Treatments are available for severe and debilitating forms of osteoarthritis or OA. Unfortunately, there is no known cure for arthritis. For light and moderate forms of OA, your doctor may likely provide advice on how to properly manage your symptoms by making corresponding modifications to your lifestyle as they will be all what you need to keep your symptoms under control.
For more severe kinds of osteoarthritis drugs, devices or surgery may be recommended.
Paracetamol – This analgesic (painkiller) is available over-the-counter (OTC). Your doctor may recommend it for temporary relief of your pain if it becomes unbearable.
NSAIDs or Non-steroidal anti-inflammatory drugs –These drugs can be used if paracetamol fails to address the pain. NSAIDs kill pain by relieving inflammation. Two types of NSAIDs are available today: One is the conventional NSAIDs like diclonefac, naproxen and ibuprofen and the other are called COX-2 inhibitors that include etoricxib and celecoxib. NSAIDs are also available as OTC topical cream and are applied directly to the painful joints. NSAIDs help relieve pain by reducing swelling in your joints.
Opioids – These include codeine which is a much stronger painkiller compared to paracetamol or NSAIDs. Opioids are effective in addressing severe pain but come with side effects like constipation, nausea and drowsiness. Your doctor may prescribe you a laxative that you need to take along with any opioid medication.
Capsaicin cream – If NSAID fails to relieve pain in your knees or hands your doctor may prescribe capsaicin cream. This cream stops pain by preventing the nerves to transmit pain messages. This cream may need to be applied for some time before it elicits an effect. Pain relief may be experienced in about a couple of weeks of applying this medicine; however, its full effectiveness may be felt in about a month.
Intra-articular injections – This treatment is for severe forms of OA if painkillers prove ineffective. Intra-articular injections are applied into the painful areas in the joints.
TENS or Transcutaneous electrical nerve stimulation – TENS utilizes a machine that numbs nerve endings and prevents any transmission of pain signals to the brain. TENS is often performed by a physiotherapist. It is done by placing electrodes (small electrical pads) to the skin over the painful joint. These electrodes convey small electrical pulses from the machine. TENS therapy is often done by a physiotherapist. It entails the use of electrodes (small electrical pads) placed on the skin where the site of the affected joint is located. The electrodes convey mild electrical currents from the TENS machine. The physiotherapist will recommend on the length of your treatment and the strength of the electrical current to be used.
Hot or cold packs – Also called cryotherapy or thermotherapy, hot or cold packs are easy and effective ways to relieve the symptoms of osteoarthritis especially pain. You can fill a hot-water bottle with hot or cold water and directly apply it over the painful joints to lessen pain.
Manual therapy – This type of therapy helps weak muscles become more flexible and supple. Weak muscles usually imply that the joints are seldom used which can be at high risk for developing OA. Manual therapy is about stretching exercises that help maintain joint flexibility and suppleness.
Assistive devices – If you have OA in the lower limbs (feet, knees or hips) your occupational therapist or physiotherapist may recommend special insoles or footwear for you. Shock absorbing soles in your footwear can lessen stress and pressure on your leg joints when you walk, can help you stay mobile and can help you perform your everyday activities. Leg supports and braces as well as special insoles can distribute your weight more properly. For people with OA in the knee or hip, a walking aid such as a cane or stick can help you stay mobile and balanced as you walk. For a painful joint you can use a splint to prevent it from bearing any pressure. Your physiotherapist can furnish you with a splint and provide you with all the necessary advice and instructions on how to properly use it.
Surgery – Surgery is only recommended after all forms of OA treatment mentioned above have proven unsuccessful or if the joints are seriously damaged. An orthopedic surgeon usually performs surgery for osteoarthritis.
Surgery for OA can include arthroplasty, athrodesis and osteotomy
Arthroplasty – This is also known as joint replacement therapy and is the mot common form of OA surgical procedure. Arthroplasty is done to replace the joints of the knee or hip. The procedure entails removing the damaged joint replacing it with a prosthesis (artificial joint) that’s made from metal or plastic materials. This prosthesis may need to be replaced after 20 years.
Arthrodesis – This type of joint replacement surgery joins your joint in a permanent position causing the joint to be much stronger and addresses the OA pain as well. The drawback of this procedure is that you my never be able to move the joint again.
Osteotomy – You can undergo and osteotomy if you’re too young to have knee arthroplasty. The surgeon adds or removes a small segment of bone located above or below the affected knee joint in this procedure. This is to realign the knee to steer pressure away from the affected joint.
Acupuncture
Acupuncture therapy for OA involves the use of very thin needles inserted into specific points in the skin (acupoints). The acupoints, in turn, are associated to energy pathways called meridians that convey vital energy called chi that reenergizes the body much like blood nourishes the body. Acupuncture helps relieve the painful symptoms of OA by releasing the body’s natural pain-killing chemicals called endorphins. Acupuncture is also combined with Chinese herbal medicine along with lifestyle changes to make the treatment more powerful, effective and long lasting.
The needles trigger a nerve response that stimulates the body to produce and release endorphins. These endorphins are a much better and safer alternative to synthetic painkillers like codeine, Motrin, Tylenol and Advi l that cause a number of negative side effects when used.
Ni Nan Gilbert is a licensed acupuncturist in Bellmore, NY with certification in Chinese Herbology and over 16 years experience in traditional Chinese medicine.