Treatment:

OA cannot be cured. It will also most likely become worse over time. However, your OA symptoms can be controlled.

While you can always have surgery, other therapies can improve your pain and make your life much better. Although these treatments cannot make the arthritis go away, they can often delay surgery.

MEDICATIONS

Over-the-counter pain relievers, which you can buy without a prescription, can help with OA symptoms.

• Most doctors recommend acetaminophen (Tylenol) first, because it has fewer side effects than other drugs.
• If your pain continues, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs help relieve pain and swelling. Types of NSAIDs include aspirin, ibuprofen, and naproxen.
• Taking acetaminophen or another pain pill before exercising is okay. However, do not overdo the exercise because you have taken medicine.
• If you are taking pain relievers on most days, tell your doctor. You may need to be watched for side effects, such as ulcers and bleeding. These drugs may also increase the risk for heart attacks and strokes.

Corticosteroids injected right into the joint can also be used to reduce swelling and pain. However, relief only lasts for a limited time. More than two or three injections a year may be harmful.

Many people use over-the-counter remedies such as glucosamine and chondroitin sulfate.

• These supplements may help control pain, although they do not seem to help your joint grow new cartilage.
• Some doctors recommend a trial period of 3 months to see whether glucosamine and chondroitin work.

Capsaicin (Zostrix) skin cream may help relieve pain. You may feel a warm, stinging sensation when you first apply the cream. This sensation goes away after a few days of use. Pain relief usually begins within 1 - 2 weeks.

Artificial joint fluid (Synvisc, Hyalgan) can be injected into the knee. It may relieve pain for 3 - 6 months.

LIFESTYLE CHANGES

Exercise helps maintain joint and overall movement. Ask your health care provider to recommend an appropriate home exercise routine. Water exercises, such as swimming, are especially helpful.

Other lifestyle recommendations include:

• Applying heat and cold
• Eating a healthy, balanced diet
• Getting rest
• Losing weight if you are overweight
• Protecting the joints

As the pain from your hip or knee OA becomes worse, keeping up with everyday activities may become more difficult or painful.

• Sometimes making changes around the home will take some stress off your joints, and relieve some of the pain.
• People whose work is causing stress in certain joints should find ways to reduce trauma. You may need to adjust your work area or change work tasks.

PHYSICAL THERAPY

Physical therapy can help improve muscle strength and the motion of stiff joints, as well as your sense of balance. Therapists have many techniques for treating OA. If therapy does not make you feel better after 6 - 8 weeks, then it likely will not work at all.

Massage therapy may also help provide short-term pain relief. Make sure you work with an experienced massage therapist who understands how to work with sensitive joint areas.

BRACES

Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement. You should use a brace only when your doctor or therapist recommends one. Using a brace the wrong way can cause joint damage, stiffness, and pain.

ALTERNATIVE TREATMENTS

Acupuncture is a treatment based on Chinese medicine. How it works is not entirely clear. Some studies have found that acupuncture may provide short-term pain relief for people with OA.

S-adenosylmethionine (SAMe, pronounced "Sammy") is a man-made form of a natural byproduct of the amino acid methionine. It has been marketed as a remedy for arthritis, but scientific evidence to support these claims is lacking.

SURGERY

Severe cases of OA might need surgery to replace or repair damaged joints. Surgical options include:

• Arthroscopic surgery to trim torn and damaged cartilage
• Changing the alignment of a bone to relieve stress on the bone or joint (osteotomy)
• Surgical fusion of bones, usually in the spine (arthrodesis)
• Total or partial replacement of the damaged joint with an artificial joint (knee replacement, hip replacement, shoulder replacement, ankle replacement, elbow replacement)

Support Groups:

For more information and support, see arthritis resources.

Expectations (prognosis):

Every person with OA is different. Pain and stiffness may prevent one person from performing simple daily activities, while others are able to maintain an active lifestyle that includes sports and other activities.

Your movement may become very limited. Treatment generally improves function.

Complications:

• Adverse reactions to drugs used for treatment
• Decreased ability to perform everyday activities, such as personal hygiene, household chores, or cooking
• Decreased ability to walk
• Surgical complications

Calling your health care provider:

Call your health care provider if you have symptoms of OA.