the key to prevention and treatment of osteoarthritis (scroll down to view complete page)
Currently there is no cure
for osteoarthritis (OA), except surgery to
replace joints. There are, however, many important strategies to
minimize the pain and disability from joint destruction.
Exercise has been found to have substantial benefits depending on an individual’s arthritis and the specific exercise. It is well known that avoiding exercise reduces muscle strength, mobility and overall energy, and increases joint stiffness. Studies have shown that stronger muscles help support and protect joints. This may lessen the degenerative process and alleviate pain and inflammation.
Recommended exercises will vary from person to person depending on the severity of their symptoms and location. Always consult with your
doctor before beginning an exercise program. A physical therapist or health care provider should recommend the specific exercise program. In general, walking, swimming, and water-based exercise programs are low impact and generally well tolerated. The saying “no pain, no gain” does not apply to people with arthritis. Pain during exercise is the body’s protective mechanism for letting you know when to stop.
Three types of exercise are best for people
- Range-of-motion exercises help keep
normal joint movement and relieve stiffness. This type of exercise
also maintains flexibility.
- Strengthening exercises help keep or
increase muscle strength. Strong muscles can help support and
protect joints affected by arthritis.
- Aerobic or endurance exercises (bicycle
riding, walking, swimming) improve cardiovascular fitness, help
control weight, and improve overall function. Some studies show
that aerobic exercise also may reduce swelling in some joints.
For more details and important facts, read Questions and Answers about Athritis and Exercise from the National Institute of Health
|What else you can do:
- Good nutrition is important: Eat a healthy, well-balanced diet,
- Celery juice has long been thought to control the pain of arthritis. The vegetable can be cooked or raw. In the juice form, a large amount is consumed and is the most health effective treatment of all. (This remedy is based on anecdotal reports of pain relief and is not based on evidence from scientific studies.)
- Maintain an ideal body weight to minimize
extra pressure on weight-bearing joints
- Use correct body mechanics to minimize
stress on the joints. Activities that especially put stress
on a joint include repetitive squatting, kneeling, or heavy
- Physical therapy can help relieve the acute
symptoms during a flare up and initiate a regular home exercise
- Splints or braces can be helpful
- Apply local warm or cold compresses for
20 min at a time, as often as four times a day
- Soaking in a warm bath
- Swimming in a heated pool is an ideal
therapy for OA
|Medications can reduce inflammation and relieve pain
been much controversy
recently regarding the safety of the
NSAIDS. Concerns have been raised regarding the
potential for increased cardiovascular complications in patients
using these drugs over long periods of time. It is important
to discuss these issues with your health care provider.
- NSAIDs (nonsteroidal anti-inflammatory
drugs--should be used very cautiously in the elderly due to the
increased risk of stomach irritation resulting in GI bleeding.
The risk of stomach injury and gastric ulcers is even more
significant in patients who are also taking low-dose aspirin to
prevent heart disease. Long term continuous use may increase the risk of heart attack or stroke).
- Over-the-counter: Advil (ibuprofen),
Alleve, (naproxen sodium)
- Prescription: Anaprox, Ansaid,
Arthrotec, Cataflam, Clinoril, Daypro, Feldene, Indocin, Lodine,
Mobic, Motrin, Naprelan, Naprosyn, Oruvail, Prevacid Naprapac,
- COX-2 inhibitor NSAIDs prescription, newer type of drug, possibly has fewer gastrointestinal side effects than NSAIDs, however there is a potential for increased risk of cardiovascular events(3)
- Celebrex (200 mg once daily, or 100 mg
- Aspirin (Ecotrin--OTC) read more
- Steroids (prescription) are stronger medications
that can be very effective but can have many side effects. read more
Chondroitin (available over-the-counter) has been found to ease
arthritis pain, reduce swelling and tenderness, as well as improve mobility and function in some people who have osteoarthritis. Previous research indicates that the supplements might also slow cartilage damage in people with OA. Definitive results about the effects of these supplements are expected from a clinical study currently underway by the National Institutes of Health.
Glucosamine is made from the shells of crabs and lobsters, while chondroitin is derived from animal cartilage. A study in 2005 found that patients with more severe arthritis pain got significant relief from the glucosamine-chondroitin combination, however, those study participants in the mild pain subset did not obtain significant pain relief. Many doctors recommend a 3-month trial of these supplements for those with arthritis pain. If you decide to take this therapy, it is important not to discontinue too soon. At least two months of continuous use is necessary before the full effect is realized.
Dietary supplements are unregulated and the quality and content may vary widely. If you decide to take these supplements, talk to your doctor first. Recommended doses should cost about $1 to $3 per day, but most insurance companies do not cover this cost.(5)
Although glucosamine and chondroitin sulfate are natural substances, sometimes classified as food additives, they can cause side effects such as headaches, stomach upset, nausea, vomiting, and skin reactions. These supplements can interact with other medications, so discuss your use of these substances with your doctor.
Read more from the National Institute of Health.(4)
- Hyaluronic acid A relatively new treatment, injections of hyaluronic acid (hyaluronic
acid viscosupplementation) to the area around the knee joint adds fluid to replace
natural fluids that the body has lost. The injections are thought to help people with
arthritis keep movement in the knee without pain. Whether or not these products actually provide significant relief is somewhat controversial. Read more from the Cleveland Clinic
- Cortisone injections can help decrease inflammation in the joint
|If all attempted
treatment fails, surgery is often used as a last resort but can be
very helpful in restoring the functional usefulness of the joint.
Hip and knee replacements are frequently performed in patients with
severe pain and disability. These are routine operations and
may help alleviate the pain and restore the patient's mobility.
|Many people with arthritis try remedies that have not been tested.
Some of these remedies, such as snake venom, are harmful. Others,
such as copper bracelets, are harmless but also useless. The safety
of many unproven remedies is unknown.
Here are some signs that a remedy may be unproven:
- The remedy claims that a treatment, like
a lotion or cream works, for all types of arthritis and other
- Scientific support comes from only one
research study; or
- The label has no directions for use or
warnings about side effects.
Read more: Overview and Causes, Symptoms, Diagnosis, Educational Videos, National Organizations, Internet References
|Written by N Thompson, ARNP, MSN, reviewed by M Thompson, MD, Internal Medicine, last updated December 2007
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