Conservative treatment of arthritis
The treatment of arthritis can include several options depending on the type and severity of involvement. In general, the use of heat, rest, and exercise can be helpful to those with arthritis. Heat will make the joint feel better, while exercises that help to maintain strength in the muscles around the joint will keep it mobile. Those exercises should be carefully selected and include stretching exercises and strengthening exercises, neither of which should cause pain while performing. For hip and knee patients, this may include swimming, bike riding, walking, cross-country skiing or other low impact activities.
The use of weights is allowable so long as it does not cause pain. The use of a cane or walker can also take the stress off of painful joints. If you are overweight or obese, even the slightest amount of weight loss can make a big difference to your joints. Generally speaking, every extra pound you carry feels like an additional three to five pounds to your weight-bearing joints!
While there is as yet no cure for arthritis, there are medications to decrease the pain and/or inflammation associated with the disease. Over the counter drugs, which can be obtained without a prescription, including Tylenol, Aspirin, Ibuprofen and Naprosyn. While Tylenol can reduce the aching pain, Aspirin is a drug, which can decrease pain and inflammation. Ibuprofen and Naprosyn are drugs are in a class known as nonsteroidal anti-inflammatory drugs (NSAID) and are also used to treat pain and inflammation. There are many drugs in this category and most require a prescription to obtain. These types of medications are usually most effective for symptom relief if they are taken regularly rather than waiting until the pain becomes severe. The medications can cause side effects including stomach irritation or ulcers, liver or kidney malfunction. Patients who take these medications chronically should be evaluated by their family doctor and have a blood test periodically.
Other conservative treatments for arthritic joints include cortisone injections. Cortisone is a powerful anti-inflammatory, which is naturally produced in your body. It is a steroid but should not be confused with the muscle-building steroid used by athletes. Cortisone is injected directly into the joint space and may provide weeks or even months of relief but does not “cure” arthritis. The injections can be repeated every three to four months as needed. Cortisone can be injected into knees, hips (under x-ray) and shoulders.
Another kind of injection for arthritic knees is called viscosupplementation. Viscosupplementation is an injection of a lubricating substance into the knee joint. Depending on the preparation used, you may receive one to five injections over several weeks. The effects of this type of injection may last for several months but, similar to receiving a cortisone injection, it may not work for everyone. Recent evidence suggests that this type of treatment may not be as successful as previously reported.
Sometimes the use of a brace or knee sleeve for arthritic knees can improve symptoms and thereby improve function and ability to walk longer distances.
Glucosamine and/or chondroitin sulfate and other supplements taken orally may be helpful for arthritic pain and symptoms of stiffness. These supplements are available over the counter and should be used according to the package inserts. The method of action and the true effectiveness of these supplements are currently unknown and they are not recommended by the American Academy of Orthopaedic Surgeons (AAOS). Because these supplements may interact with other medications you use, please notify your doctor that you are using them.