Osteoarthritis is a disease process that affects the cartilage within a joint. It is the most common form of arthritis, affecting around 21 million Americans. Cartilage exists at the surface of the ends of the bones. It provides joints with a gliding surface and shock absorber during activities of daily living. Osteoarthritis causes the cartilage layer to break down and wear away, exposing raw bone. The rubbing of bone on bone in the joint causes inflammation of the joints’ inner lining. That causes symptoms of pain, swelling, and stiffness. In response, the body forms more bone (bone spurs) and increases joint stiffness.
Osteoarthritis is more common in older adults, but it can affect younger adults as well. Often, this is the result of injury to the joint. Osteoarthritis is more common in men under the age of 45 and more common in women over the age of 45. Patients who participate in activities that overstress certain joints, as well as patients with overweight or obesity, may be at an increased risk of osteoarthritis.
Osteoarthritis doesn’t only affect your joints. It can also cause stiffness in the surrounding tendons, ligaments, and muscles. This may make it difficult for you to keep up your normal level of activity and may reduce your quality of life.
Doctors can’t stop this disease process. But there is good news: There are many options available to help treat and manage osteoarthritis so you can get back to your desired activities.
Many patients with osteoarthritis are afraid they may need surgery—but that is not usually the case. There are many nonsurgical treatments that can help control your pain while allowing you to be as active as you would like to be.
Exercise is one of the best treatments for osteoarthritis. A routine home exercise program with regular cardiovascular activity can decrease joint pain and stiffness. It can also strengthen the heart and contribute to overall good health. Exercise, when done correctly, has practically no side effects. It can take place in a supervised (via physical therapy or fitness training with a professional) or non-supervised fashion in a gym or at home.
If you’re having problems with pain during exercise, try activities that are less stressful on the joints such as biking, swimming, water exercise, or tai chi. Your doctor can also help you find exercises that work. There are many osteoarthritis self-care options you can try at home to improve your arthritis pain. These include:
Sometimes, a doctor will recommend medical intervention to manage pain and support movement. They may suggest one of several medications and/or tools to help you return to normal activity.
Below are a list of details about different treatment options.
Tylenol is very effective for pain control, but it does not decrease inflammation. For this reason, doctors often suggest combining it with anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (NSAIDs)
These drugs are very effective in reducing pain and swelling. You may need to try different NSAIDs to get the best effect.
Glucosamine and chondroitin sulfate
These drugs are a provided as a medical food supplement. They may decrease swelling and pain in the joint in some patients, but they do not work for everyone.
Steroid injections are sparingly applied directly into the joint. The steroid typically used is a powerful anti-inflammatory agent that decreases the swelling of an osteoarthritic joint. A single steroid injection can provide symptom relief for several months to a year and longer, with few side effects.
These drugs usually are a treatment option if NSAIDS and steroid injections have failed. They act as a lubricant for the joint and can decrease the swelling. Depending on brand, you may receive either a single injection of viscosupplementation or a set of three injections. Most insurance companies do not consider these injections to be medically necessary and decline to reimburse for them. As a result, viscosupplementation may require an out-of-pocket expense.
Sometimes osteoarthritis will only affect one part of a joint. In that case, your doctor may prescribe a brace for you that can decrease the load that your affected joint must bear and reduce pain.
If all the above options have failed to give you relief, it is likely that you may require surgery. Your surgeon will discuss the different surgical options with you. These options may include:
“Orthobiologics” describes a group of treatment options that aim to use a patient’s own blood and tissues (such as plasma or cells from fat or bone marrow) to improve joint pain and swelling. These treatments collect blood or tissue from the patient that are then concentrated and injected back into the patient at the treatment site. Researchers do not understand the effects of these treatments as well as the effects of FDA-approved drugs but clinical results over the several-year course of their use are encouraging. Insurance carriers do not reimburse for these injections; they require an out-of-pocket expense.