osteoarthritis
Osteoarthritis cannot be cured or reversed; however, effective treatment can reduce its progression and slow down complications.

Disease-modifying osteoarthritis drugs (DMOADs) are currently being considered a “cure” for osteoarthritis (OA).

  • These molecules aim to target the precise mechanism of cell destruction seen in osteoarthritis, as well as enhance joint repair at the cellular level, thus showing potential to “cure” OA if it is in its early stages.
  • These drugs have yielded good results in phase II and III clinical trials. However, they have not yet been approved by the U.S. Food and Drug Administration.
  • At present, osteoarthritis cannot be cured or reversed. Although, with the right care and medications, you can reduce its progression and slow down its complications.

Osteoarthritis is a degenerative disorder, which means it is a result of long-standing wear and tear of the structures (cartilage and bone surfaces) that make up a joint. Once the joint surface is eroded and the bone develops degenerative changes, the joint function is compromised, causing severe pain and reduced movement at the joint.

How is osteoarthritis treated?

Medications, physiotherapy, and lifestyle modifications are cornerstones of osteoarthritis (OA) management.

Mild osteoarthritis

  • This is often managed by physiotherapy and weight-bearing exercises to improve bone mass.
  • Supplements containing calcium, magnesium, vitamin D, zinc, as well as adequate protein intake are a must.
  • Weight management to prevent or treat obesity and the use of good fitness gear and joint supports for the wrist, knee, and ankle while exercising help with the symptoms and strengthen the muscle around the affected joints.

Moderate osteoarthritis

These cases exhibit symptoms, such as joint pain and stiffness, which are best managed with the following treatment modalities:

  • Medications: Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, muscle relaxants (in case of stiffness around muscles) along with hot water fomentation, and physiotherapy. The antidepressant, Cymbalta (duloxetine hydrochloride), is approved by the U.S. Food and Drug Administration in individuals who do not respond well to NSAIDs.
  • Physiotherapy sessions include active and passive exercises. Underwater exercises are helpful if joint movement or weight-bearing causes pain.
  • Weight loss (if overweight) under supervision (avoid crash dieting that may further accelerate bone loss and muscle loss).
  • Protein-rich diet, adequate intake of calcium and vitamin D, management of diabetes and cholesterol.
  • Use of braces, shoe inserts, cane, or walker to reduce joint stress while walking or exercising.
  • Intraarticular injection therapies (steroid, hyaluronic acid “gel”) in case of joint space swelling.

Severe osteoarthritis

Surgery for joint fusion, realignment, or joint replacement is often the only effective modality to relieve pain and disability associated with advanced osteoarthritis. This must be followed by proper rehabilitation and physiotherapy post-surgery for maximum benefit.

The following osteoarthritis (OA) therapies may help:

  • Platelet-rich plasma injections are administered into the joints, which is believed to promote tissue regeneration.
  • Transcutaneous electrical nerve stimulation, especially in cases of muscle stiffness due to OA of the hip, knee, and lower back.
  • Acupuncture may help some individuals though the effect is often temporary.
  • Supplements containing fish oils, curcumin (the active ingredient of turmeric), Boswellia serrata may be attempted in early OA.
  • Arthroscopy (minimally invasive or "keyhole" surgery) for removal of bone spurs in case of knee OA.

These approaches are not harmful and may be used in people who do not want to use surgical intervention. Most doctors do not routinely recommend these for the treatment of OA because their benefits are uncertain and unproven.

QUESTION

What joints are most often affected by osteoarthritis? See Answer

What are the 2 types of osteoarthritis?

Osteoarthritis (OA) is classified into two types:

  1. Primary OA is the most common form and a consequence of aging, hormonal disruptions of menopause, and general wear and tear. It affects larger joints, such as the spine, hip, knee, and ankle.
  2. Secondary OA occurs in a joint with a preexisting abnormality. It is often seen in those with a history of trauma, joint fracture, sports-related injury, joint tuberculosis, rheumatoid arthritis, genetic musculoskeletal disorders, and congenital defects, such as Marfan’s and Ehlers Danlos syndrome. It is often the early onset OA (seen in younger individuals).

Whare the risk factors for osteoarthritis?

The risk factors for osteoarthritis are seen below:

Table. Certain risk factors for osteoarthritis
Nonmodifiable Modifiable
Advancing age Obesity
Hereditary (seen in families) Poor bone health due to calcium and vitamin D deficiency
Menopausal changes Medications, such as steroids and proton pump inhibitors
Testosterone deficiency in elderly men Diabetes, hypertension, and other comorbidities
Poor posture
Ergonomic factors and occupational injury
Sports-related injury

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Medically Reviewed on 2/16/2022
References
Image Source: iStock Images

Arthritis Foundation. Slowing Osteoarthritis Progression. https://www.arthritis.org/diseases/more-about/slowing-osteoarthritis-progression

Deveza LA, Bennell K. Patient education: Osteoarthritis treatment (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/osteoarthritis-treatment-beyond-the-basics?search=osteoarthristis&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3