Osteoarthritis

Although there is no cure for osteoarthritis, treatment can help you reduce your symptoms. The more you understand about osteoarthritis and what you can do to treat your pain and stay active, the less discomfort and disability you are likely to have. You may also be able to limit further joint damage.

The goals of treatment are to:

• Reduce symptoms.
• Maintain joint function.
• Minimize disability.
• Limit structural changes.

Treatment is based on:

• How severe your symptoms are (mild to severe).
• How your symptoms affect your daily activities.
• The success or failure of prior treatments.
• The amount of joint damage.

Initial treatment

When your doctor first diagnoses your osteoarthritis, he or she will probably recommend a treatment plan that combines medicine with education about how to treat your symptoms yourself. Your initial treatment plan may include:

• Medicines, such as acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs).
• Exercise to keep your joints mobile.
• Weight loss, if you are overweight.
• Changing activities to reduce additional stress on your joints.
• Heat and cold therapy, such as hot compresses, cold packs, ice massage, or paraffin wax.
• Learning all you can about the natural course of osteoarthritis.

Ongoing treatment

Osteoarthritis normally is a slowly progressing condition, though its course is difficult to predict. Some people remain stable for a number of years or even experience periods of remission. For mild to moderate osteoarthritis, you can usually manage your symptoms over many years with a program that includes:

• Medicines, such as acetaminophen or topical capsaicin.
• Exercise to keep your joints mobile.

  Osteoarthritis: Exercising with arthritis

• Weight loss, if you are overweight.
• Protection of your joints from injury or trauma.
• Use of assistive devices and orthotics, such as tape, braces, splints, or canes.
• Changing activities to reduce additional stress on your joints.
• Heat and cold therapy, such as hot compresses or cold packs or ice massage.
• Paraffin wax. This is a form of moist heat for your hands or feet.
• Physical therapy or occupational therapy.
• Education about the natural course of osteoarthritis.
• Learning and practicing a "good-health attitude."

Research suggests that, for people who have depression in addition to osteoarthritis, treatment of the depression may also decrease the pain of osteoarthritis and improve the ability to perform daily activities.³

Treatment if the condition gets worse

If pain and stiffness from osteoarthritis fail to improve or are getting worse, your doctor may recommend treatment, such as:

• Corticosteroid injections.
• Opioids.
• Physical therapy or occupational therapy.
• Hyaluronan (hyaluronic acid) injections.

You may need joint replacement or other surgical treatments to maintain joint function and prevent progressive disability:

• Arthroscopy
• Osteotomy (knee or hip)
• Shoulder replacement
• Hip replacement
• Knee replacement
• Finger or toe surgery
• Arthrodesis

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