Even though there is no treatment for osteoarthritis it doesn’t mean that the condition will get worse over time. Different treatments are available that might help relieve some of the symptoms.
One of the most important treatments for an individual suffering from osteoarthritis is exercise. A combination of physical exercises are recommended to train and strengthen the muscles and joints. It’s very important that the instructions from the doctors are correctly followed, as too much or too quickly can cause more harm than good. The best about this treatment if done correctly, it doesn’t have side effects but it will prolong further damage. Some individuals that experience pain and stiffness often think that exercise will increase the pain, but that is not the case. Exercising and a balanced, healthy diet can benefit an individual by helping them to lose weight, if needed which will mean less pressure on the joints.
Occasionally a combination of therapies is recommended, exercise and medicines may be needed to help control the individuals pain. Which painkillers are required depends on the individuals severity of pain and other conditions they might have. The main painkillers used are: paracetamol, (NSATDs), opioids, capsaicin cream, corticosteroid injection and viscosupplementation.
Paracetamol is usually recommended as one of the first painkillers, which is usually taken regularly not just when the pain starts. It’s safe for most people to take and is one of the drugs with very rare side effects.
If paracetamol doesn’t effectively help with pain control the doctor might prescribe a non-steroidal anti-inflammatory drug (NSAID) which help to reduce inflammation. There are two types that work slightly differently to each-other: ibuprofen, diclofenac or naproxen and the other ones are COX-2 inhibitors such as etoricoxib and celecoxib. The (NSAIDs) have side effects such as; stomach pains, stomach ulcers, liver and kidney problems, bleeding – especially when they are using aspirin. COX-2 drugs have a lower risk of causing stomach issues but they can cause insomnia, diarrhoea, sinusitis and nausea.
Opioids painkillers such as codeine, can ease severe the pain but does have side effects such as nausea, drowsiness and constipation. Codeine combined with paracetamol is found in co-codamol.
Sometimes when the NSAIDs haven’t been effective the doctor might prescribe capsaicin cream. Capsaicin cream numbs the nerves that signal pain messages at the effected area. It doesn’t have any side effects apart from a slightly burning sensation when applied.
When the osteoarthritis is severe, painkillers will not be enough to manage the pain. Doctors might offer the patient treatment – medicine injected into the joint. The patient shouldn’t have more than three injections a year and at list three months in between.
If all other non-surgical treatments have been unsuccessful, viscosupplementation might be offered as a treatment option. It can come in up to five injections of hyaluronic acid injected into the affected joints over a few weeks. Hyaluronic acid is in synovial fluid in the joints and acts as shock absorber and lubricant.
In some cases if non-surgical treatments haven’t been effective the only option is surgery. Having surgery might improve your mobility, symptoms and quality of life. Surgery doesn’t guarantee to remove all symptoms and the patient may still experience some pain and stiffness. Joint replacement therapy, also known as an arthroplasty, is most commonly carried out to replace hip and knee joints. Surgeon will remove the affected joint and replace it with an artificial joint (prosthesis) made of special metal and plastic. Although it may eventually need to be replaced it can last up to 20 years. There’s also a newer type of joint replacement surgery called resurfacing. This uses only metal components and may be more suitable for younger patients.
If joint replacement isn’t suitable for you, your surgeon may suggest an operation known as an arthrodesis, which fuses your joint in a permanent position. This means your joint will be stronger and much less painful, although you will no longer be able to move it.