Consumer Information Center Osteoarthritis How Is Osteoarthritis

Return to Savvy Consumer Information Center - Home Page

How Is Osteoarthritis Treated? Most successful treatment programs involve a combination of treatments tailored to the patient’s needs, lifestyle, and health. Osteoarthritis treatment has four general goals: Control pain through drugs and other measures. Improve joint care through rest and exercise. Maintain an acceptable body weight. Achieve a healthy lifestyle. Osteoarthritis treatment plans often include ways to manage pain and improve function. Such plans can involve exercise, rest and joint care, pain relief, weight control, medications, surgery, and nontraditional treatment approaches. Exercise: Research shows that one of the best treatments for osteoarthritis is exercise. This activity can improve mood and outlook, decrease pain, increase flexibility, improve the heart and blood flow, maintain weight, and promote general physical fitness. It is also inexpensive and, if done correctly, has few negative side effects. The amount and form of exercise will depend on which joints are involved, how stable the joints are, and whether a joint replacement has already been done. (See Be a Winner! Practice Self-Care and Keep a Good-Health Attitude.)   On the Move: Fighting Osteoarthritis With Exercise You can use exercises to keep strong and limber, extend your range of movement, and reduce weight. Ask your doctor or physical therapist what exercises are best for you. Strength: Exercise bands are inexpensive devices that add resistance. Aerobics: Activities that keep your lungs and circulation systems in shape. Range of Motion: These activities keep the joints limber. Agility: Many of these exercises help you to maintain daily living skills. Neck and Back Strength: Don’t forget to keep your spine strong and limber. Ask your doctor or physical therapist what exercises are best for you. Ask for guidelines on exercising when a joint is sore or if swelling is present. Also, check if you should 1) use drugs such as analgesics or anti-inflammatories (NSAID’s) to make exercising easier, or 2) use ice afterwards.

Rest and Joint Care: Treatment plans include regularly scheduled rest. Patients must learn to recognize the body’s signals, and know when to stop or slow down. This prevents pain caused by overexercising. Some patients find that relaxation techniques, stress reduction, and biofeedback help. Some use canes and splints to protect joints and take pressure off them. Splints or braces provide extra support for weakened joints. They also keep the joint in proper position during sleep or activity. Splints must be used for limited periods because joints and muscles need to be exercised to prevent stiffness and weakness. An occupational therapist or a doctor can help the patient get a properly fitting splint. Pain Relief: People with osteoarthritis may have nonmedical ways to relieve pain. Patients can use warm towels, hot packs, or a warm bath or shower to apply moist heat to the joint. This can relieve pain and stiffness. In some cases, cold packs (a bag of ice or frozen vegetables wrapped in a towel) can relieve pain or numb the sore area. (Check with a doctor or physical therapist to find out if heat or cold is the best treatment.) Water therapy in a heated pool or whirlpool may also relieve pain and stiffness. For osteoarthritis in the knee, patients may wear insoles or cushioned shoes to redistribute weight and reduce joint stress. Weight Control: Osteoarthritis patients who are overweight or obese need to lose weight. Weight loss can reduce stress on weight-bearing joints and limit further injury. A dietician can help patients develop healthy eating habits. A healthy diet and regular exercise help reduce weight.

Medicines: Doctors use medicines to eliminate or reduce pain and to improve functioning. Doctors consider a number of factors when choosing medicines for their patients with osteoarthritis. Two important factors are the nature of the pain and potential drug side effects. Patients must use medicines carefully and tell doctors about any changes that occur. The following types of medicines are commonly used in treating osteoarthritis: NSAID’s (Nonsteroidal anti-inflammatory drugs). Many NSAID’s are used to treat osteoarthritis. Patients can buy some over the counter (for example, aspirin, Advil®*, Motrin® IB, Aleve®, ketoprofen). Others need a prescription. These drugs work in a similar way: they fight inflammation or swelling and relieve pain. However, each NSAID is a different chemical, and has slightly different effects in the body. Side effects. NSAID’s can cause stomach irritation or affect kidney function. The longer a person uses NSAID’s, the more likely he or she is to have side effects, and the more serious those effects can be. Many other drugs cannot be taken with NSAID’s, because NSAID’s alter the way the body uses or gets rid of these drugs. NSAID’s are associated with serious gastrointestinal problems, including ulcers, bleeding, and perforation. They should be used with caution in people over 65 and in those with any history of ulcers or gastrointestinal bleeding. COX-2 inhibitors. Two new NSAID’s, Celebrex® and Vioxx®, from a class of drugs known as COX-2 inhibitors, are now being used against osteoarthritis. These medicines reduce inflammation like traditional NSAID’s, but cause fewer gastrointestinal side effects. Acetaminophen. A non-anti-inflammatory pain reliever (for example, Tylenol®). This drug does not irritate the stomach, and is less likely than NSAID’s to cause long-term side effects. Research has shown that in many patients with osteoarthritis, acetaminophen relieves pain as effectively as NSAID’s. Warning: Patients with liver disease, heavy alcohol drinkers, and those on blood-thinning medicines should use acetaminophen with caution. Note: Brand names included in this booklet are provided as examples only. Their inclusion does not mean they are endorsed by the National Institutes of Health or any other Government agency. Also, if a certain brand name is not mentions, this does not mean or imply that the product is unsatisfactory.

Other Medicines. Doctors may prescribe several other medicines for osteoarthritis. They include: Topical pain-relieving creams, rubs, and sprays (for example, capsaicin cream) applied directly to the skin. Mild narcotic painkillers, which—while very effective—are addictive and rarely used. Corticosteroids, powerful anti-inflammatory hormones made naturally in the body or man made for use as drugs. Corticosteroids are typically injected into affected joints to relieve pain temporarily. This is a short-term measure, not recommended for more than two or three times per year. Hyaluronic acid, a new medicine for joint injection, used to treat osteoarthritis of the knee. This substance is a normal component of the joint, involved in joint lubrication and nutrition. Many patients experience pain relief after a series of three to five injections.   Questions to Ask Your Doctor or Pharmacist About Medicines How often should I take this medicine? Should I take this medicine with food or between meals? What side effects can I expect? Should I take this medicine with other prescription medicines I take? Should I take this medicine with the over-the-counter medicines I take? Most medicines used to treat osteoarthritis have side effects. So it is important for patients to learn about the drugs they are taking. Even nonprescription drugs should be checked. Several groups of patients are at high risk for side effects. Those patients are people with a history of peptic ulcers or digestive tract bleeding, those taking oral corticosteroids or anticoagulants (blood thinners), those who smoke, and those who consume alcohol. Patients may be able to help reduce side effects by taking some drugs with food. Others should avoid stomach irritants such as alcohol, tobacco, and caffeine. Some patients take other medicines to try to protect their stomachs by coating the stomach or blocking stomach acids. These measures help, but are not always completely effective.   Treatment Approaches to Osteoarthritis Exercise Rest and joint care Pain relief techniques Weight control Medicines Surgery Alternative therapies

Surgery: For some people, surgery helps relieve the pain and disability of osteoarthritis. Surgery may be performed to Resurface (smooth out) bones. Reposition bones. Replace joints. Surgeons may replace affected joints with artificial joints called prostheses. These joints can be made from metal alloys, high-density plastic, and ceramic material, and can be joined to bone surfaces by special cements. Artificial joints can last from 10 to 15 years or more. About 10 percent may need revision. Surgeons choose the design and components of prostheses according to their patient’s weight, sex, age, activity level, and other medical conditions. Remove loose pieces of bone or cartilage from the joint to improve joint function. The decision to use surgery depends on several things. Both surgeon and patient consider the patient’s level of disability, intensity of pain, interference with lifestyle, age, and occupation. Currently, more than 80 percent of osteoarthritis surgery cases involve replacing the hip or knee joint. After surgery and rehabilitation, the patient usually feels less pain and swelling, and can move more easily. Nontraditional Approaches: Among the alternative therapies for treating osteoarthritis are Acupuncture. Some people have found pain relief using acupuncture (the use of fine needles inserted at specific points on the skin). Preliminary research shows that acupuncture may be a useful component in an osteoarthritis treatment plan for some patients. (See the Current Research section.) Folk Remedies. Some patients seek alternative therapies for their pain and disability. Some of these alternative therapies have included wearing copper bracelets, drinking herbal teas, and taking mud baths. While these practices are not harmful, some can be expensive. They also cause delays in seeking medical treatment. To date, no scientific research shows these approaches to be helpful in treating osteoarthritis. * Note: Brand names included in this booklet are provided as examples only. Their inclusion does not mean they are endorsed by the National Institutes of Health or any other Government agency. Also, if a certain brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Health Professionals Who Treat Osteoarthritis Many types of health professionals care for people with osteoarthritis: Rheumatologists. Doctors who specialize in treating arthritis and related conditions that affect joints, muscles, and bones. Orthopaedists. Doctors who specialize in treatment of and surgery for bone dieases Physical therapists. Health professionals who work with patients to improve joint function. Occupational therapists. Health professionals who teach ways to protect joints, minimize pain, and conserve energy. Dieticians. Health professionals who teach ways to use a good diet to improve health and maintain a healthy weight. Nurse educators. Nurses who specialize in helping patients understand their overall condition and implement their treatment plans. Physiatrists (rehabilitation specialists). Doctors who help patients make the most of their physical potential. Licensed acupuncture therapists. Health professionals who reduce pain and improve physical functioning by inserting fine needles into the skin at various points on the body. Psychologists. Health professionals who help patients cope with difficulties in the home and workplace resulting from their conditions. Social Workers. Professionals who assist patients with social challenges caused by disability, unemployment, financial hardships, home health care, and other needs resulting from their conditions. The decision to use surgery depends on several things. Both surgeon and patient consider the patient's level of disability, intensity of pain, interference with lifestyle, age, and occupation. Currently, more than 80 percent of osteoarthritis surgery cases involve replacing the hip or knee joint. After surgery and rehabilitation, the patient usually feels less pain and swelling, and can move more easily. Nontraditional Approaches: Among the alternative therapies for treating osteoarthritis are Acupuncture. Some people have found pain relief using acupuncture (the use of fine needles inserted at specific points on the skin). Preliminary research shows that acupuncture may be a useful component in an osteoarthritis treatment plan for some patients. (See Current Research.) Folk Remedies. Some patients seek alternative therapies for their pain and disability. Some of these alternative therapies have included wearing copper bracelets, drinking herbal teas, and taking mud baths. While these practices are not harmful, some can be expensive. They also cause delays in seeking medical treatment. To date, no scientific research shows these approaches to be helpful in treating osteoarthritis.

Return to Savvy Consumer Information Center - Home Page

Search this site: Match ALL words Match ANY word Get the Savvy Consumer Newsletter! (FREE)