Osteoarthritis is a painful disease which can interfere with a patient's ability to perform routine daily activities, depending on which joints are affected. Early diagnosis and treatment is very important. The goals of osteoarthritis treatment are to:
- Relieve pain and other osteoarthritis symptoms
- Preserve or improve joint function
- Reduce physical disability
The American College of Rheumatology (ACR) offers guidelines for the treatment of osteoarthritis, though it emphasizes that treatment decisions ultimately rest with the doctor and patient. ACR guidelines include non-pharmacologic and pharmacologic (i.e., drug) treatment options for osteoarthritis.
Non-Pharmacologic Treatments for Osteoarthritis Patients
Conservative, non-drug treatment options should be considered first. If satisfactory relief can be achieved using non-drug options, risk associated with medication side effects is avoided. Non-drug treatment options include:
- Patient education and self-management programs
- Weight loss if patient is overweight
- Physical therapy for range of motion exercise, muscle strengthening, aerobic conditioning
- Assistive devices
- Taping and bracing
- Lateral-wedged insoles
- Occupational therapy for joint protection, energy conservation
Medications for Osteoarthritis
Medications should be considered for treating osteoarthritis in addition to non-drug treatment options. Medications are used for pain management. Choice of medication is based on severity of pain, risk of side effects for an individual patient, and the specific joint involved.
- Opioid analgesics (e.g. Ultram or more potent opioid therapy)
- NSAIDs (e.g., ibuprofen, naproxen, dicofenac, meloxicam)
- COX-2 inhibitor (e.g., Celebrex)
- Nonacetylated salicylate
Localized (intraarticular) injections
Topical creams and gels
- Capsaicin cream
- Methylsalicylate cream
Surgery for Osteoarthritis
Surgery is considered a last resort treatment option. Joint surgery is recommended for patients with severe pain or progressive functional limitations who have failed to respond to other treatment options.
Surgery can relieve pain, improve joint alignment, and restore joint mobility and function. The most common types of surgery used to treat osteoarthritis include:
- Arthroscopic surgery
- Total joint replacement
Alternative Treatments for Osteoarthritis
Alternative treatments have gained popularity over the last several years. Glucosamine and chondroitin sulfate have been recommended for treatment of osteoarthritis. Some studies, however, have questioned the effectiveness of the supplements as well as the quality of products sold.
Vitamins, specifically antioxidants, reportedly ease osteoarthritis and may even prevent the disease. Vitamin C has been associated with decreased pain and progression of osteoarthritis. Vitamins D and E also have been linked to osteoarthritis relief.
Chiropractic has also been touted as beneficial for osteoarthritis. Manipulation, by a chiropractor experienced with arthritis patients, may help relieve osteoarthritis pain for some patients.
Osteoarthritis Treatment. Primer on the Rheumatic Diseases. Edition 12. Published by the Arthritis Foundation.
Osteoarthritis Treatment Options. Arthritis Foundation. 7/23/2007. <http://www.arthritis.org/disease-center.php?disease_id=32&df=treatments>
Recommendations for the Medical Management of Osteoarthritis of the Hip and Knee. American College of Rheumatology. September 2000. <http://www.rheumatology.org/publications/guidelines/oa-mgmt/oa-mgmt.asp?aud=mem>