Treatment

Currently, the process underlying osteoarthritis cannot be reversed, but symptoms can usually be effectively managed with lifestyle changes, physical and other therapies, medications, and surgery. Exercising and achieving a healthy weight are generally the most important ways to treat osteoarthritis. Your doctor may also suggest:

Medications

Osteoarthritis symptoms, primarily pain, may be helped by certain medications, including:

  • Acetaminophen. Acetaminophen (Tylenol, others) has been shown to be effective for people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dosage of acetaminophen can cause liver damage.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, including ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve, others), taken at the recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs, available by prescription, may also slightly reduce inflammation along with relieving pain.

    NSAIDs can cause stomach upset, cardiovascular problems, bleeding problems, and liver and kidney damage. Topical NSAIDs have fewer side effects and may relieve pain just as well.

  • Duloxetine (Cymbalta). Normally used as an antidepressant, this medication is also approved to treat chronic pain, including osteoarthritis pain.

Therapy

  • Physical therapy. A physical therapist can work with you to create an individualized exercise program that will strengthen the muscles around your joint, increase your range of motion and reduce pain. Regular gentle exercise that you do on your own, such as swimming or walking, can be equally effective.
  • Occupational therapy. An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have finger osteoarthritis. A bench in your shower could help relieve the pain of standing if you have knee osteoarthritis.
  • Tai chi and yoga. These movement therapies involve gentle exercises and stretches combined with deep breathing. Many people use these therapies to reduce stress in their lives, and research suggests that tai chi and yoga may reduce osteoarthritis pain and improve movement. When led by a knowledgeable instructor, these therapies are safe. Avoid moves that cause pain in your joints.

Surgical and other procedures

If conservative treatments don't help, you may want to consider procedures such as:

  • Cortisone injections. Injections of corticosteroid medications may relieve pain in your joint. During this procedure your doctor numbs the area around your joint, then places a needle into the space within your joint and injects medication. The number of cortisone injections you can receive each year is generally limited to three or four injections, because the medication can worsen joint damage over time.
  • Lubrication injections. Injections of hyaluronic acid may offer pain relief by providing some cushioning in your knee, though some research suggests these injections offer no more relief than a placebo. Hyaluronic acid is similar to a component normally found in your joint fluid.
  • Realigning bones. If osteoarthritis has damaged one side of your knee more than the other, an osteotomy might be helpful. In a knee osteotomy, a surgeon cuts across the bone either above or below the knee, and then removes or adds a wedge of bone. This shifts your body weight away from the worn-out part of your knee.
  • Joint replacement. In joint replacement surgery (arthroplasty), your surgeon removes your damaged joint surfaces and replaces them with plastic and metal parts. Surgical risks include infections and blood clots. Artificial joints can wear out or come loose and may need to eventually be replaced.

Alternative medicine

Various complementary and alternative medicine may help with osteoarthritis symptoms. Treatments that have shown promise for osteoarthritis include:

  • Acupuncture. Some studies indicate that acupuncture can relieve pain and improve function in people who have knee osteoarthritis. During acupuncture, hair-thin needles are inserted into your skin at precise spots on your body.
  • Glucosamine and chondroitin. Studies have been mixed on these nutritional supplements. A few have found benefits for people with osteoarthritis, while most indicate that these supplements work no better than a placebo.

    Don't use glucosamine if you're allergic to shellfish. Glucosamine and chondroitin may interact with blood thinners such as warfarin and cause bleeding problems.

  • Avocado-soybean unsaponifiables. This nutritional supplement — a mixture of avocado and soybean oils — is widely used in Europe to treat knee and hip osteoarthritis. It acts as an anti-inflammatory, and some studies have shown it may slow down or even prevent joint damage.
April 22, 2016
References
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