What are Some of the Most Effective Ways to Treat Osteoarthritis? | Ask the Expert: Orthopedics with Dave Stoll, PA-C, Utica Park Clinic

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ask the expert Q: What are some of the most effective ways to treat osteoarthritis?

A: As osteoarthritis (OA) is progressive, so is its treatment. Care for an arthritic joint is dependent upon several things including the level of pain involved and the level of advancement of the joint degeneration. Your age and health status also enter into consideration. The bottom line in treatment of OA is the controlling of symptoms.

Physical activity: The adage of “use it or lose it” applies in this situation. Our joints are meant to move. As joint degeneration takes place resulting from any number of reasons, it becomes even more important to keep them moving. A walking program or light exercise program is beneficial in maintaining strength and mobility. Being active when we are hurting is often the last thing we want to do; yet if we choose not to be active, we will likely see a decline in our ability to do so. This is true regarding the small joints of our hands to the larger joints including hips, knees, and shoulders.
Stretching and strengthening go hand in hand with being physically active. Flexibility and strength are easier to maintain than to regain after they are lost. This is why yoga and other such classes are so popular today. People are realizing that movement is key. Physical therapy fits into this area as well. The therapist can assist in stretching, strengthening and range of motion techniques.
Medications can be helpful. Most medications used for arthritis are now available over the counter. The broad categories include oral and topical pain medicine, non-steroidal anti-inflammatories (NSAIDS) and steroids.

Tylenol is still considered the first line of defense against arthritic pain. Narcotic pain medicine is not recommended for use on a regular basis to treat arthritis. It is usually reserved for post-operative pain. Those who have been using narcotics prior to surgery often have a difficult time maintaining pain control after their procedure.

The list of topical applications for arthritis is ever lengthening. Some have found these to be very helpful.

Over-the-counter ibuprofen and naproxen sodium have become very popular in arthritis treatment. They work by decreasing the inflammatory response in a joint and thereby decreasing the pain. There are other NSAIDS that require a prescription that are more stomach protective than the over-the-counter preparations. Whether using prescription or over-the counter NSAIDS on a regular basis, you should visit with your primary doctor to have your kidney function monitored. These medications are also not advised if you are on blood thinners or have a history of stomach ulcers.

Introducing steroids into a joint is most commonly done by injection. Oral steroids are not usually advised for joint pain as an injection can much more effectively place the steroid precisely where it is desired without systemic side effects.

Hyaluronic acid injections are also an option. This is sometimes referred to as the “chicken shot” or “rooster shot”. This compound is naturally found in the joint cartilNewage and these injections are thought to help maintain the health of the cartilage that is present. These injections do not form new cartilage or repair damaged cartilage. They are usually reserved for those who aren’t candidates for steroid injections and surgery is not indicated.

Braces and assistive devices are beneficial in helping to keep you ambulatory. If you are struggling with instability of a joint, a brace may provide the stabilization that is needed. Braces can also be used to unweight a portion of a joint and transfer the weight to an area that may have less cartilage loss and provide relief. Walkers, canes and crutches may also help with weight bearing and balance issues.
Surgical intervention is available for most patients who have failed to achieve the desired pain relief by the conservative treatments already discussed. Surgeries may include both arthroscopic and invasive approaches. Joint replacement surgeries have become quite advanced and are available for many of the more commonly arthritic joints. Joint replacement surgery is an extensive topic in itself that we will address at a later time.