Conditions in Depth
This page contains the basic information about Osteoarthritis .
Return to the Osteoarthritis Main Condition Center
Treatment
Treatment focuses on managing pain and maintaining the ability to use the joint.
An over-the-counter painkiller, such as acetaminophen (Tylenol), can help to ease stiffness and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin and others) or naproxen (Aleve, Naprosyn and others) also may help. However, NSAIDs may be unsafe for people at high risk of developing ulcers, including people who have had ulcers in the past and the elderly. For these people, newer medications called cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib (Celebrex), may be less irritating to the stomach and intestines but has similar effectiveness as older medicines. Stomach problems, including ulcers, are the most common side effects of these medications. Other pain medications, such as tramadol (Ultram) or codeine-type medicines, may be prescribed if the other medicines don't work.
In some instances, when inflammation is significant, your health care professional may remove fluid from the joint and inject the joint with a corticosteroid drug. However, these drugs can damage the joint if they are used too much, so your health care professional will use them only when absolutely necessary.
Another approved treatment for osteoarthritis of the knee is hyaluronate injections. Hyaluronate is a natural substance in joints that provides lubrication. The injectable hyaluronate drugs are synthesized forms that can be injected one time or weekly for three to five weeks. Some studies suggest that these injections help, although others have found no benefit.
Studies also suggest that an over-the-counter supplement called glucosamine sulfate is safe and may help people with osteoarthritis in the knees. A study published in 2001 described improvement over three years for patients taking 1,500 milligrams of glucosamine a day compared with a placebo (an inactive pill). A newer study in 2006 found that glucosamine seems to work better when combined with chondroitin for moderate to severe osteoarthritis. However, there is no compelling evidence that joint deterioration can be slowed or stopped by treatment with glucosamine. The issue continues to be studied. Over-the-counter creams containing capsaicin applied to the skin over painful joints also may help.
Applying heat or cold can relieve pain temporarily. Your doctor also can advise you on the use of heating pads, hot baths and ice packs to ease the discomfort.
Your doctor likely will suggest that you do certain exercises to reduce stiffness and improve your ability to move the joints. Because extra pounds put pressure on sensitive joints, it is important that you lose excess weight. In addition, if you have osteoarthritis of the spine, it is important to maintain good posture to distribute weight and pressure evenly throughout the body. Physical therapists can be helpful in recommending (and supervising) an exercise program and measures to reduce joint stress.
In severe cases where deterioration is significant, your doctor may recommend surgery to correct deformity in a joint or to reconstruct or replace a hip or knee joint.
From Health A-Z, Harvard Health Publications. Copyright 2006 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.