Osteoarthritis is a common condition that affects the joints as we age. In a fit and healthy young adult, the bones that make up the major joints are cushioned by cartilage and fluid, which prevent the edges of the bones at the hip, knee, elbow, wrist and other joints rubbing together. Cartilage can thin with age, and wear away; once there is friction between bones this causes inflammation and damage, making the joint stiff and painful. Osteoarthritis treatment then becomes necessary to reduce symptoms and to prevent joint damage as much as possible. Various osteoarthritis treatments are available for different stages of the disease.
Once you have been diagnosed with osteoarthritis, treatment in the early stages usually takes the form of lifestyle changes; later on medical and surgical osteoarthritis treatments can help you keep moving around and make sure you are free from pain.
This article on osteoarthritis treatment is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
Treatment in the early stages
Aches and pains affect everyone from time to time but when you start to get pain related to one of your joints and this persists for weeks and months, it may be that you are in the early stages of osteoarthritis. Your GP can refer you to a specialist for an accurate diagnosis; your joints will be examined for pain and stiffness and X-rays will be taken to assess the extent of joint damage.
Early diagnosis is important because self-help osteoarthritis treatment can help relieve pain and stiffness and can delay the progress of the disease:
- Losing weight is a very effective osteoarthritis treatment as this takes pressure off load-bearing joints such as the hips and knees.
- Taking more exercise is very useful as it strengthens the muscles, ligaments and tendons, helping to support the joint itself. Exercise may seem a strange osteoarthritis treatment but it does not wear out the joint even more if the correct type of exercise is done. Swimming or walking is excellent but taking up a contact sport is probably not a good idea.
- Eating a healthy diet is always beneficial and it may help you lose weight if you need to. There are some suggestions that eating a diet rich in fish oils may be an effective osteoarthritis treatment; this has not been demonstrated definitely, but many people find it helps.
Self-help osteoarthritis treatments can only work for a time; osteoarthritis is a progressive disease that does not go into remission by itself. When a hip or knee joint becomes particularly painful and stiff, this can make walking and getting around difficult. Your GP will probably suggest the following medical osteoarthritis treatments:
- Paracetamol is a good starting point to relieve pain that is not too severe. It is effective as an early stage osteoarthritis treatment but you need to be careful to never exceed the maximum daily dose as paracetamol taken in excess causes liver damage. For more serious pain, paracetamol can be combined with codeine.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in osteoarthritis treatment. Drugs such as ibuprofen or the newer generation of NSAIDs that inhibit the COX-2 enzyme reduce pain and the swelling in and around the joints. Side effects include stomach problems as the drugs block some of the enzymes that create the protective lining to the gut; and you may also need to take a proton-pump inhibitor to protect the stomach from damage.
- Injections into the joint can also be used as an osteoarthritis treatment to reduce inflammation and pain in a specific joint that becomes very troublesome. These can be repeated if they work well, providing good symptom control for several months.
Once the inner surfaces of the joint have been exposed and the bones are grating together causing unrelenting pain and making getting around very difficult, surgical osteoarthritis treatment is probably the best option. Thousands of hip replacements and knee replacements are performed each year in the UK, both on the NHS and in private hospitals, and are considered to be extremely effective osteoarthritis treatments. The diseased joint is removed and replaced by an artificial joint made from metal and a medical grade plastic.
Joint replacement operations are major procedures that are considered only when other osteoarthritis treatments fail to have a beneficial effect. People who have had the surgery report that although they do have some discomfort for a couple of weeks after the operation as the wound heals, the terrible joint pain is just not there when they come round from the anaesthetic.
In addition to joint replacements, there are other surgical approaches to osteoarthritis treatment. The hip joint can be ‘capped’ with metal, for example, preventing it from further deterioration. It is also possible to have an osteotomy to insert a piece of bone to take the weight of the body off the knee joint. This is a more common osteoarthritis treatment in people whose condition is due to repeated sports injuries.
Alternative osteoarthritis treatments such as acupuncture, aromatherapy and massage may help you cope with the pain but none have been scientifically proven to be effective on the underlying joint disease. Some people swear by dietary supplements containing fish oils, glucosamine and chondroitin but, again, there is no hard evidence that they help with joint mobility or prevent progression of osteoarthritis. If you have sore joints in your hands and wrists, rubbing the skin with oils or creams containing rubefacients, which make the skin red and warm, can provide some relief as this helps to block pain signals from the joints to the brain.