Treatment for osteoarthritis

treatment

Currently, there’s no known cure for cartilage loss in osteoarthritis. Treatment focuses on symptom reduction and improving joint function. 

    • Education about osteoarthritis is important to understand the condition. 
    • Exercises can alleviate pain and enhance joint function. 
    • Once function improves, increasing physical activity is recommended to maintain weight loss and overall health. Early intervention, including information, exercise, and weight reduction if needed, is crucial for managing osteoarthritis symptoms. 

Management Pyramid

The management pyramid provides a visual representation of recommended treatment approaches.

 

Level 1 – MINOR symptoms

 Individuals experiencing osteoarthritis symptoms or at high risk of developing it should receive intervention to prevent progression or symptom development. 

This includes:

    • Disease information.
    • Joint stability training.
    • Promoting stability in daily activity.
    •  Weight reduction as needed.

 

Education

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, physical activity and joint stability

Exercise has been shown to be the best treatment for people who have trouble with their osteoarthritis. 

    • Exercise reduces pain and makes it easier for people to do their daily activities. 
    • Being active can lead to lots of positive things like a strong heart and good overall health. 
    • It is easier to control your weight with exercise compared to without exercise.

 

Weight control and reduction

Obesity increases the risk of osteoarthritis in the hip and knee in 2 ways:

  1. Higher joint load: Even a small weight difference significantly impacts joint stress. 
  2. Metabolic changes associated with obesity.

Obesity accelerates cartilage breakdown which will worsen osteoarthritis symptoms. Weight loss is therefore essential for reducing pain and improving function in overweight individuals.

 

Level 2 – MODERATE symptoms

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.

 

Medication

 Various medications can manage OA symptoms, some OTC, others by prescription.

    • They come in oral, topical, and injectable forms.
    • Consulting a primary care provider is advised for proper medication use.
    • Adherence to prescription and awareness of potential side effects are crucial.

 

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.

 

Assistive devices

There are a number of aids that can be used to assist individuals with osteoarthritis who are experiencing significant pain and disability. They include:

  • Shoe inserts that change the weight bearing patterns through the leg can off load the knee thereby reducing symptoms
  • Braces, such as knee braces, which wrap around the joint to help to stabilize it and decrease some of the load going through the joint
  • Walking aids can be used by individuals who are limited in their walking related to the pain and disability within their hip or knee joints.

Level 3 – SEVERE disease

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/Joint replacement


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.

 

Osteotomy

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.

 

Additional treatments

There are some additional treatments that may help you in managing your osteoarthritis symptoms including:

  • Hot/cold packs
  • TENS (Transcutaneous Electrical Nerve Stimulation)
  • Acupuncture

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.

Patients who have gone through the GLA:D™ Canada program are invited to share their feedback with this short form.


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