Treatment of Osteoarthritis

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Apart from joint replacement, there is no specific remedy for osteoarthritis. However, there are lots of ways to relieve the symptoms. It is important to avoid too much stress or injury to the joints. Losing excess weight is very helpful. Rubber heels on shoes and using a walking stick can reduce impact on the joints.

There are several aspects to treatment, including:

preventing the condition from getting worse, or at least slowing down its progression,
doing everything possible to deal with the existing problems,
controlling pain,
adjusting your lifestyle, and
maintaining the best achievable fitness.

The first step is to shed excess weight. This in itself can greatly reduce the severity of symptoms. At the same time, an exercise program should be set up to improve your general health and the health of affected joints. Regular stretching can help to increase range of movement in the joints. Exercises must be prescribed by your doctor and done under medical or paramedical supervision. Physiotherapists are trained in this work.

It is dangerous to avoid moving the joint. This can speed the progress and worsen the outlook of the disease. Properly conducted exercise can halt the progress and even, to some extent, reverse the severity of osteoarthritis, especially of the hips and knees.

Drug treatment can also be important. This includes pain control and, in some cases, relief of muscle spasm. Aspirin or one of the other non-steroidal anti-inflammatory drugs (NSAIDs) is often all that is required to relieve pain. Paracetamol has been proven to be just as effective in relieving the pain of osteoarthritis as NSAIDs, and along with other newer drugs has less effect on the stomach lining, which is one of the problems with aspirin and older anti-inflammatory drugs. However, people with existing liver damage may be advised not to take low doses of paracetamol over a long period. The use of NSAIDs may increase the risk to older people of damage to their kidneys or stomach lining.

In some cases, injecting corticosteroids into the affected joint can markedly reduce pain and disability. Physiotherapy may help, and muscle strength in the legs should be kept up by, for example, swimming. Some evidence suggests that the dietary supplement glucosamine probably improves osteoarthritis symptoms. In severe cases of persistent pain and disablement, joint replacement should be considered. This can be a very successful procedure.

Surgery to replace joints is viewed only as a last resort, but is considered before total loss of function occurs. There is now a lot of surgical experience of hip and knee replacement for osteoarthritis, and the results are usually very good. Other joints affected by osteoarthritis can also be replaced.