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OSTEOARTHRITIS TREATMENTS |
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Treatment of Osteoarthritis patients is tailored to
the needs of each individual. Patients vary widely in the location
of the joints involved, the rate of progression, the severity of
symptoms, the degree of disability, and responses to specific forms
of treatment. Most treatment programs include several forms of
therapy. Patient education and psychotherapy Patient education is an important part of Osteoarthritis treatment because of the highly individual nature of the disorder and its potential impacts on the patient's life. Patients who are depressed because of changes in employment or recreation usually benefit from counseling. The patient's family should be involved in discussions of coping, household reorganization, and other aspects of the patient's disease and treatment regimen. Medications Patients with mild Osteoarthritis may be treated only with pain relievers such as acetaminophen (Tylenol) or propoxyphene (Darvon). Most patients with Osteoarthritis, however, are given nonsteroidal anti-inflammatory drugs, or NSAIDs. These include compounds such as ibuprofen (Motrin, Advil), ketoprofen (Orudis), and flurbiprofen (Ansaid). The NSAIDs have the advantage of relieving inflammation as well as pain. They also have potentially dangerous side effects, including stomach ulcers, sensitivity to sun exposure, kidney disturbances, and nervousness or depression. Some Osteoarthritis patients are treated with corticosteroids injected directly into the joints to reduce inflammation and slow the development of Heberden's nodes. Injections should not be regarded as a first-choice treatment and should be given only two or three times a year. Physical therapy Patients with Osteoarthritis are encouraged to exercise as a way of keeping joint cartilage lubricated. Exercises that increase balance, flexibility, and range of motion are recommended for Osteoarthritis patients. These may include walking, swimming and other water exercises, yoga and other stretching exercises, or isometric exercises. Physical therapy may also include massage, moist hot packs, or soaking in a hot tub. Surgery Surgical treatment of osteoarthritis may include the replacement of a damaged joint with an artificial part or appliance; surgical fusion of spinal bones; scraping or removal of damaged bone from the joint; or the removal of a piece of bone in order to realign the bone. Protective measures Depending on the location of the affected joint, patients with Osteoarthritis may be advised to use neck braces or collars, crutches, canes, hip braces, knee supports, bed boards, or elevated chair and toilet seats. They are also advised to avoid unnecessary knee bending, stair climbing, or lifting of heavy objects. New treatments Since 1997, several new methods of treatment for Osteoarthritis have been investigated. Although they are still being developed and tested, they appear to hold promise. They include: Disease-modifying drugs. These compounds may be useful in assisting the body to form new cartilage or improve its repair of existing cartilage. Hyaluronic acid. Injections of this substance may help to lubricate and protect cartilage. Electromagnetic field therapy Gene therapy Cartilage transplantation. This technique is presently used in Sweden. Alternative treatment Diet Food intolerance can be a contributing factor in Osteoarthritis, although this is more significant in rheumatoid arthritis. Dietary suggestions that may be helpful for people with Osteoarthritis include emphasizing high-fiber, complex-carbohydrate foods, while minimizing fats. Plants in the Solanaceae family, such as tomatoes, eggplant, and potatoes, should be avoided, as should refined and processed foods. Foods that are high in bioflavonoids (berries as well as red, orange, and purple fruits and vegetables) should be eaten often. Nutritional supplements In the past several years, a combination of glucosamine and chondroitin sulfate has been proposed as a dietary supplement that helps the body maintain and repair cartilage. Studies conducted in Europe have shown the effectiveness of this treatment in many cases. These substances are nontoxic and do not require prescriptions. Other supplements that may be helpful in the treatment of Osteoarthritis include the antioxidant vitamins and minerals (vitamins A, C, E, selenium, and zinc) and the B vitamins, especially vitamins B6 and B5. Naturopathy Naturopathic treatment for Osteoarthritis includes hydrotherapy, diathermy (deep-heat therapy), nutritional supplements, and botanical preparations, including yucca, devil's claw (Harpagophytum procumbens), and hawthorn (Crataegus laevigata) berries. Traditional Chinese medicine Practitioners of Chinese medicine treat arthritis with suction cups, massage, moxibustion (warming an area of skin by burning a herbal wick a slight distance above the skin), the application of herbal poultices, and internal doses of Chinese herbal formulas. |
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