Treatment and Research
Treatment Goals: Manage Pain, Improve Function
Osteoarthritis treatment plans often include ways to manage pain and improve function. Such plans can include exercise, rest and joint care, pain relief, weight control, medicines, surgery, and non-traditional treatment approaches.
Current treatments for osteoarthritis can relieve symptoms such as pain and disability, but right now there are no treatments that can cure osteoarthritis.
Exercise is one of the best treatments for osteoarthritis. It can improve mood and outlook, decrease pain, increase flexibility, and help you maintain a healthy weight.
The amount and form of exercise will depend on which joints are involved, how stable the joints are, whether or not the joint is swollen, and whether a joint replacement has already been done. Ask your doctor or physical therapist what exercises are best for you
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Heat or Cold
For temporary relief of pain from osteoarthritis, you can use warm towels, hot packs, or a warm bath or shower. In some cases, cold packs such as a bag of ice or frozen vegetables wrapped in a towel can relieve pain or numb the sore area.
A doctor or physical therapist can recommend if heat or cold is the best treatment. For osteoarthritis in the knee, wearing insoles or cushioned shoes may reduce joint stress.
Doctors consider a number of factors when choosing medicines for their patients. In particular, they look at the type of pain the patient may be having and any possible side effects from the drugs.
For pain relief, doctors usually start with acetaminophen because the side effects are minimal. If acetaminophen does not relieve pain, then non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be used. Some NSAIDs are available over the counter, while more than a dozen others, including a subclass called COX-2 inhibitors, are available only with a prescription.
Other medications, including corticosteroids, hyaluronic acid, and topical creams are also used. Most medicines used to treat osteoarthritis have side effects, so it is important for people to learn about the medicines they take. For example, people over age 65 and those with any history of ulcers or stomach bleeding should use non-steroidal anti-inflammatory drugs, or NSAIDs, with caution.
There are measures you can take to help reduce the risk of side effects associated with NSAIDs. These include taking medications with food and avoiding stomach irritants such as alcohol, tobacco, and caffeine. In some cases, it may help to take another medication along with an NSAID to coat the stomach or block stomach acids. Although these measures may help, they are not always completely effective.
Protecting and Supporting the Affected Joints
Protecting and supporting the affected joint or joints is important. Some people use canes and splints to protect and to take pressure off the joints. Splints or braces are used to provide extra support for weakened joints.
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For some people, surgery helps relieve the pain and disability of osteoarthritis. A doctor may perform surgery to smooth out, fuse, or reposition bones, or to replace joints.
The decision to have an operation depends on several factors. Both surgeon and patient should consider the patient's level of disability, intensity of pain, lifestyle, age, and occupation.
Researchers suspect that heredity plays a role in some osteoarthritis cases. For example, scientists have identified a mutation, or gene defect, affecting collagen -- an important part of cartilage -- in patients with an inherited kind of osteoarthritis that starts at an early age.
In the future, a test to determine who carries a genetic defect or defects could help people reduce their risk for osteoarthritis with lifestyle adjustments
Research on Tissue Engineering
Tissue engineering is an exciting area of research in osteoarthritis. This approach involves removing cells from a healthy part of the body and placing them in an area of diseased or damaged tissue. In some cases, this improves joint movement.
Research on Exercise
Researchers also are studying whether exercise can treat or prevent osteoarthritis. Studies on knee osteoarthritis and exercise found that strengthening the thigh muscle, also known as the quadriceps, can relieve symptoms of knee osteoarthritis and prevent more damage.
Studies also show that people with knee osteoarthritis who exercise appropriately feel less pain and function better.
Research on Acupuncture
Early research suggests that acupuncture, which is the use of fine needles inserted at specific points in the skin, may provide pain relief for some patients. Some people claim that the dietary supplements glucosamine and chondroitin sulfate can relieve the symptoms of osteoarthritis.
The Glucosamine and Chondroitin Arthritis Intervention Trial
Some people claim that the dietary supplements glucosamine and chondroitin sulfate can relieve the symptoms of osteoarthritis. The NIH-funded Glucosamine and Chondroitin Arthritis Intervention Trial, or GAIT, tested whether or not glucosamine and/or chondroitin have a beneficial effect for people with knee osteoarthritis. The results of the four-year study indicated that these supplements did not provide significant relief from osteoarthritis pain among all participants. However, a smaller subgroup of study participants with moderate-to-severe pain showed significant relief with the combined supplements. A long-term GAIT study revealed that subjects who took the supplements (alone or in combination) had outcomes similar to those experienced by patients who took an NSAID or a placebo pill.