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Symptoms

Treatment

Diagnosis

Causes

Prevention

Medications

Hip

Knee

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Osteoarthritis Treatment Options

The treatment and management of osteoarthritis involves lifestyle changes, medications, other treatments, and surgery. The goals of treatment include:

  • controlling pain
  • improving mobility and joint use
  • minimizing disability and returning normal functioning
  • slowing the progression of osteoarthritis
  • protecting other joints from developing osteoarthritis
 

Lifestyle changes

Lifestyle changes can help slow the progression of osteoarthritis, and help you maintain your normal level of functioning.

Diet
Maintaining an appropriate weight can help:

  • improve your symptoms of osteoarthritis
  • slow the progression of osteoarthritis
  • reduce osteoarthritis injury to other joints
  • lessen the stress on joints affected by osteoarthritis. A modest loss of five pounds can eliminate at least 15 pounds of stressful impact on an affected joint. The more weight lost, the greater the benefit.

The heavier you are, the more stress you put on your joints. Consult your healthcare provider before radically changing your diet, however. You may benefit from talking with a registered dietitian to find out how to achieve an optimal weight while maintaining a healthful, nutritious, varied diet.

Research suggests that vitamins C and D can help protect you against the progression of osteoarthritis. Consult your healthcare provider to see the best way to supplement your diet with these vitamins.

Exercise

Reasonable, careful exercise can help restore mobility and flexibility. Exercise can strengthen your muscles, which can help keep your joints more stable. Consult your health care provider before beginning a new exercise program. You'll need to customize your exercise program to protect the joints that are affected by osteoarthritis. Swimming and water aerobics are particularly good, because they don't put stress on the joint. You may be advised to consult an exercise physiologist or physical therapist to help you design a safe exercise plan.

Always contact your healthcare provider if:

  • Your symptoms don't improve with the recommended changes.
  • Your symptoms worsen.
  • You develop any new symptoms.

Medications
The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your health care provider if you need to take any special precautions. Use each of these medications as recommended by your health care provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your health care provider.
There are a variety of medications available to treat the pain and inflammation of osteoarthritis. You may have to try different medicines before you find the one that works best for you, with the least number of side effects.

Prescription medications
Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Naproxen (Naprosyn, Anaprox, Aleve)
  • Ketoprofen (Orudis)
  • Ibuprofen (Motrin, Advil, Nuprin)
  • Indomethacin (Indocin)
  • Sulindac (Clinoril)
  • Meclofenamate (Meclomen)
  • Ketorolac (Toradol)
  • Piroxicam (Feldene)
  • Diclofenac sodium (Voltaren)
  • Diclofenac (Voltaren, Cataflam)

Cyclooxgenase-2 or COX-2 Inhibitors

  • Celecoxib (Celebrex)
  • Rofecoxib (Vioxx)
  • Meloxicam (Mobic)

Over-the-counter medications
Acetaminophen (Tylenol)

Acetaminophen (Tylenol) can be helpful in relieving some of the pain associated with osteoarthritis. Do not take a larger dose than is recommended by your healthcare provider. Do not drink alcoholic beverages if you are taking acetaminophen on a daily basis. Side effects are rare. Few people may experience an allergic reaction after taking the drug. If you develop a rash, swelling, or difficulty breathing, stop taking the acetaminophen and get medical attention.

Capsaicin cream (Zostrix)

Capsaicin cream (Zostrix) is rubbed on the skin of an affected joint to relieve the pain and inflammation of osteoarthritis. Capsaicin cream is made from the active ingredient of hot Chile peppers. Some people prefer to wear rubber gloves while applying the cream. If you don't, be sure to wash your hands very thoroughly with soap and water after using the cream. Be very careful not to get the cream near your eyes, as it will burn and sting. If you do get some in your eyes, flush them thoroughly with cool water. Possible side effects include burning, stinging, or warm sensation when first applied to the skin.

Nonsteroidal anti-inflammatory agents (NSAIDs)

  • Naproxen (Naprosyn, Anaprox, Aleve)
  • Ketoprofen (Orudis)
  • Ibuprofen (Motrin, Advil, Nuprin)
  • Indomethacin (Indocin)
  • Sulindac (Clinoril)
  • Meclofenamate (Meclomen)
  • Ketorolac (Toradol)
  • Piroxicam (Feldene)
  • Diclofenac sodium (Voltaren, Cataflam)

    Although many NSAIDs are available as over-the-counter medications, you may be given a prescription for a higher dose. Nonsteroidal anti-inflammatory agents help decrease inflammation, swelling, and joint pain.

    Be sure to take NSAIDs with food to decrease the chance of stomach irritation.

    Drinking alcoholic beverages or taking other NSAIDs while you're already using a NSAID can increase your risk of side effects.

    Possible side effects include:

    stomach upset
    stomach ulcers
    kidney damage
    liver inflammation
    confusion, dizziness, lightheadedness
    severe allergic reaction (hives, difficulty breathing, swelling around the eyes)
    increased risk of bleeding: Always inform your healthcare providers that you're taking an NSAID before having any medical or dental procedures or surgeries

Cyclooxygenase-2 or COX-2 Inhibitors

  • Celecoxib (Celebrex)
  • Rofecoxib (Vioxx)
  • Meloxicam (Mobic)

    COX-2 inhibitors work in a way similar to NSAIDs, helping to decrease inflammation, swelling, and joint pain. In addition, they have the benefit of causing less stomach irritation. In particular, COX-2 inhibitors cause far fewer stomach ulcers than do NSAIDs.
    Drinking alcoholic beverages or taking NSAIDs while you're using a COX-2 inhibitor can increase your risk of side effects.
    Possible side effects include:

    liver inflammation
    confusion
    severe allergic reaction (hives, difficulty breathing, swelling around the eyes)
    stomach upset

Special considerations
Whenever you are taking a prescription medication, take the following precautions:

  • Take them as directed, not more, not less, not at a different time.
  • Do not stop taking them without consulting your health care provider.
  • Don't share them with anyone else.
  • Know what effects and side effects to expect, and report them to your health care provider.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
  • Plan ahead for refills so you don't run out.

Dietary Supplements
There is some evidence that glucosamine and chondroitin may relieve pain. Fish oils have also been noted to reduce inflammation. Increasing the intake of omega–3 fatty acids may reduce osteoarthritis pain and inflammation.

Mechanical Aids

Shoes with shock-absorbing soles can provide relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports. A neck brace or corset can relieve back pain, as can a firm mattress. Canes, crutches, walkers, and orthopedic shoes also can be of benefit to patients with advanced osteoarthritis.

Other treatments

  • Application of heat
    Heat improves blood circulation to the affected area. Applying heat via warm soaks, paraffin, or heating pads can be very soothing. Most health care providers recommend that you apply the heat for about ten minutes at a time, three to four times a day.
  • Application of cold
    Cold can help decrease inflammation in an affected joint, relieving pain, and improving stiffness and movement. Apply an ice pack for 20 to 30 minutes at a time, several times each day.
  • Acupuncture/Spa therapy
    Some clinicians report that acupuncture has been successful in reducing the pain of osteoarthritis. Hydrotherapy, or spa therapy, is an ancient therapy that uses mineral baths to relieve pain.
  • Intra-articular corticosteroid injections
    Your health care provider may choose to inject the affected joint with a solution containing a corticosteroid medication such as:

    Methylprednisolone (Medrol)
    Triamcinolone (Aristocort)

    The steroid injection can help decrease inflammation and pain in the joint. Sometimes, excess joint fluid will be removed from the joint just before injecting the steroid medicine.
    Steroid injections often have to be repeated every several months. Most practitioners believe that no more than three or four such injections should be given in a year; more than that number may cause damage to the cartilage.

  • Viscosupplementation
    Viscosupplementation involves injecting the affected joint with a fluid containing a substance called hyaluronic acid. Hyaluronic acid is a chemical found in normal cartilage and in normal joint fluid. Viscosupplementation uses laboratory-produced substances called:

    Sodium hyaluronate (Hyalgan)
    Hylan G-F 20 (Synvisc)

    Viscosupplementation is thought to:

    lubricate the joint
    provide "shock absorption"
    allow the joint to glide more freely
    decrease pain and stiffness


Surgery
Surgical procedures are usually reserved for patients who have noted no improvement with medications or procedures such as steroid injections or viscosupplementation.

 

  • Arthroscopy
    In this procedure, several tiny incisions are made on the sides of your knee. A lighted camera is inserted through one incision. The view inside your knee can be broadcast onto a large monitor in the operating room. Operating instruments are passed through a second incision. These instruments are used to clean out shards of bone and cartilage that might be causing your pain and interfering with movement. The procedure usually takes less than an hour and is done as an outpatient surgery.

    It takes four to six weeks for the affected joint to recover, but you probably will return to work or resume daily activities within a few days. A specific activity and rehabilitation program may be suggested to speed your recovery and protect future joint function.

  • Osteotomy
    In this procedure, a deformed joint (usually the knee) is surgically reshaped and realigned. The surgeon reshapes the shinbone (tibia) or thighbone (femur) to improve your knee's alignment. The healthy bone and cartilage is realigned to compensate for the damaged tissue.

    You will need to walk with crutches for one to three months. Next, you will begin rehabilitative leg strengthening and walking exercises. You will probably be able to resume your full activities after three to six months.

  • Arthroplasty
    This is a joint replacement surgery. The joint is usually replaced with a synthetic joint, made of a chromium alloy and plastic. Knee replacements and hip replacements are particularly common.

    The surgeon makes an incision along the joint, moves aside muscles, and removes damaged bone and cartilage. The remaining bone is prepared to receive the prosthesis and the new plastic and metal joint is placed in position. Depending on the type of prosthesis, the surgeon may use cement to hold one or both parts of the artificial joint. The incision is closed with stitches or staples, which will be removed in about two weeks. The procedure will take a few hours.

    Within six weeks, you should be able to resume normal light activities. To speed your recovery and protect future joint function, follow the recommended activity and rehabilitation program.

  • Arthrodesis
    This procedure is an absolutely last resort for patients who have not had good pain relief from other efforts. In this procedure, the two bones making up a joint are permanently fused together. While this can greatly improve pain, it also means that the joint is permanently nonfunctional.

 

 

 

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This web site is intended for your own informational purposes only. No person or entity associated with this web site purports to be engaging in the practice of medicine through this medium. The information you receive is not intended as a substitute for the advice of a physician or other health care professional. If you have an illness or medical problem, contact your health care provider.

Arthritis can develop as a result of an infection. For example, bacteria that cause gonorrhea or Lyme disease can cause arthritis. Infectious arthritis can cause serious damage, but usually clears up completely with antibiotics. Scleroderma is a systemic disease that involves the skin, but may include problems with blood vessels, joints, and internal organs. Fibromyalgia syndrome is soft-tissue rheumatism that doesn't lead to joint deformity, but affects an estimated 5 million Americans, mostly women. The approximate number of cases in the United States of some common forms of arthritis.

Arthritis-Symptom.com is an informational out reach of the Consumer Health Information Network. It is our goal to provide up to date information about arthritis and other inflammatory and bone conditions in a easy to understand format.

Where we get our information.

Most of the information in the site is compiled by editors from information provided by the National Institutes of Health. We are in the process of updating our pages. In the past we have not made reference to the source for information provide by our editors. In the next few weeks we hope to have all our pages marked as to the source.

We have included information from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Pages that uses information from this source are so acknowledged.

We have contributing authors that send information. Where information is provided by an outside author it is acknowledged by a byline under the title.

Updates of Pages.

Not all of our pages have a date as to the last update. We are in the processes of reviewing all our pages and as we do we include a reference as to when the page was updated. This web site was first published in January of 2003. All pages in the site were created at sometime during or after that time.