There is no permanent treatment for osteoarthritis, but pain and disomfort caused by it can be relieved and managed over time.
There is no cure for osteoarthritis but treatment can help to relieve pain and other symptoms, prevent or reduce disability, and help you live independent and active life. Treatment for osteoarthritis includes both medications and nondrug approaches such as life style changes, physiotherapy, exercises, complimentary therapy. Important aspects of treatment approach for osteoarthritis include:
- access to right information to manage the disease
- exercise for better fitness and strengthening of muscles
- weight loss, if you are overweight/obese.
Lifestyle changes: Osteoarthritis symptoms can improve with lifestyle changes such as regular exercise and weight loss.
- Exercise: Exercise is an essential part of treatment plan for people with osteoarthritis. You age and level of fitness is never a contradiction for exercises. Many people think that exercise can worsen osteoarthritis symptoms such as pain and stiffness. Regular exercises improve muscle strength, joint flexibility, your posture and general fitness. Doing regular exercises for about 20 to 30 minutes on most days of the week is recommended. However avoid any exercise that causes joint pain which lasts for more than an hour after you finish exercising. Your doctor or physiotherapist can advise you regarding the exercises you can do.
- Weight loss: Being overweight or obese can worsen symptoms of osteoarthritis as the extra weight increases the strain on damaged joints. Joints in the lower limbs, which are the weight bearing joints are particularly affected if you are overweight or obese. If you are overweight, try to lose weight to reach a healthy weight. You can consult a health professional for exercises and diet advice.
Medicines for osteoarthritis: Your doctor may prescribe medicine (painkillers) to help control pain in osteoarthritis. Besides medications other therapies that may be recommended include devices or surgery.
- Pain relieving medicines: The painkiller (analgesic) that your doctor will prescribe will depend on the severity of your pain, your overall health and other health problems. Paracetamol; non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, diclofenac; opioids analgesics such as codeine, dihydrocodeine, tramadol are some of the commonly prescribed analgesics. Paracetamol is a safe medication but follow the dosage that your doctor recommends and do not take more than the dose stated on the pack. The NSAIDs are good analgesics and are most often prescribed to relieve pain. But in high dose or when given for long time they can cause gastric irritation or even gastric bleeding. Opioids analgesics are also effective in reducing pain but they are associated with side effects such as drowsiness, nausea, constipation and dependence (on a long term use).
- Topical application: Topical NSAIDs or capsaicin cream can ease your pain on local application. Capsaicin cream blocks the nerves that send pain messages but it has to be used for about a month regularly for the treatment to be fully effective. Avoid applying capsaicin cream on delicate areas, such as your eyes, mouth, nose and genitals as it can be very painful for a few hours. However, it does not cause any permanent damage.
- Intra-articular injections: Some people with severe osteoarthritis may need intra-articular corticosteroid injections to control pain. In this treatment the medicine is injected into the part/parts of your body that are affected by osteoarthritis. Use of intra-articular injections of hyaluronic acid for osteoarthritis is not recommended.
Supportive treatments: Some of the non-drug approaches for osteoarthritis include physiotherapy, applying hot or cold packs, transcutaneous electrical nerve stimulation (TENS).
- Transcutaneous electrical nerve stimulation (TENS): Transcutaneous electrical nerve stimulation (TENS) can help to ease your pain by numbing the nerve endings in your spinal cord which control pain. This technique uses a machine to numb the nerve endings in the spinal cord.
- Hot or cold packs: Use of hot or cold packs (sometimes called thermotherapy or cryotherapy) on the joints can ease the pain and symptoms of osteoarthritis.
- Manual therapy: Manual therapy helps tokeep your joints supple and flexible and can reduce pain by stretching techniques. Physiotherapist provides manual therapy.
Assistive devices: If the pain of osteoarthritis or mobility problems, make everyday tasks difficult, your health professional (physiotherapist or occupational therapist) may recommend use of assistive devices. Use of special footwear or insoles for your shoes can help to relieve pain of osteoarthritis of lower limbs, such as your hips, knees or feet. Similarly footwear with shock-absorbing soles can reduce pressure on the joints of your legs while you walk. Use of walking aid, such as a stick or cane may be recommended if osteoarthritis in your hip or knee affects your mobility. Your health professional can advise you regarding need and use of assistive devices.
Surgery: Surgery for osteoarthritis is rarely needed. Most patients withosteoarthritis can be managed with medications but patients with severe pain or joint deformity may need surgery. Some of the surgeries that are performed for osteoarthritis include joint replacement (replacing the joint with an artificial joint), arthroplasty, arthrodesis and osteotomy. A joint replacement surgery can improve the mobility of a patient. An orthopedic surgeon will advise regarding need for surgery after examining you. Surgery for osteoarthritis can help to significantly improve your symptoms, mobility and quality of life but it does not ensure complete resolution of symptoms. You may continue to experience pain and stiffness.
Complementary and alternative therapies: Owing to the limitations of prescription medication in the treatment of osteoarthritis many people with osteoarthritis try complementary and alternative therapies. Some of the most commonly used complementary therapies for osteoarthritis include acupuncture, aromatherapy and massage. Some evidence suggests that these therapies may help to relieve symptoms but a definite and significant benefit is not observed.
[Read: Osteoarthritis and Acupuncture]
Nutritional supplements: Several nutritional supplements are available for treatment of osteoarthritis. Glucosamine sulphate and chondroitin sulphate are the two of the most commonly used supplements for osteoarthritis. They may help to relieve symptoms and do not cause any significant side effects.
Read more articles on Osteoarthritis.
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