The aim of osteoarthritis treatment includes the following
- reduce the pain
- maintain the function
The different modalities of treatment available include the following
- reducing load across the joint by different methods
- mal-alignment correction or even distribution of load
- drug treatment
- joint replacement surgery
Reduction in load across the joint decreases the force acting on the diseased cartilage and causes a reduction in pain of osteoarthritis. Load can be reduced by
- losing excess body weight in obese and over weight people
- using a cane or a crutch during activity is helpful in reducing load across the diseased joint as now load is passing through three points (two legs and the cane) instead of two (two legs only). The cane should be used in the hand opposite to the effected joint and should be of proper height.
Mal-alignment correction or even distribution of load can be accomplished with the following methods
- Using a brace that attempts to straighten the deformed joint. This is effective in knee osteoarthritis. The device is uncomfortable for some patients and may slip off the limb of obese patients. It is effective in patients that are motivated and willing to use it.
- Foot wear modification by inserting wedges can also correct the mal-alignment to a certain degree. This can also lead to reief from pain in knee osteoarthritis.
- Mal-alignment can also be corrected surgically. This can be effective in the osteoarthritis of the knee and sometimes in the osteoarthritis of the hip. It is mainly indicated when only part of the joint is diseased and the remaining is quite healthy.
As activity precipitates pain in osteoarthritis hence people with this disease tend to become inactive. This leads to weakening of the muscles. These weak muscles cannot support the joint effectively leading to more cartilage wear and tear.
In knee osteoarthritis isotonic and isokinetic strengthening exercises have been shown to be effective. These can be done when the individual moves his or her knee against resistance,. These can be done by tying a weight to the ankle and extending the knee or flexing the knee while lying face down. Exercises performed in water are also effective.
To be effective exercise should be done regularly and should not be discontinued.
Two types of injections are used in osteoarthritis treatment.
Steroids should only be injected into the joint to provide relief from acute flare-ups of the disease. They bring down the pain and inflammation rapidly. They are cheap.
Hyaluronic acid is injected into the joint weekly for 3 to 6 weeks. It is mainly indicated in knee osteoarthritis. It is costly.
Drugs used for the osteoarthritis treatment include the following
SAMe is a co-enzyme that is involved in the transfer of methyl groups. SAMe donates its methyl group to a accepting compound. It is a nutritional supplement and has been found to be effective in liver disease, osteoarthritis and depression. Dose is 400 to 1600mg per day. It is better absorbed empty stomach. Side effects include stomach upset, headache, sleeplessness and anxiety. It has to be taken for 1 month before full therapeutic effect takes place.
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This page was last updated on 10th June 2009.
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