Osteoarthritis Treatment and Research

by National Institute on Aging

(Page 5 of 7)

Although there is no cure for most forms of arthritis, various therapies can help patients manage symptoms and improve their overall quality of life. The choice of treatment depends on the type of arthritis, the severity of symptoms, the patient's general health, and other factors.

Osteoarthritis treatment plans often include ways to manage pain and improve function. Such plans can include exercise, rest and joint care, pain relief, weight control, medicines, surgery, and non-traditional treatment approaches.

Current treatments for osteoarthritis can relieve symptoms such as pain and disability, but right now there are no treatments that can cure osteoarthritis.

Exercise is one of the best treatments for osteoarthritis. It can improve mood and outlook, decrease pain, increase flexibility, and help you maintain a healthy weight.

How Exercise Can Help

The amount and form of exercise will depend on which joints are involved, how stable the joints are, whether or not the joint is swollen, and whether a joint replacement has already been done. Ask your doctor or physical therapist what exercises are best for you.

For temporary relief of pain from osteoarthritis, you can use warm towels, hot packs, or a warm bath or shower. In some cases, cold packs such as a bag of ice or frozen vegetables wrapped in a towel can relieve pain or numb the sore area.

A doctor or physical therapist can recommend if heat or cold is the best treatment. For osteoarthritis in the knee, wearing insoles or cushioned shoes may reduce joint stress.

Doctors consider a number of factors when choosing medicines for their patients. In particular, they look at the type of pain the patient may be having and any possible side effects from the drugs.

For pain relief, doctors usually start with acetaminophen because the side effects are minimal. If acetaminophen does not relieve pain, then non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be used.

In addition, COX-2 inhibitors such as celecoxib and valdecoxib may be used. These medicines reduce inflammation similarly to traditional NSAIDs, but they cause fewer gastrointestinal side effects. However, these medications occasionally are associated with harmful reactions ranging from mild to severe.

Corticosteroids, hyaluronic acid, and topical creams are also used. Most medicines used to treat osteoarthritis have side effects, so it is important for people to learn about the medicines they take. For example, people over age 65 and those with any history of ulcers or stomach bleeding should use non-steroidal anti-inflammatory drugs, or NSAIDs, with caution.

Using Assistive DevicesProtecting and supporting the affected joint or joints is important. Some people use canes and splints to protect and to take pressure off the joints. Splints or braces are used to provide extra support for weakened joints.

For some people, surgery helps relieve the pain and disability of osteoarthritis. A doctor may perform surgery to smooth out, fuse, or reposition bones, or to replace joints.

The decision to have an operation depends on several factors. Both surgeon and patient should consider the patient's level of disability, intensity of pain, lifestyle, age, and occupation. Today, more than 80 percent of surgeries for osteoarthritis involve replacing the hip or knee joint.

Researchers suspect that heredity plays a role in 25 to 30 percent of osteoarthritis cases. Scientists have identified a mutation, or gene defect, affecting collagen - an important part of cartilage - in patients with an inherited kind of osteoarthritis that starts at an early age.

In the future, a test to determine who carries a genetic defect or defects could help people reduce their risk for osteoarthritis with lifestyle adjustments.

Tissue engineering is an exciting area of research in osteoarthritis. This approach involves removing cells from a healthy part of the body and placing them in an area of diseased or damaged tissue. In some cases, this improves joint movement.

Researchers also are studying whether exercise can treat or prevent osteoarthritis. Studies on knee osteoarthritis and exercise found that strengthening the thigh muscle, also known as the quadriceps, can relieve symptoms of knee osteoarthritis and prevent more damage.

Studies also show that people with knee osteoarthritis who exercise feel less pain and function better.

The U.S. National Institutes of Health, through its National Library of Medicine and other Institutes, maintains a database of clinical trials, including those funded by the NIH, at ClinicalTrials.gov.

Early research suggests that acupuncture, which is the use of fine needles inserted at specific points in the skin, may provide pain relief for some patients. Some people claim that the dietary supplements glucosamine and chondroitin sulfate can relieve the symptoms of osteoarthritis.

The NIH is currently funding the Glucosamine and Chondroitin Arthritis Intervention Trial, or GAIT, to test whether or not glucosamine and/or chondroitin have a beneficial effect for people with knee osteoarthritis. The results of the recently completed first phase of the study indicate that these supplements have a limited effectiveness for most patients with osteoarthritis.

Quiz

1. There is no cure for osteoarthritis.

TRUE is the correct answer. Current treatments for osteoarthritis can relieve symptoms such as pain and disability, but right now there is no cure for the disease.

2. Exercise can help a person with osteoarthritis.

TRUE is the correct answer. Exercise is one of the best treatments for osteoarthritis. It can improve mood and outlook, decrease pain, increase flexibility, and help you maintain a healthy weight. The amount and form of exercise will depend on which joints are involved, how stable the joint is, the amount of joint inflammation, and whether a joint replacement has already been done. Ask your doctor or physical therapist what exercises are best for you.

3. Both heat and cold can be useful treatments for osteoarthritis.

TRUE is the correct answer. For temporary pain relief from osteoarthritis, you can use warm towels, hot packs, or a warm bath or shower. Cold packs are often used to reduce the inflammation of swollen joints.

4. Scientific studies have proven that glucosamine and chondroitin sulfate relieve symptoms of osteoarthritis.

FALSE is the correct answer. Clinical trials have shown that glucosamine and chondroitin sulfate may have some usefulness in relieving symptoms of osteoarthritis. However, definitive answers about the effectiveness of glucosamine and chondroitin sulfate are not yet available. The NIH is currently funding the Glucosamine and Chondroitin Arthritis Intervention Trial, or GAIT, to test whether or not glucosamine and chondroitin have a beneficial effect for people with knee osteoarthritis. The results of the recently completed first phase of the study indicate that these supplements have a limited effectiveness for most patients with osteoarthritis.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.