The Basics of Osteoarthritis
What Medications Are Used to Treat Osteoarthritis?
The first step with medication is often over-the-counter pain relievers as needed. These include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve). Don't take over-the-counter medications for more than 10 days without checking with your doctor. Taking them longer than that increases the chance of side effects. If over-the-counter treatments aren't effective, your doctor may decide to prescribe a stronger anti-inflammatory drug or other medication to help ease the pain. Some medications in the form of creams, rubs, or sprays may be applied over the skin of affected areas to relieve pain. For some people with persistent pain despite these pills or creams, steroids can be injected directly into the joint. These injections can be given several times a year, though some experts believe this may ultimately accelerate joint damage.
Injections of hyaluronic acid directly into the knee joint can relieve pain in some people with osteoarthritis.
When osteoarthritis pain is severe and other treatments are not working, some doctors will give stronger pain pills, such as narcotics.
Unfortunately, none of these will reverse or slow the progression of joint damage caused by osteoarthritis.
Are There Alternative Treatments for Osteoarthritis?
While recent research has questioned their usefulness, some medical research has shown that the supplements glucosamine and chondroitin may relieve pain in some people with osteoarthritis, especially in the knee. There is no evidence that glucosamine can help rebuild cartilage. SAMe is another supplement with potential benefits for osteoarthritis. In fact, some research has shown it may be as effective an anti-inflammatory drugs. Remember to always let your doctor know about any supplements you're taking, because they can have side effects and interact with medications.
Acupuncture has also been shown to provide significant and immediate pain relief in some people with osteoarthritis.
What Supportive Devices Are Available to Help With Osteoarthritis?
Supportive or assistive devices can help to decrease pressure on the joints with osteoarthritis. Knee supports may be helpful for some people to stabilize the ligaments and tendons and decrease pain. Canes or crutches may be helpful to take pressure off certain joints.
In addition to pain relief, assistive devices improve function and prevent falls. A licensed physical therapist or other health care professional is needed to recommend what devices are best for you.
There are also many available devices to help you perform routine daily activities that may be difficult, such as housework or cooking. Ask your doctor about talking to an occupational therapist to give you ideas about which devices may help.
Is There a Surgery for Osteoarthritis?
When osteoarthritis pain is not controlled with other treatments, or when the pain prevents you from participating in your normal activities, you may want to consider surgery.
There are several types of surgery for osteoarthritis. They include:
- Arthroscopy to clean out the damaged cartilage or repair tissues. It is most commonly performed on the knee and shoulder. Recent evidence has questioned its effectiveness for osteoarthritis.
- Joint replacement surgery to replace the damaged joint with an artificial one. Joint replacement surgery should be considered when the severity of the joint pain significantly interferes with a person’s function and quality of life. Even under the best of circumstances, surgery cannot return the joint to its normal state (artificial joints do not have all of the motion of a normal joint), but movement and function are significantly improved. In addition, an artificial joint will greatly diminish pain. The two joints most often replaced are the hip and the knee. Artificial joints are now also available to replace shoulders, fingers, elbows, and ankles to treat severe pain that has not responded to other treatments.
- Joint fusion to remove the damaged joint and fuse the two bones on each side of the joint. This is done more often in areas in which joint replacement is not effective.