Treatment
Osteoarthritis is treated in the same way irrespective of the joint affected.
Level 1:
Weight loss
Reducing body weight takes stress off the joint and will help relieve the pain. It is estimated that seven times your body weight goes through the knee joint with each step. Therefore the result of losing weight is magnified. It is undoubtedly a major way of reducing pain from osteoarthritis.
Exercise
Movement of the joint helps nourish the cartilage left on the surface of the joint. It improves strength around the joint.
Tablets
There are several types of tablet that can be taken to help with arthritis pain relief.
a. Simple analgesia, such as Paracetamol, can be used to control the pain in the early stage of arthritis. It is possible to take these tablets intermittently when the joint is going to be stressed, for example just before playing a game of golf.
b. Non-steroidal anti-inflammatory drugs, ?NSAID?s? such as Ibuprofen, can be taken to help reduce the inflammation associated with osteoarthritis. These can be very effective but may have side effects which sometimes prevent them being taken for a prolonged period of time.
c. Glucosamine and Condroitin may be successful in some people. These substances are found in the cartilage and do in a minority of patients seem to give pain relief from arthritis.
Alternative treatments
There are a variety of other alternative treatments recommended which have for some people been very effective although there is no scientific evidence to support how these things work. They have provided relief for some patients.
Your doctor will be able to discuss with you the medication that you should use to help manage the arthritis problem.
Level 2:
Two basic types of injection are available:
Steroid.
An injection of steroid will produce a rapid decrease in the amount of inflammation in the joint. With this will come pain relief. It can be dramatic in settling down pain but does not help in the long-term as the result may be only short-lived and recurrent injections produce less benefit while perhaps increasing the speed of deterioration.
Aleuronic acid.
This is found in healthy joints as a lubricant and shock absorber. The injection of high aleuronic acid has been used particularly in the knee. A series of injections containing the acid are required to supplement the high aleuronic acid which is missing from the osteoarthritic joint. This can produce some benefit.
Level 3:
Surgery - There are two types of surgery that may be appropriate in osteoarthritic joints.
Arthrodesis.
In some joints arthrodesis, or fusing the joint or stiffening the joint, may be the most appropriate form of treatment. If a joint is taken away and the bones allowed to heal together, the joint will become stiff and without movement will not hurt. This obviously has the disadvantage of increasing stiffness. In some joints however, such as the ankle or wrist, it has been a very successful procedure with excellent pain relief and minimal functional disruption.
Joint replacement.
It is much more common to offer patients a joint replacement now as techniques, particularly in the hip and knee, have advanced. This has become a much more successful operation with excellent long-term results.
