A cure for osteoarthritis (OA) isn’t available, but you can approach treatment in many ways. From over-the-counter (OTC) pain relievers all the way up to total knee replacement and quite a few things in between, you have options. Before you consider surgery, you’ll want to meet with your doctor to explore all of these options.
Prepare for your appointment by bringing this list of questions with you.
First, your doctor needs some important information
Provide a few key details to help your doctor answer your questions and make recommendations, such as:
- How bad is your pain and stiffness? Can you bend your knee and walk without assistance? Is OA becoming a quality of life issue?
- Have you previously been treated for OA of the knee?
- Do you exercise? Are you missing out on activities you enjoy? Is OA becoming a problem on the job?
- Do you currently take any prescription or OTC medications? Do you take dietary supplements? How long have you been taking them and in what doses?
- Have you ever had a knee injury? Do you have any allergies or other medical conditions?
You’ll be less likely to forget to mention these things if you list the answers in advance of your visit.
Now that your doctor is up to date on your health, it’s your turn to ask a few questions.
What can I do to take stress off my knees?
Whatever treatment you ultimately choose, a few lifestyle changes can help improve symptoms.
Your knees have to support the weight of your body. They take on a lot of added stress when they have to carry extra weight. If you have more than a few pounds to lose, your doctor can give you some tips on how to lose weight in a healthy way.
Knee pain and stiffness can turn you off to exercise, but it’s still vitally important for your joints and your overall health.
Exercising the right way can help with flexibility and increase your range of motion. In addition, if you build up your leg muscles, they’ll help support your knees. Certain activities, such as swimming and cycling, are less stressful on your knees than jogging or playing competitive sports.
Your doctor’s office can recommend exercises for OA of the knee. They can also refer you to a physical therapist who can create a program designed for your particular needs.
Ask your doctor what else you can do to avoid stressing your knees.
Is it OK to use an assistive device?
Certain assistive devices may help ease OA knee pain. But purchasing the wrong product or using it incorrectly can hurt more than help. This is why it’s a good idea to get a professional opinion.
Your doctor can recommend or even prescribe the appropriate:
- shoe inserts or special shoes
- knee brace or knee sleeve
- cane or walker
What medicines can I take?
If you’re in pain, you may already be using an OTC nonsteroidal anti-inflammatory drug. These products are generally safe when used in moderation. If you take a lot, talk to your doctor about side effects and safety, especially if you take other medication as well.
Heat and cold therapy can help reduce inflammation and ease pain. You may also find some relief with topical creams.
If these aren’t working, ask your doctor if there are any stronger alternatives.
Would joint fluid aspiration help?
Sometimes, OA can cause a buildup of fluid on the knee. In a procedure called arthrocentesis, the doctor inserts a hollow needle into the joint space to remove fluid. This can provide relief from pain and swelling. Ask your doctor if this is an appropriate therapy for you.
What about corticosteroid injections?
Corticosteroids are anti-inflammatories that your doctor can inject directly into your knee joint. It only takes a few minutes and can be done in your doctor’s office. These powerful medications can ease symptoms, but you should consider some important things.
Corticosteroids have no effect on some people. Others find their symptoms improve but only for a few days. When it works well, it can provide relief for several months.
One drawback is that if you overuse corticosteroid injections, they can damage cartilage even further. For that reason, you won’t be able to have more than a few injections in a year in the same joint.
What is viscosupplementation, and is it a good choice for me?
Viscosupplementation may be a good option if you’ve already tried other treatments without success but you’re not yet a candidate for surgery.
Viscosupplementation involves injecting a thick fluid called hyaluronate into your knee. Hyaluronate promotes lubrication and shock absorption.
The injection is usually given once a week for 3 to 5 weeks. The procedure, which only takes a few minutes each time, can be performed right in your doctor’s office.
Viscosupplementation can ease pain and make it easier to move the joint, but you probably won’t feel any improvement for several weeks. You’ll get the full effects about eight to 12 weeks after the first injection.
As with corticosteroid injections, this treatment works for some people but not for others. If it works for you, relief may last many months or as long as a year. You can start the treatment again in about six months or so.
Questions to ask your doctor about viscosupplementation:
- What are the potential side effects and complications?
- Do I need to do anything special after the procedure? Will my activities be restricted?
- What are my options if viscosupplementation doesn’t work?
Is it time for me to think about surgery?
Surgery is usually the treatment of last resort. If nothing else has helped, various surgical options can be very effective:
- During arthroscopic chondroplasty, your doctor uses small incisions to trim and smooth damaged cartilage so that new cartilage can grow in.
- During cartilage grafting, your doctor takes healthy cartilage from another part of the knee to fill in where cartilage is damaged.
- An osteotomy is a procedure to cut and reshape bone on the shin or thigh and take pressure off of the knee.
- During arthroplasty, such as a partial or total knee replacement, the damaged bone and cartilage is removed. It’s replaced with plastic or metal joints.
Questions to ask your doctor about surgery:
- How might this procedure help?
- What are the potential risks and complications?
- Is it an outpatient or inpatient procedure?
- How long will it take to return to work and my normal routine?
Remember, the more open and honest you are with your doctor about your symptoms, pain level, and mobility constraints, the better off you’ll be in terms of finding the treatment that’s best for you and your OA of the knee.