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Treatments

Visiting your doctor
Visiting your doctor

If you are experiencing symptoms such as joint pain, stiffness and swelling, talk to your doctor about whether you have osteoarthritis.

Before your visit it would be a good idea to write a list that includes:1

  • Your symptoms and when you experience them e.g. “my knee is very stiff when I wake up I the morning”
  • Details of any other medical problems you have
  • Details of any other medical problems in your family
  • All the prescription and over-the-counter medications and dietary supplements you take, when and in what dose
  • Questions you want to ask the doctor

During your appointment your doctor may do the following:

Ask questions

Your doctor will most likely ask when the joint problems began and whether the symptoms come and go or if that are constant. He or she will want to know if any particular activities make them worse, such as climbing the stairs or writing with a pen. It will also be important for them to know if the affected joint has been injured in the past.1

Carry out a physical examination

During the physical examination your doctor will look for a number of things such as tenderness, swelling or redness, creaking and swelling, and for the range of motion in the joint.2,3

Perform tests

Your doctor may order imaging tests such as x-rays or magnetic resonance imaging (MRI) to obtain pictures of the affected joint. They may also order blood or joint fluid tests. Certain blood tests may help rule out other causes of joint pain, such as rheumatoid arthritis. Joint fluid can also be tested to see if there's inflammation and if your pain is caused by gout or an infection. Osteoarthritis can vary in intensity, ranging from mild to moderate to severe.2,3

Discuss treatments

There are a number of different treatment options that depend on which joint is affected, the symptoms and their severity. Your doctor will talk with you to work out a plan that is right for you.4


References
1. Mayo Clinic. Osteoarthritis preparing for your appointment.
http://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-
treatment/preparing-for-appointment/ptc-20198303.
Last accessed 07/07/2017.
2. Mayo Clinic. Osteoarthritis diagnosis. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/drc-20351930. Last accessed 07/07/2017.
3. Healthline. Stages of osteoarthritis of the knee. http://www.healthline.com/health/osteoarthritis-stages-of-oa-of-the-knee#1. Last accessed
31/08/2017.
4. Mayo Clinic. Osteoarthritis treatment.
http://www.mayoclinic.org/diseases-conditions/osteoarthritis/diagnosis-treatment/treatment/txc-
20198275.
Last accessed 07/07/2017.

Treatment options
Treatment options png

Your doctor will talk to you about finding a plan that suits your needs. Doctors usually treat osteoarthritis with a combination of therapies:1

Lifestyle modifications

There are a number ways of relieving osteoarthritis symptoms without using medications.2-4

Exercise

Although it might seem counterintuitive, physical activity can actually help osteoarthritis. Not only will appropriate activities decrease osteoarthritis pain, they can improve motion and function. Your doctor may recommend activities such as walking, swimming, water aerobics. Find out more here.

Weight management

A weight loss program may be recommended, if needed, particularly if osteoarthritis affects weight-bearing joints (such as the knee, hip, spine, or ankle). Excess weight puts stress on your joints so removing that stress can relieve symptoms.

Orthotic devices

These support (“assistive”) devices, such as a knee brace or shoe insert, can help by taking strain off joints.

Medications

There are different types of medication that may help osteoarthritis:3,4

Topical (placed directly on the skin)

Topical pain relievers can be applied directly on the skin over the affected joints. These medicines include capsaicin cream, lidocaine and diclofenac gel.

Oral (by mouth)

Oral pain relievers such as paracetemol are common first treatments. So are nonsteroidal anti-inflammatory drugs (often called NSAIDs), which decrease swelling and pain.

Injections (shots)

Joint injections with hyaluronic acid can also give months of pain relief from osteoarthritis. Find out more here.

Dietary supplements

Many over-the-counter nutrition supplements have been used for osteoarthritis treatment. Most lack good research data to support their effectiveness and safety. Consult your doctor or pharmacist before using any of these supplements. This is especially true when you are combining these supplements with prescribed drugs.

Surgery

Surgical treatment is an option for severe osteoarthritis, however not everyone can have surgery:3

Surgical intervention can be considered when the joint has serious damage, or when medical treatment fails to relieve pain and there is major loss of function.
Surgical options for osteoarthritis include joint replacement.


References
1. Centers for disease control and prevention. Osteoarthritis Fact Sheet.
https://www.cdc.gov/arthritis/basics/osteoarthritis.html. Last accessed 23/06/17.
2. American Academy of Orthopedic Surgeons. Osteoarthritis.
http://orthoinfo.aaos.org/topic.cfm?topic=a00227. Last accessed 23/06/17
3. American College of Rheumatology. Diseases and conditions Osteoarthritis.
https://www.rheumatology.org/i-am-a/patient- caregiver/diseases-conditions/osteoarthritis. Last accessed 23/06/17.
4. Osteoarthritis Research Society International. Non-Surgical Management of Knee Osteoarthritis.
https://www.oarsi.org/sites/default/files/library/2014/pdf/patientsumfinal.pdf. Last accessed 18/08/17.

Should I have treatment with Hyaluronic Acid?
treatment with Hyaluronic Acid png

Hyaluronic acid (HA), a component of synovial fluid, is the thick fluid that acts as a lubricant in joints. Intra-articular injection of Hyaluronic Acid, or viscosupplemetation, consists of an injection of exogenous Hyaluronic Acid into the joint.

Furthermore, in knee osteoarthritis, modifications of Hyaluronic Acid in synovial fluid and the deterioration of cartilage lead to the release of damaging biological products that cause inflammation. The injected Hyaluronic Acid replenishes the synovial fluid and replaces modified Hyaluronic Acid, helping to lubricate the joint and ease symptoms. Hyaluronic Acid injections can provide pain reduction in mild osteoarthritis of the knee for up to 24 weeks.1

The use of intra-articular Hyaluronic Acid therapy to treat osteoarthritis is growing worldwide, due to important results obtained from several clinical trials, which reported intra-articular Hyaluronic Acid - related improvements in functional activity and pain management.2,3 Find out more here.


References
1. Ayhan E. Intraarticular injections (corticosteroid, hyaluronic acid,platelet rich plasma) for the knee osteoarthritis. World J Orthop 2014 July 18; 5(3): 351-361.
2. Xing D. Intra-articular Hyaluronic Acid in Treating Knee Osteoarthritis: a PRISMA-Compliant Systematic Review of Overlapping Metaanalysis. Nature Sci Rep. 2016 Sep 12;6:32790.
3. Iannitti T et al. Intra-Articular Injections for the Treatment of Osteoarthritis: focus on the Clinical Use of Hyaluronic Acid. Drugs R D.2011; 11:13-27.

WHAT I NEED TO REMEMBER

1. IF YOU ARE EXPERIENCING SYMPTOMS...

... such as joint pain, stiffness and swelling, talk to your doctor about whether you have osteoarthritis

2. IF YOU HAVE OSTEOARTHRITIS, YOUR DOCTOR...

... will talk to you about finding a plan that suits your needs. Doctors usually treat osteoarthritis with a combination of therapies1

3. THE USE OF INTRA-ARTICULAR...

... hyaluronic acid therapy to treat osteoarthritis is growing worldwide, due to important results obtained from several clinical trials, which reported intra-articular hyaluronic acid-related improvements in functional activity and pain management2,3

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LIVING WITH OA