Living with Osteoarthritis

Osteoarthritis is a condition that affects 27 million Americans. It can be described as the "wear and tear" form of arthritis where the cartilage, that surrounds and protects the joints, breaks down. The knee, hip and shoulder are among the most common joints affected by this disease. Many treatments help combat the symptoms that make this disease such a major issue in the medical field today. Recent studies have helped pinpoint which treatments are more effective than others at reducing pain, ranging from oral medications to injections.

Many symptoms are associated with osteoarthritis (OA). First people suffering from OA experience pain. The joints may ache or the pain may feel burning or sharp. The pain may be constant or come and go. Secondly, people will experience stiffness. They may have difficulty getting up in the morning. Their joints may feel stiff and creaky for a short period of time until the body gets moving. This can also happen when the individual sits for a prolonged period of time. People with OA may also experience muscle weakness, especially the knee, due to decreased movement caused by pain. Although not common many people with OA of the knees tend to have moderate swelling of the joint. Severe cases of OA have deformed joints. Joints begin to take on an odd shape due to all the foreign stresses the disease causes. As the disease progresses individuals will begin to experience reduced range of motion and may actually lose the ability to use the joint. Lastly, individuals with OA often experience sleeping problems due to constant pain as the disease progresses. Lack of sleep can lead to irritability and make it harder for person to deal with the pain.

It's typical in the early stages of OA that the doctor will prescribe over the counter pain medications, such as Acetominophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibruprofen (Advil, Motrin) and Naproxen (Aleve).

Injections are also another option of treatment. Most injections are often Hyaluronic Acid (HA) or the anti-inflammatory drug Cortisone. Hyaluronic Acid is a lubricating substance that is naturally found in human joints. Cortisone is also a natural substance found in the body. It's a hormone that is released by the adrenal gland in response to stress and can be given as an injection to help relieve pain and reduce swelling of the joint.

In a publication released in the January 6, 2015 issue of Annals of Internal Medicine a study by Dr. Raveendhara Bannuru, a rheumatologist at Tufts University, measured the effectiveness of various treatments for Osteoarthritis. The study proved that all forms of treatment are better than placebo pills at easing the symptoms but they are not all equal in effectiveness. In the study, some patients were given injections of HA, some cortisone, some Acetaminophen, some NSAIDs and lastly some were given placebo pills.

Injections of HA were proven to be most effective in treating the symptoms of OA followed closely by Cortisone. NSAIDs came next, with acetaminophen rounding out the bottom of the list.

However, as with all oral medications and injections come many side effects. NSAIDs have proven to increase the risk of heart attack and stroke in older adults who take them long term. Side effects that accompany injections are often limited to temporary pain and swelling but can also include allergic reactions and infection. In the study, Dr. Bannuru mentioned, "Even though we didn't test them in our study it's important for people with arthritis to know there are several non-drug treatments, such as exercise and physical therapy." With all this being said, it is important that people who suffer from Osteoarthritis consult with their physician when choosing their plan of care.

Written By: Joshua Rivera, ATC

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