Arthritis Treatment Options
Hyaluronic Acid Therapy (Viscosupplementation)
The joints contain a natural lubricant and shock absorber called hyaluronic acid that keeps them moving smoothly, but people with osteoarthritis have less of this substance than normal. Hyaluronic acid injections with products such as Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc-One can help relieve the pain of mild-to-moderate osteoarthritis of the knee and improve mobility. Side effects from viscosupplementation are usually mild and may include pain or swelling at the injection site.
Some doctors may recommend the use of an antidepressant drug for chronic pain whether you suffer from depression or not. In 2010, the FDA approved the antidepressant duloxetine (Cymbalta) for chronic musculoskeletal pain including the pain of osteoarthritis. Although not FDA-approved for this use, another class of antidepressants called tricyclics may also help manage chronic pain. These include amitriptyline (Elavil), desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor). Although it is unclear how they help with chronic pain, antidepressant effects on brain chemicals that cause you to feel pain is believed to play a role. Side effects can range from drowsiness to dry mouth and blurred vision. Rarely, these drugs can also lead to mood changes or suicidal thoughts.
In addition to taking steroids, NSAIDs, or other pain relievers for gout, your doctor may prescribe a medication that reduces the amount of uric acid in your body, such as allopurinol (Zyloprim), febuxostat (Uloric), or probenecid (Probalan). Colchicine may also be used in gout treatment to treat or help prevent attacks. In 2010, the FDA approved the drug Krystexxa, the first medication designed for gout that doesn't respond to other treatments. Krystexxa is an enzyme that breaks down uric acid so it can be removed in the urine. The enzyme is often used only in the most severe cases where large deposits of uric acid are present. Side effects of the drug include allergic reactions, nausea, and bruising at the injection site.