Osteoarthritis

How is osteoarthritis treated? 

There is currently no cure for osteoarthritis. Hence, sustained and increasing research is necessary. Treatment of osteoarthritis focuses on alleviating its symptoms, regaining lost muscle strength and surgery.

• Physiotherapy
  

  Exercise is needed to build up the strength in the surrounding muscles so that they can hold up the joint better, lessening the stress and strain that is exerted on it. It is a wrong concept that exercise worsens osteoarthritis, because it may only happen in physical activities of very strenuous intensity, such as athletics. On the contrary, a sedentary lifestyle weakens the muscles around the joints making the joints more vulnerable. Physiotherapists are the best exercise coaches, who assess the condition of the muscle and joints and teach / prescribe the appropriate exercise regimen to patients (as if doctors prescribe the appropriate medicine). Exercise is the most effective strategy to relieve pain for patients who have osteoarthritis. Apart from having a good coach, the keys to success are discipline and perseverance.
  
  Exercises such as swimming are the most gentle and recommended for most forms of arthritis. Land-based exercises like cycling, brisk walking and slow jogging are also helpful. Exercises that focus on strengthening of muscle around the joints are advised. Please consult your physiotherapist for the exercise regimen that suits you most.
  



• Medication
  

  Sometimes, medicine is useful to relieve joint pain, especially during bad days. Creams, balms, ointments and plasters are very safe and helpful options. Paracetamol (Panadol) can be prescribed for low level pain, while stronger drugs like non-steroidal anti-Inflammatory drugs (NSAIDs) and COX-2 inhibitors may be necessary for more severe pain. Supplements like glucosamine and chondroitin may relieve pain for some patients, but do not protect one from the wearing of cartilages. Speak to your doctor first before you try these medicines.



• Injection of medicine into the joints
  

  Lubricant injections into the joints can relieve in the short terms for some patients. The effect of lubricant injections usually does not last more than five months. It is more useful for younger patients who need temporary relief of pain in order to achieve an increased exercise demand in short term. Steroid injection into the joint can also relieve pain, but the effect is usually shorter-lasting. Repeated steroid injection into joints or repeated removal of fluid from joints is not recommended as a choice of treatment. Every injection into joints carries a small risk of joint infection.



• Surgery

  For a minority of patients, surgery may be required to remove bone fragments, realign the joints, or even replace the joint with an artificial part. Joint replacement surgery should be considered when the pain is severe, for those who need long term use of pain killers, and when the joint pain is affecting his / her mobility. Not everybody needs a joint replacement surgery. Speak to your doctor on the risks and benefits, and to decide on the most appropriate timing for joint replacement surgery.