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What is the treatment for osteoarthritis?
Mild cases are treated with nonsteroidal anti-inflammatory drugs (NSAIDs). These include acetaminophen (paracetamol) - which mainly reduces the pain - and agents such as diclofenac, ibuprofen and naproxen. High doses are often required. All NSAIDs act by inhibiting the formation of prostaglandins, which play a central role in inflammation and pain. Unfortunately, there is an increased risk of peptic ulceration with earlier NSAIDs. COX-2 selective inhibitors (such as valdecoxib, celecoxib,
and the withdrawn rofecoxib) reduce this risk substantially. The substances glucosamine and chondroitin sulphate have recently been shown to improve symptoms of osteoarthritis. However, recent evidence shows that glucosamine is not effective in treating osteoarthritis of the knee (McAlindon et al 2004). Another nutritional supplement showing promise is S-adenosyl-methionine. Small scale studies have shown it to be as effective as NSAIDs in reducing pain although it takes about four weeks for the effect to take place. A newer treatment that may help is a series of injections of a substance called hyaluronate (brand names Synvisc and Hyalgan). Hyaluronate is a chemical that provides lubrication and nutrition to the joint. Synvisc and Hyalgan are synthesized forms that can be injected weekly for three to five weeks into an osteoarthritic knee. Some studies suggest that these injections help, although others have found no benefit.
Severe pain in specific joints can be treated with local injections with lidocaine (or similar local anaesthetics) and glucocorticoids (such as hydrocortisone). If the above management is ineffective, surgery (joint replacement) may be required. Individuals with very painful osteoarthritic joints may require surgery such as fragment removal, repositioning bones, or fusing bone to increase stability and reduce pain. For severe pain, narcotic pain relievers such as tramadol and eventually opioids (hydrocodone, oxycodone or morphine) may be necessary; this is reserved for very severe cases and is rarely necessary. Surgery may help when all other treatments fail to relieve pain. Some joints, most commonly the hip and knee, can be replaced with an artificial joint; replacement is usually very successful, almost always improving motion and function and dramatically decreasing pain. Therefore, joint replacement should be considered when function becomes limited. Because the artificial joint does not last forever, such surgery is often delayed as long as possible in young people so the need for repeated replacements can be minimized. A variety of methods that restore cells inside cartilage have been used in younger people with osteoarthritis to help heal small defects in cartilage. However, such methods have not yet been proven valuable when cartilage defects are extensive, as commonly occurs in older people.
Joint replacement involves removing the arthritic portions of the joint and replacing them with a plastic and metal artificial joint. It is generally available for hip, knee, shoulder, and elbow joints and is very effective for relieving pain at these joints. Patients usually maintain good range of motion after surgery. Joint replacement is usually recommended for older patients, but is sometimes performed on younger patients as well. At the hip and knee, an uncomplicated joint replacement has an approximately 85% chance of being intact and functioning after 15 years. The overall results of joint replacement in properly selected patients are excellent and most patients have little or no pain after recovery from the surgery. The hospital stay is between four and six days, with full recovery between six weeks and three months. Following a hip or knee replacement, patients can drive, walk as far as they would like, ride an exercise bicycle, swim, play golf, dance, bike, and enjoy most other activities that do not involve repeated jumping or twisting.
Patients with osteoarthritis are encouraged to exercise as a way of keeping joint cartilage lubricated. Exercises that increase balance, flexibility, and range of motion are recommended for osteoarthritis patients. These may include walking, swimming and other water exercises, yoga and other stretching exercises, or isometric exercises. Appropriate exercises - including stretching, strengthening, and postural exercises - help maintain healthy cartilage, increase a joint's range of motion, and strengthen surrounding muscles so that they can absorb shock better. Exercise must be balanced with rest of painful joints, but immobilizing a joint is more likely to worsen osteoarthritis than to improve it. Using excessively soft chairs, recliners, mattresses, and car seats may worsen symptoms; using car seats moved forward, straight-backed chairs with relatively high seats (such as kitchen or dining room chairs), firm mattresses, and bed boards (available at many lumber yards) is often recommended. For osteoarthritis of the spine, specific exercises sometimes help, and back supports or braces may be needed when pain is severe. Exercises should include both muscle strengthening as well as low impact aerobic exercises (such as walking, swimming, and bicycle riding). If possible, the person should maintain ordinary daily activities and continue to perform his or her normal activities, such as a hobby or job. However, physical activities may have to be adjusted to avoid bending and thus aggravating the pain of osteoarthritis.
More information on osteoarthritis and other arthritis conditions (rheumatoid arthritis, septic arthritis, psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, gout)
What is osteoarthritis? - Osteoarthritis (OA), also known as arthrosis or degenerative joint disease, is a disease featuring pain and impaired function of the joints.
What causes osteoarthritis? - Primary osteoarthritis is mostly related to aging. Osteoarthritis results from a combination of genetic predisposition and joint injuries.
What're the risk factors for osteoarthritis? - Risk factors for osteoarthritis are congenital hip luxation, obesity, osteoporosis, and inflammatory diseases.
What're the complications of osteoarthritis? - The major complication of osteoarthritis is pain. The degree of pain can vary greatly. Osteoarthritis itself is not life threatening.
What are symptoms of osteoarthritis? - The main symptoms of osteoarthritis are is pain that worsens during activity and that gets better during rest.
How is osteoarthritis diagnosed? - The doctor makes the diagnosis of osteoarthritis based on the characteristic symptoms, physical examination, and the x-ray appearance of joints.
What's the treatment for osteoarthritis? - Osteoarthritis is treated with nonsteroidal anti-inflammatory drugs. Severe pain in specific joints can be treated with local injections with lidocaine.
What're the medications for osteoarthritis? - Acetaminophen is used for mild to moderate osteoarthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs) or COX-2 medications for moderate to severe arthritic pain.
What nutritional supplements cure osteoarthritis? - A combination of glucosamine and chondroitin sulfate is used as a dietary supplement to cure osteoarthritis. Vitamin D and calcium are recommended for strong bones.
Treatments for osteoarthritis pain relief - OTC pain relievers like acetaminophen (Tylenol) and aspirin are familiar choices for the treatment of osteoarthritis pain relief.
What osteoarthritis exercise is suggested? - Regular exercise is very important for successful control of osteoarthritis. Exercise helps patients ostearthritis in the hip or in the knee.
Can osteoarthritis be prevented? - Obese people are at risk of osteoarthritis and that weight loss can help prevent or delay osteoarthritis from occurring.
What is osteoarthritis of the hip? - Osteoarthritis of the hip can cause insidious pain in the groin or inguinal region and, on occasion, pain in the side of the buttock or upper thigh.
What is arthritis? - Arthritis is a group of conditions that affect the health of the bone joints in the body. Arthritis is painful inflammation of a joint or joints of the body.
What types of arthritis are there? - Types of arthritis include osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, gout, infectious arthritis, fibromyalgia, lupus.
What causes arthritis? - The causes of arthritis depend on the form of arthritis. The cause of arthritis may be an infection, injury, abnormality of the immune system, aging.
What're the risk factors for arthritis? - Risk factors for arthritis include age, gender, obesity, injury, ethnicity. The risk of developing arthritis increases with age.
What're the signs and symptoms of arthritis? - Different types of arthritis have different symptoms. Other arthritis symptoms include fatigue, fever, a rash and the signs of joint inflammation.
How is arthritis diagnosed? - The diagnosis of arthritis is based on the pattern of symptoms, medical history, family history, physical examination, X-rays and lab tests.
What's the treatment for arthritis? - The objectives in the treatment of arthritis are controlling inflammation, preserving joint function, and curing the disease if that is possible.
Therapies for arthritis pain relief - Short-term relief for arthritis pain and inflammation may include pain relievers. NSAIDs are used to reduce pain and inflammation.
What natural therapies are available to cure arthritis? - Natural therapies for arthritis pain relief include glucosamine, chondroitin sulfates, nettle leaf, S-adenosylmethionine, and exrutine.
What can be done to prevent arthritis? - Consumption of green tea may prevent arthritis damage and benefit the arthritis patient by reducing inflammation and slowing cartilage breakdown.
What is the Arthritis Foundation? - The Arthritis Foundation is the only nationwide, nonprofit health organization helping take greater control of arthritis in the United States.
What is rheumatoid arthritis? - Rheumatoid arthritis (RA) is an autoimmune disorder that marked by stiffness and inflammation of the joints, weakness, loss of mobility, and deformity.
What causes rheumatoid arthritis? - The cause of rheumatoid arthritis (RA) is unknown. Rheumatoid arthritis involves an attack on the body by its own immune cells (auto-immune disease).
What're the symptoms of rheumatoid arthritis? - The symptoms that distinguish rheumatoid arthritis are inflammation and soft-tissue swelling of many joints at the same time (polyarthritis).
How is rheumatoid arthritis diagnosed? - Health professionals diagnose rheumatoid arthritis by examining joints and evaluating ymptoms, medical history, and results of several tests.
What's the treatment for rheumatoid arthritis? - The treatment of rheumatoid arthritis includes the use of non-drug treatment such as rest and physiotherapy, drugs may be required both to control symptoms of the disease.
What rheumatoid arthritis medications are available? - Rheumatoid arthritis medications include nonsteroidal anti-inflammatory drugs, injectable gold salts, plaquenil or hydroxychloroquine.
What rheumatoid arthritis diet is suggested? - Certain vitamin supplements may be beneficial. Many herbs also are useful in the treatment of rheumatoid arthritis.
What is juvenile rheumatoid arthritis? - Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger that causes inflammation and stiffness of joints for more than six weeks.
What causes juvenile rheumatoid arthritis? - Juvenile rheumatoid arthritis is an autoimmune disorder. Juvenile rheumatoid arthritis is considered to be a multifactorial condition.
What're the symptoms of juvenile rheumatoid arthritis? - Symptoms of juvenile rheumatoid arthritis may appear during episodes (flare-ups) or may be chronic and continuous.
How is juvenile rheumatoid arthritis diagnosed? - Diagnosis of juvenile rheumatoid arthritis is often made on the basis of the child's collection of symptoms.
What're the treatments for juvenile rheumatoid arthritis? - The treatment of juvenile rheumatoid arthritis centers on decreasing joint inflammation, suppressing pain, and preserving movement.
What is septic arthritis (infectious arthritis)? - Septic arthritis, also known as infectious arthritis or pyogenic arthritis, is an infection in the joint (synovial) fluid and joint tissues.
What causes septic arthritis? - Septic arthritis develops when bacteria spread from a source of infection through the bloodstream to a joint or the joint is directly infected by traumatic penetration.
What're the symptoms of septic arthritis? - The symptoms of septic arthritis (infectious arthritis) include swelling in the infected joint and pain when the joint is moved.
How is septic arthritis diagnosed? - The diagnosis of infectious arthritis depends on a combination of laboratory testing with careful history-taking and physical examination of the affected joint.
What is the treatment for septic arthritis? - The goal of treatment for septic arthritis is to eliminate the infection with antibiotic therapy. Septic arthritis requires immediate treatment.
What is psoriatic arthritis? - Psoriatic arthritis is a chronic inflammation of the joints that occurs in some people with a chronic skin and nail condition known as psoriasis.
What causes psoriatic arthritis? - The cause of psoriatic arthritis is unknown. Psoriatic is triggered by an attack of the body's own immune system on itself.
What're the symptoms of psoriatic arthritis? - Symptoms of psoriatic arthritis include dry, scaly, silver patches of skin combined with joint pain and destructive changes in the feet, hands, knees, and spine
How is psoriatic arthritis diagnosed? - The diagnosis of psoriatic arthritis is made by identifying the typical symptoms of arthritis in a person with psoriasis.
What's the treatment for psoriatic arthritis? - Treatment of psoriatic arthritis focuses on controlling the skin rash and relieving joint inflammation.
What is Reiter's syndrome (reactive arthritis)? - Reiter's syndrome (reactive arthritis) is a group of symptoms consisting of arthritis, urethritis, conjunctivitis, and lesions of the skin.
What causes Reiter's syndrome (reactive arthritis)? - Reiter's syndrome appears to be a reaction to an infection that begins in an area of the body other than the joints.
What're the symptoms of Reiter's syndrome? - The symptoms of of Reiter's syndrome appear within days or weeks of infection followed by a low-grade fever, conjunctivitis.
How is Reiter's syndrome diagnosed? - Diagnosis of Reiter's syndrome is often difficult because there is no specific test to confirm that a person has reactive arthritis.
What's the treatment for Reiter's syndrome? - The objective of treatment for Reiter's syndrome is to alleviate the symptoms associated with the syndrome and to treat any underlying infection.
What is ankylosing spondylitis? - Ankylosing spondylitis is a chronic inflammatory disease that affects the joints between the vertebrae of the spine, and the joints between the spine and the pelvis.
What causes ankylosing spondylitis? - The specific cause of ankylosing spondylitis is unknown, but the disease tends to run in families, indicating that genetics plays a role.
What're the symptoms of ankylosing spondylitis? - Symptoms of ankylosing spondylitis include back pain, loss of appetite, weight loss, fatigue, and anemia.
How is ankylosing spondylitis diagnosed? - Doctors usually diagnose ankylosing spondylitis simply by the patient's report of pain and stiffness.
What's the treatment for ankylosing spondylitis? - Physical therapy for ankylosing spondylitis can provide a number of benefits, from pain relief to improved physical strength and flexibility.
What is gout (gouty arthritis)? - Gout or gouty arthritis is a form of arthritis caused by the accumulation of uric acid crystals (due to hyperuricemia) in joints.
What causes gout (gouty arthritis)? - Gout is caused by a defect in metabolism which results in an overproduction of uric acid or leads to reduced ability of the kidney to eliminate uric acid.
What are the risk factors for gout? - Risk factors for gout (gouty arthritis) include genetics, age, gender, alcohol use, obesity, medications, and medical conditions.
What're the complications of gout? - Gout often accompanies heart problems, including high blood pressure, coronary artery disease, and congestive heart failure.
What are the symptoms of gout (gouty arthritis)? - An attack of chronic gout is similar to an attack of acute gouty arthritis. The affected joints show signs of warmth, redness, and tenderness.
How is gout diagnosed? - The diagnosis of gout is generally made on a clinical basis. Physicians can diagnose gout based on the physical examination and medical history.
What's the treatment for gout (gouty arthritis)? - The goals of treatment for gout consist of alleviating pain, avoiding severe attacks in the future, and preventing long-term joint damage.
What gout medications are available? - Gout medications include nonsteroidal anti-inflammatory drugs, colchicine, corticosteroids, xanthine oxidase inhibitors, uricosuric agents.
What gout diet is suggested? - The principle of a gout diet is to reduce purines or lower uric acid when we take food. Avoid foods high in purines. Alcohol should be avoided.
How to prevent gout (gouty arthritis)? - Prevention is the best defense against gout (gouty arthritis). Losing weight and limiting alcohol intake can help ward off gout.