Osteoarthritis Treatment Options
If you've already tried a variety of pain relievers and your joints are still painful, or you just can't tolerate NSAIDs or acetaminophen, your doctor may recommend a stronger opioid pain reliever like codeine, oxycodone, hydrocodone, or tramadol, or one of these drugs combined with acetaminophen. Narcotic medications can become habit-forming and cause constipation and sedation, so it's important that you keep in close touch with your doctor while taking them.
Corticosteroid injections into the knee joint offer fast relief from joint pain and inflammation, and their effects can last for a few weeks to months.
Hyaluronic Acid Therapy (Viscosupplementation)
Your joints contain a natural lubricant and shock absorber called hyaluronic acid, but people with osteoarthritis have less of this substance than normal. Hyaluronic acid is injected in the knee joint using products such as Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc-One, which may ease osteoarthritis pain in the knees, shoulders, and hips. This treatment may also help your joints move more smoothly. Side effects from viscosupplementation are usually mild and may include pain or swelling at the injection site.
Your doctor may recommend the use of antidepressants to help treat chronic pain whether you have 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, desipramine (Norpramin), and imipramine (Tofranil). It is not exactly clear how antidepressants help curb pain, but antidepressant effects on brain chemicals is believed to play a role. Side effects can range from drowsiness to dry mouth and blurred vision. Rarely, these drugs can lead to mood changes or suicidal thoughts.
Most people with osteoarthritis don't need surgery, but if your pain and stiffness are so severe that you just can't function, your doctor might suggest it as a last resort. Surgery can improve your joint alignment, help your joints move more smoothly, and relieve your pain. Techniques used for osteoarthritis include: