSICAL THERAPY

Physical therapy can help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it likely will not work at all.

BRACES

Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

SURGERY

Severe cases of osteoarthritis might need surgery to replace or repair damaged joints. Surgical options include:

• Arthroscopic surgery to trim torn and damaged cartilage and wash out the joint
• Cartilage restoration to replace the damaged or missing cartilage in some younger patents with arthritis
• Change the alignment of a bone to relieve stress on the bone or joint (osteotomy)
• Surgical fusion of bones, usually in the spine (arthrodesis)
• Total or partial replacement of the damaged joint with an artificial joint (knee arthroplasty, hip arthroplasty)

Support Groups

For more information and support, see arthritis resources.

Outlook (Prognosis)

Your movement may become very limited. Treatment generally improves function.

Possible Complications

• Adverse reactions to drugs used for treatment
• Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking
• Decreased ability to walk
• Surgical complications

When to Contact a Medical Professional

Call your health care provider if you have symptoms of osteoarthritis.

References

Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77:177-184.

Glass GG. Osteoarthritis. Dis Mon. 2006;52:343-362.