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Osteoarthritis (cont.)

IN THIS ARTICLE

What Is the Treatment for Osteoarthritis?

The overall goal of treatment is early elimination of risk factors, early diagnosis and surveillance of the disease, and appropriate treatment of pain. It's also important to help people regain their mobility. These goals may be reached through a logical approach to care, including the overlapping of treatment that does not involve medications and treatment with medication and possibly surgical management.

Treatment that does not involve medications includes education, physical and occupational therapy, weight reduction, exercise, and assistive devices (orthoses).

What Are the Medications for Osteoarthritis?

Initially, simple over-the-counter pain relievers such as acetaminophen are recommended, followed by NSAIDs. Prescription NSAIDs may be needed if the over-the-counter medications are ineffective. A new generation of prescription NSAIDs are the COX-2 medicines (celecoxib [Celebrex]). The COX-2 drugs have fewer reported gastrointestinal side effects but similar results compared to the typical NSAIDs.

The antidepressant duloxetine (Cymbalta) is now approved by the Food and Drug Administration (FDA) for chronic musculoskeletal pain (joint and muscle pain). This medication works on neurotransmitters in the brain that control pain perception and has been shown to decrease chronic low back pain and pain caused by knee osteoarthritis.

What Is the Surgery for Osteoarthritis?

Surgery may relieve pain and improve function.

  • Arthroscopy is the examination of the inside of a joint using a small camera (endoscope). Arthroplasty is the repair of a joint in which the joint surfaces are replaced with artificial materials, usually metal or plastic.
  • Osteotomy is incision or cutting of bone.
  • Chondroplasty is surgical repair of the cartilage.
  • Arthrodesis is a surgical fusion of the bony ends of a joint preventing joint movement. For example, fusion of an ankle joint prevents any further joint movement of the ankle itself. This is done as a result of many years of significant joint pain resulting from a previous significant injury or severe osteoarthritis. The procedure is performed to help block further pain by preventing any further joint movement.
  • Joint replacement is removal of diseased or damaged bony ends and replacement with a manmade joint composed of a combination of metal and plastic. Knee joint replacement and hip replacement are the most common. Some joints, such as those of the spine, cannot be replaced presently.

What Is the Follow-up for Osteoarthritis?

Use medications in the prescribed manner and watch for side effects. This is especially important with the NSAIDs. Acetaminophen, however, may also have side effects if you take too much or if you have liver disease.

How Can You Prevent Osteoarthritis?

No absolute way to prevent osteoarthritis is available. Lifestyle changes may reduce or limit symptoms.

What Is the Prognosis for Osteoarthritis?

A single prognosis is difficult to establish because of the variety of factors influencing the disease. It also may be important to look at the particular joint involved rather than lumping all the joints together to predict the outcome. For example, the prognosis for hip osteoarthritis may be different than the prognosis for hand osteoarthritis. Symptoms may not be able to be predicted based on X-rays, because some people experience a great deal of pain with only mild osteoarthritis on X-ray, and some people experience only mild pain while their X-rays show severe osteoarthritis. But a few studies may predict joint deterioration.

Some findings suggest that the following are true:

  1. Narrowing of the joint space seems to be linked with deterioration of the condition.
  2. The presence of osteoarthritis of the hands is a predictive sign for deterioration of the knee joints.
  3. People with rapid progression seemed to have knee pain upon entry into clinical studies.

Future research into causes of joint pain in patients with osteoarthritis will likely lead to improved treatments. Ongoing scientific studies are encouraging and include work looking at the effects of antibodies against nerve growth factor, which seems to play a role in pain perception in those afflicted by osteoarthritis of the knees and hips.

Medically Reviewed by a Doctor on 9/8/2017

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Osteoarthritis - Experience

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Osteoarthritis - Symptoms

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Osteoarthritis - Prognosis

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Osteoarthritis - Treatment

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Read What Your Physician is Reading on Medscape

Osteoarthritis »

Osteoarthritis (OA) is the most common articular disease worldwide, affecting over 20 million individuals in the United States alone.

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