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|How Is Osteoarthritis Treated?
There is no cure for osteoarthritis. Any medications and therapies prescribed are aimed at reducing symptoms so that the patient can continue performing daily tasks with minimum pain. Ultimately if a joint disintegrates to the point where it causes disability, surgery to replace the joint with an artificial one will be necessary. Below, we explain the different options for treating osteoarthritis.
Any treatment plan for osteoarthritis should include scheduled periods of rest. You need to learn to recognize your body's signals and know when it's time to stop or slow down. This will prevent joint pain caused by too much physical activity. Some people find it useful to wear special insoles in their footwear to reduce pain when walking or to use canes to take pressure off sore joints. Another common therapy is to use braces or splints to support joints or to keep them in place (immobile) during sleep or activity. Both devices should only be used for short periods of time, and be properly fitted by an occupational therapist (this therapist can also advice you on other suitable arthritis equipment). This is because braces that are rigid enough to stabilize a joint may also dangerously compress the flesh and cut off blood supply. And while splints may temporarily ease pain, they tend to cause muscle atrophy (the surrounding muscles weaken due to lack of use). In certain joints that don't require much movement, such as the thumb, this may not be a problem. But for other important joints like the knee, specific muscle strengthening exercises done under the supervision of a physical therapist are a better way at relieving pain and stiffness.
Doctors prescribe medications to reduce or eliminate pain in patients with symptoms of osteoarthritis. Which drug is prescribed, depends on the intensity of the pain, your medical history (what other diseases you may have or may be at risk for) and the potential side effects. Antiinflammatory drugs (also called NSAIDs or nonsteroidal anti-inflammatory drugs), including aspirin and ibuprofen are effective pain relievers (although they do nothing to halt the progress of the disease). However excessive use of NSAIDs can lead to serious side effects, so it is probably better to use softer drugs like acetaminophen (Tylenol) for everyday moderate pain. Your doctor may prescribe several types of medications for your condition, including topical creams and sprays. For more information see, medications for treating osteoarthritis.
Corticosteroids are powerful antiinflammatory steroids which your doctor injects directly into the affected joints for temporary pain relief. More commonly used for the treatment of rheumatoid arthritis, these injections can give instant relief. However, if taken over a long period of time then can cause osteoporosis, high blood pressure or diabetes. No more than 2 to 4 treatments a year are recommended.
Hyaluronic Acid Injections
Also known as viscosupplementation (or by brand names Suplasyn, Synvisc and Orthovisc), these medications are a new treatment approved only for osteoarthritis of the knee. Depending on which product your doctor uses, the treatment will be given in a series of 3 to 5 injections. Injections help restore the normal consistency of synovial fluid, a substance that breaks down as osteoarthritis progresses. In about 75 percent of cases, pain relief is achieved, mobility improved and the need for surgery delayed. There appear to be few side effects, although long term studies are not yet available.
For advanced joint degeneration, orthopedic surgery may be required. Advances in orthopedic surgery have made total reconstruction of joints an effective alternative to medications. Techniques are still evolving but even with current methods, surgery can dramatically improve a patient's quality of life. Surgeries include:
Also called, arthroplasty, this surgery is the definitive treatment for osteoarthritis of the knee or hip (sometimes, but less commonly, the shoulder, ankle, elbow and toes). The destroyed joint is replaced with an artificial one (called a prosthesis). Over a million arthroplasty surgeries are performed in the United States every year, and the figures are rising. Newer prosthesis have a life of up to 20 years, which means for many older patients, it offers a permanent fix. Younger patients will require joint replacement surgery at a later stage.
There are several non-drug therapies for relieving osteoarthritis pain. They include:
Despite popular myth, there is no evidence that any of the following are useful in treating osteoarthritis:
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