Management & Treatment of Osteoarthritis
Treatment of OA concentrates on controlling the symptoms as there is no way to control the process, and pain is the measure used to check success or otherwise.
Treatment is progressed from less invasive and risky treatments up to surgery, depending on severity and areas of joint involvement.
This is a 10 point list:
- Education about the condition, treatment and the future is important. Self-help groups are organized by arthritis charities such as the Arthritis Research Campaign in the UK.Self-management programmes and cognitive-behavioural programmes are aimed at teaching attitude change and coping skills. There is some scientific evidence that education reduces pain and disability in hip or knee arthritis.
- Physiotherapy is important in the management of OA. Strengthening of the quadriceps muscles has shown to be effective in reducing pain and improving function in knees. A study showed that aerobic and resisted exercise, combined with education and drugs, gave better results than education and drugs alone in people with knee OA and mild disability
- Weight reduction reduces the risk of developing OA of the knees, and helps reduce pain and improve function in older women with knee OA. Routine diet management has a useful place here
- Drugs are used to combat pain and paracetamol is the first choice, with non-steroidal anti-inflammatory drugs (NSAIDS) added if the pain does not respond. Medical advice is needed to choose the best drug or the one with the least side-effects.Scientific reviews have found paracetamol (acetaminophen) and anti-inflammatory drugs to be effective in controlling the pain of OA, although anti-inflammatories have not been shown to be more effective than paracetamol.There can be severe side effects on the gastrointestinal system from non-steroidal anti-inflammatory drugs and the situation should be discussed with your medical adviser
- Application of creams to the joints can be helpful, such as NSAIDS or capsiacin, especially if only one or two joints are affected. There is limited evidence for the effectiveness of this treatment, and no guide as to which agent is any better than any other.
- Injection of corticosteroids into the joint is a common treatment but there is little scientific evidence to back it up. Some people report long term improvement in their pain after injection but there is no way of telling which people will respond well to the treatment
- Injection of hyaluronic acid is helpful in knee OA, but needs to be done weekly for three to five weeks
- Strong painkillers such as narcotic drugs (morphine etc) may be helpful but the risks of side-effects, addiction and abuse are an issue
- Arthroscopy and washing out the joint with saline solution can be effective in knee OA but the reason for this is not well understood
- Total knee replacement and total hip replacement (internal links in this site) are highly effective treatments for hip and knee OA, resulting in great improvements in the function and quality of life of these people. The success rate of TKR has risen to match that of hip replacement as a reliable operation
The Future for Osteoarthritis
Research into OA is very active and has increased the understanding of this condition over the last decade. New drugs are coming forward to control the pain symptoms or to alter the disease and its progression.
Some people with restricted areas of damage to the joint cartilage can have their own cartilage grown into a graft to replace the damaged region. This is known as Autologous Chondrocyte Implantation