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Osteoarthritis - Treatment

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of the most common form of arthritis.

Alternative Names

Arthritis - osteoarthritis

Treatment:

Osteoarthritis itself is not life threatening, but a person's quality of life can significantly deteriorate as a result of pain and lost mobility. No treatment can cure osteoarthritis, and none can alter its progression with certainty, but many available treatments can relieve symptoms and significantly improve the quality of life.

The goals of osteoarthritis treatment are to reduce pain and improve joint function. Treatment approaches include:

Lifestyle Changes. Lifestyle modifications and non-drug therapies are an important first step for treatment, and are used in combination with other treatment modalities. Lifestyle measures include exercise, weight loss, hot and cold therapies, and pain management techniques.
Medications. For mild pain relief, doctors recommend acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and topical ointments. Patients with more severe pain may require stronger narcotic pain medication, corticosteroid injections, or visco-supplementation with injections of hyaluronic acid drugs.
Surgery. For severe osteoarthritis that is not helped by other treatments, surgery such as joint replacement may be considered.

Resources

www.rheumatology.org -- American College of Rheumatology
www.arthritis.org -- Arthritis Foundation
www.niams.nih.gov -- National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.aaos.org -- American Academy of Orthopaedic Surgeons

References

Brouwer RW, Raaij van TM, Bierma-Zeinstra SM, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2007;(3):CD004019.

Cepeda MS, Camargo F, et al. Tramadol for osteoarthritis: a systematic review and metaanalysis. J Rheumatol. 2007;34(3):543-555.

Das A, Neher JO, Safranek S. Clinical inquiries. Do hyaluronic acid injections relieve OA knee pain? J Fam Pract. 2009 May;58(5):281c-e.

Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD004376.

Gregory PJ, Sperry M, Wilson AF. Dietary supplements for osteoarthritis. Am Fam Physician. 2008;77(2):177-184.

Gutierrez GP. Managing osteoarthritis: what's best for your patient? J Fam Pract. 2008 Oct;57(10):644-50.

Hamel MB, Toth M, Legedza A, et al. Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: decision making, postoperative recovery, and clinical outcomes. Arch Intern Med. 2008;168(13):1430-1440.

Harris ED Jr., Barnett GD, Budd RC, et al., eds. Kelley's Textbook of Rheumatology, 7th ed. Philadelphia, PA: Saunders; 2005.

Hernández-Molina G, Reichenbach S, Zhang B, Lavalley M, Felson DT. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheum. 2008 Sep 15;59(9):1221-8.

Hunter DJ. In the clinic: Osteoarthritis. Ann Intern Med 2007;147(3):ITC8-1-ITC8-16.

Lane NE. Clinical practice. Osteoarthritis of the hip. N Engl J Med. 2007;357(14): 1413-1421.

Lange AK, Vanwanseele B, Fiatarone Singh MA. Strength training for treatment of osteoarthritis of the knee: a systematic review. Arthritis Rheum. 2008 Oct 15;59(10):1488-94.

Laupattarakasem W, Laopaiboon M, Laupattarakasem P, et al. Arthroscopic debridement for knee osteoarthritis. Cochrane Database Syst Rev. 2008;(1):CD005118.

Leopold SS. Minimally invasive total knee arthroplasty for osteoarthritis. N Engl J Med. 2009 Apr 23;360(17):1749-58.

Manheimer E, Linde K, Lao L, et al. Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med. 2007;146(12):868-877.

Rozendaal RM, Koes BW, van Osch GJ, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. 2008;148(4):268-277.

Sun BH, Wu CW, Kalunian KC. New developments in osteoarthritis. Rheum Dis Clin N Am. 2007;(33):-135-148.

Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16(2):137-162.

Reviewed last on: 6/23/2009
Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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