Osteoarthritis Treatments: Know Your Options

How is osteoarthritis treated? continued...

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that are used to reduce pain and inflammation in the joints. Examples of NSAIDs include aspirin (Ecotrin), ibuprofen (Motrin), nabumetone (Relafen), and naproxen (Naprosyn). It is sometimes possible to use NSAIDs for a while and then discontinue them for periods of time without recurrent symptoms, thereby decreasing side effect risks.

The most common side effects of NSAIDs involve gastrointestinal distress, such as stomach upset, cramping diarrhea, ulcer and even bleeding. The risk of these and other side effects increases in the elderly. Newer NSAIDs called Cox-2 Inhibitors have been designed that have less toxicity to the stomach and bowels. Because Osteoarthritis symptoms vary and can be intermittent, these medicines might be given only when joint pains occur or prior to activities that have traditionally brought on symptoms.

Some studies, but not all, have suggested that the food supplements glucosamine and chondroitin can relieve symptoms of pain and stiffness for some persons with osteoarthritis. These supplements are available in pharmacies and health food stores without a prescription, although there is no certainty about the purity of the products or the dose of the active ingredients because they are not monitored by the FDA. The National Institutes of Health is studying glucosamine and chondroitin in the treatment of osteoarthritis. Their initial research demonstrated only a minor benefit in relieving pain for those with the most severe osteoarthritis. Further studies, it is hoped, will clarify many issues regarding dosing, safety, and effectiveness of these products for osteoarthritis. Patients taking blood-thinners should be careful taking chondroitin as it can increase the blood-thinning and cause excessive bleeding. Fish oil supplements have been shown to have some anti-inflammation properties and increasing the dietary fish intake and/or fish oil capsules (omega 3 capsules) can sometimes reduce inflammation of arthritis.

While oral cortisone is generally not used in treating osteoarthritis, when injected directly into the inflamed joints, it can rapidly decrease pain and restore function. Since repetitive cortisone injections can be harmful to the tissue and bones, they are reserved for patients with more pronounced symptoms.

For persisting pain of severe osteoarthritis of the knee that does not respond to weight reduction, exercise or medications, a series of injections of hyaluronic acid (Synvisc, Hyalgan) into the joint can sometimes be helpful, especially if surgery is not being considered. These products seem to work by temporarily restoring the thickness of the joint fluid, allowing better joint lubrication and impact capability, and perhaps by directly affecting pain receptors.

Surgery is generally reserved for those patients with osteoarthritis that is particularly severe and unresponsive to the conservative treatments. Arthroscopy, discussed above, can be helpful when cartilage tears are suspected. Osteotomy is a bone removal procedure that can help realign some of the deformity in selected patients, usually those with knee disease. In some cases, severely degenerated joints are best treated by fusion (arthrodesis) or replacement with an artificial joint (arthroplasty). Total hip and total knee replacements are now commonly performed in community hospitals throughout the United States. These can bring dramatic pain relief and improved function. For further information on joint surgeries, please read the Arthroscopy, Total Knee Replacement, and Total Hip Replacement articles.

Previous Page  [1] [2]