Currently, there’s no known cure for cartilage loss in osteoarthritis. Treatment focuses on symptom reduction and improving joint function.
Management Pyramid
The management pyramid provides a visual representation of recommended treatment approaches.
Individuals experiencing osteoarthritis symptoms or at high risk of developing it should receive intervention to prevent progression or symptom development.
This includes:
Basic information about osteoarthritis empowers individuals to manage their condition confidently. Maintaining muscle strength through physical activity can alleviate symptoms, reduce fear of movement which will enhance overall health. Supporting people in their exercise routines can greatly improve their health and wellness.
Exercise has been shown to be the best treatment for people who have trouble with their osteoarthritis.
Obesity increases the risk of osteoarthritis in the hip and knee in 2 ways:
Obesity accelerates cartilage breakdown which will worsen osteoarthritis symptoms. Weight loss is therefore essential for reducing pain and improving function in overweight individuals.
For individuals with moderate symptoms, initial treatment involves education, exercise, and weight management. If symptoms get worse despite these strategies, medications and assistive devices like walking aids and insoles can be added, along with continued exercise.
Various medications can manage OA symptoms, some OTC, others by prescription.
Acetaminophen (for example Tylenol) is usually the first choice for pain relief for osteoarthritis. It gives the fewest side effects and can be used as needed. Too much can damage the liver, therefore you should not go over the prescribed dose.
NSAID / COX-inhibitors (for example Ibuprofen, Motrin, Advil and Naproxen) can be used when Acetaminophen is not working well enough. These can also be used if the joints are hot and swollen. These drugs control pain, swelling and stiffness but may cause side effects.
Corticosteroid injection (cortisone) may also be used if the joint is hot and swollen. This can decrease pain in 1-4 weeks. Research has not found any long-term effects from corticosteroid injections.
Glucosamine and/or chondroitin sulphate are found naturally in the joints. They can be found in foods and through supplements. More research is still needed to know if some individuals will benefit from glucosamine and/or chondroitin sulphate supplements. Currently, groups of people taking these supplements do not benefit more than people taking a placebo or sugar pill. To see if either of these supplements might work for you, try taking it for six weeks without changing your daily routine. Stop taking the supplement after six weeks. If you felt better while taking the supplement than since stopping, it may be working for you.
There are a number of aids that can be used to assist individuals with osteoarthritis who are experiencing significant pain and disability. They include:
For individuals who are experiencing severe disease that is causing them sufficient pain and disability limiting their daily physical activity, surgery is an option that may be considered.
Arthroplasty is the name for joint replacement surgery in which the failed joint is removed and replaced with artificial joint surfaces of metal and plastic. This is a common procedure for people with severe hip and knee osteoarthritis. The biggest gain after the surgery is that the pain diminishes or disappears completely. Following the surgery, range of motion in the joint is still slightly limited.
In cases of severe deformity, like knock-knee or bow-leg, where only one part of the knee has thin or no articular cartilage while the other remains healthy, an osteotomy can be beneficial. This surgical procedure involves removing a wedge-shaped portion of the lower leg bone to redistribute load through the knee. The relatively unaffected compartment of the knee bears more load after the procedure. Surgeons use metal plates and screws to support the bone as it heals properly post-osteotomy.
There are some additional treatments that may help you in managing your osteoarthritis symptoms including:
If these treatments help you to control your pain your GLA:D™ Canada trainers may be able to build them into you program while you exercise to maximize the benefits in gaining joint stability.