The treatment that works best for you will depend on your individual makeup and the severity of the condition at the time of diagnosis. Treatment courses generally begin with mild, noninvasive treatments and may progress to more invasive treatments if symptoms do not resolve with conservative treatment.
Basic lifestyle changes can help you manage your symptoms.
An active lifestyle can help maintain healthy joints, relieve stiffness, reduce pain and fatigue, and increase muscle and bone strength. Arthritis experts recommend low-impact exercise that includes aerobic, strength, and stretching exercises.
Eating a low-fat diet with lots of high-fiber whole grains, fruits, and vegetables will optimize nutrition. A healthy diet may lead to weight loss that will help minimize osteoarthritis symptoms by reducing the stress placed on the joints and by reducing systemic inflammation caused by excessive weight.
Make sure you get enough quality rest—eight to 10 hours of sleep every night is optimal. Fatigue has been shown to increase pain in many conditions.
Both cold and heat can be helpful when OA symptoms are present. Ice (or a bag of frozen vegetables works well) wrapped in a towel and applied to the aching area for 20 minutes helps restrict blood vessels, which reduces fluid in the tissue and decreases swelling and pain in the area. You can repeat two or three times a day.
You can do the same 20-minute pattern with a hot water bottle or a heating pad (you can find both at your local drugstore). Heat opens the blood vessels and increases circulation, bringing nutrients and proteins essential to repairing the compromised tissue.
There are several types of OTC options to relieve minor aches, pain, and swelling associated with osteoarthritis.
Acetaminophen (Tylenol) is an over-the-counter analgesic. It reduces pain but not inflammation.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) can be effective in combating aches and pains associated with OA. NSAIDs do have potential risks for gastrointestinal bleeding and upset stomach, especially if taken over a long period of time.
- Aspirin (Bayer)
- Ibuprofen (Advil, Motrin, Nuprin)
- Naproxen (Aleve, Naprosyn)
There are a variety of creams and gels available to relieve osteoarthritis pain. These may contain active ingredients such as menthol (Ben Gay, Stopain) or capsaicin (Capzasin, Zostrix), which is made from hot peppers.
If the symptoms of OA progress in severity and start to affect your quality of life or keep you from performing normal everyday tasks, your doctor might prescribe something stronger to manage the pain and swelling.
These injections, which contain a corticosteroid, reduce swelling and relieve inflammation and pain in arthritic joints.
Prescription Nonsteroidal Anti-inflammatory Drugs
Prescription NSAIDs do the same thing that over-the-counter ones do, just in stronger doses. As mentioned above, NSAIDs can, for some, cause undesirable side effects. This class of drugs includes:
- celecoxib (Celebrex)
- piroxicam (Feldene),
- prescription-strength ibuprofen and naproxen
Tramadol (Ultram) is a prescription analgesic. 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)
Injection of hyaluronic acid is a new option for patients with symptomatic knee osteoarthritis. The treatment involves a series of injections into the knee joint. Clinical experience and studies of the products available, called hyaluronan and hylan G-F 20, seem to indicate beneficial effects with minimal adverse reactions in a significant number of patients. This is a new technology that does not help all patients, but some patients do seem to have reduced pain. This is an appropriate treatment to try if lifestyle changes and traditional medical therapies have not relieved the pain of osteoarthritis in the knee. Injection may be particularly helpful in patients over 60 years old
In some cases, physical therapy can be useful for improving muscle strength, increasing the range of motion at stiff joints, and reducing pain. Consult a physical therapist for an exercise regime tailored to your personal osteoarthritis needs. Splints, shoe inserts, and/or braces may help provide support to weakened joints, take pressure off of your injured bones, and reduce pain significantly.
Especially severe cases of osteoarthritis may require surgery to replace or repair damaged joints. Types of surgery used to treat osteoarthritis include:
Joint replacement surgery, or arthroplasty, removes damaged joint surfaces from the body and replaces them with prosthetic devices made of plastic or metal. Hip and knee replacements are the most common types of this surgery, but shoulder, elbow, finger, and ankle joints all can be replaced. Prosthetic joints last up to about 20 years, but the lifespan of a joint replacement really depends on how that joint is used. If surgery is required, joint replacement is the preferred procedure, especially for older patients.
In a surgical procedure called osteotomy, an arthritis-stricken bone is realigned in order to relieve stress on the damaged part of that bone or joint. Because joint replacement is generally the preferred procedure, osteotomy is usually performed only on younger OA patients for whom joint replacement isn’t feasible.
In this surgery, also called arthrodesis, the bones in a joint are permanently fused in order to increase joint stability and reduce pain. Unfortunately, this surgery usually results in severely limited or zero range of motion in the joint, but in serious OA cases, it may be the best way to relieve chronic, debilitating pain.
In this procedure, a surgeon trims torn and damaged cartilage from a joint. In the past, this was a popular surgery to treat osteoarthritis of the knee, but recent studies have shown that it is actually no more effective at treating long-term pain than medication or physical therapy.