Osteoarthritis (OA) is caused by cartilage degradation. This leads to joint changes including:
The best OA treatment for you will depend on your symptoms. It also depends on your needs and the severity of your OA at the time of diagnosis.
Most doctors begin OA treatment with simple, noninvasive options. However, you may need more intensive treatment if your symptoms are not manageable with lifestyle changes and medication. For some people, surgery can be the best way to manage the symptoms of OA.
Many people can help control their OA symptoms with basic lifestyle changes. Talk to your doctor about whether these options may be right for you.
An active lifestyle can help:
- maintain healthy joints
- relieve stiffness
- reduce pain and fatigue
- increase muscle and bone strength
People with OA should stick to gentle, low-impact exercise. It’s important to stop if you begin to feel any new joint pain. Any aches that last for more than a few hours after you finish exercising mean that you’ve probably done too much.
Remember, exercise isn’t just about aerobic conditioning. You also need to work on strength and stretching to support your joints and maintain your flexibility.
Maintaining a healthy weight can reduce stress on joints. If you are overweight or obese, talk to your doctor about how to lose weight safely. Weight loss can help with the pain of OA. It may also reduce systemic inflammation that contributes to OA.
If your joints are swollen and achy, give them a break. Try to avoid using an inflamed joint for 12 to 24 hours to let the swelling go down. It’s also a good idea to get enough sleep. Fatigue may increase your perception of pain.
Both cold and heat can help treat OA symptoms. Applying ice to an aching area for 20 minutes helps restrict blood vessels. This reduces fluid in the tissue and decreases swelling and pain. You can repeat the treatment two or three times a day.
A bag of frozen vegetables makes a great ice pack. Just make certain to wrap any ice pack in a t-shirt or towel. Otherwise the cold can damage your skin.
You can do the same 20-minute treatment pattern with a hot water bottle or a heating pad. Both can be found at your local drugstore. Heat opens the blood vessels and increases circulation. This brings in nutrients and proteins essential for repairing damaged tissue. Heat is also good for helping with stiffness.
You may find relief from both cold and heat. Experiment to see what works best for you. However, restrict your use to no more than 20 minutes at a time. Then give your body a break.
Several types of over-the-counter (OTC) medications may help relieve OA symptoms. However, different types of drugs have different effects. It’s important to choose the right drugs to help with your symptoms.
Acetaminophen (Tylenol) is an OTC painkiller. It reduces pain but not inflammation. Taking too much can cause liver damage.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) can help combat multiple OA symptoms. As implied by their name, they reduce inflammation. They also help with pain. OTC NSAIDS include:
- aspirin (Bayer)
- ibuprofen (Advil, Motrin, Nuprin)
- naproxen (Aleve, Naprosyn)
Over time, NSAIDs can potentially cause significant side effects. These include:
- stomach problems
- cardiovascular disease
- ringing in the ears
- liver damage
- kidney damage
- bleeding problems
There are a variety of creams and gels available to relieve OA pain. These may contain active ingredients such as menthol (Bengay, Stopain) or capsaicin (Capzasin, Zostrix). Capsaicin is the substance that makes hot peppers “hot”.
For some people with OA, OTC painkillers are not helpful enough. Prescription medications may be needed if symptoms start to affect your quality of life. Managing the pain and swelling may help you perform normal, everyday tasks.
These injections reduce inflammation which decreases swelling and pain in arthritic joints. Cortisone injections should only be administered by an experienced clinician and used judiciously to avoid complications and side effects.
Prescription NSAIDs do the same thing as OTC NSAIDS. However, they are available in stronger doses. Prescription NSAIDS include:
- celecoxib (Celebrex)
- piroxicam (Feldene)
- prescription-strength ibuprofen and naproxen
There remains a potential for undesirable side effects with prescription NSAIDS. Talk to your doctor about how to reduce your risk.
Tramadol (Ultram) is a prescription painkiller. For some, tramadol may cause fewer side effects than NSAIDs.
Strong painkillers can provide relief from severe pain. These include:
- meperidine (Demerol)
- oxycodone (OxyContin)
- propoxyphene (Darvon)
However, these drugs have the potential to be addictive.
In addition to drugs and surgery, there are other medical treatments for OA. These treatments are aimed at restoring the function of your joints.
Artificial joint fluid is a new option for patients with symptomatic knee OA. The treatment involves a series of injections into the knee joint. The fluid lubricates and cushions the joint. This allows it to move more easily. Available options include Synvisc and Hyalgan. Injections last for three to six months.
Physical therapy can be useful for some people with OA. It can help:
- improve muscle strength
- increase the range of motion of stiff joints
- reduce pain
A physical therapist can help you develop an exercise regimen suited to your needs. Physical therapists can also help you with assistive devices such as:
- shoe inserts
These can provide support to weakened joints. They can also take pressure off of injured bones and reduce pain.
Severe cases of OA may require surgery to replace or repair damaged joints. There are several types of surgery used to treat OA.
Joint replacement surgery is also known as arthroplasty. This procedure removes damaged joint surfaces from the body and replaces them with prosthetics made of plastic or metal. Hip and knee replacements are the most common types of joint replacement. However, other joints can be replaced, including:
Prosthetic joints last up to about 20 years. However, the lifespan of a joint replacement depends on how that joint is used.
If surgery for OA is required, joint replacement is generally the best option. This is particularly true for older patients who are unlikely to need a second replacement.
Osteotomy is a type of surgery used to realign bones damaged by arthritis. This relieves stress on the damaged part of the bone or joint. Osteotomy is usually performed only on younger OA patients for whom joint replacement isn’t feasible.
The bones in a joint can be permanently fused in order to increase joint stability and reduce pain. This surgery usually results in severely limited, or no, range of motion in the joint. However, in serious OA cases, it may be the best way to relieve chronic, debilitating pain.
Bone fusion is also known as arthrodesis.
In this procedure, a surgeon trims torn and damaged cartilage from a joint. This is done with the use of an arthroscope. An arthroscope is a small camera on the end of a tube. It allows doctors to see into the knee joint while performing procedures on the joint.. Arthroscopy can also be used to remove bone spurs.
In the past, this was a popular surgery to treat osteoarthritis of the knee. However, recent studies have shown that arthroscopy may be no more effective at treating long-term pain than medication or physical therapy.