One of the most successful options for mild to moderate arthritis is low impact exercise and weight loss. Even minimal weight loss can result in dramatically less stress on the joints of the hip and knee. Low impact exercise like cycling, swimming, and walking can strenghten the muscles and supporting structures of our joints as well.
Oral medications commonly used in treating this condition range from traditional NSAIDs, or non-steroidal anti-inflammatories, to acetaminophen. These can be used in an over the counter fashion, or be prescribed by your physician to provide easier once daily dosing. Other medications such as glucosamine and chondroitin sulfate have flourished in health food and supplement stores. Evidence for their benefit is quite mixed in large studies but there do appear to be patients who obtain pain relief from these medications. It can be useful to perform a trial of these medications to see if they really do work, as taking them provides no benefit toward commonly marketed goals of cartilage restoration and preservation.
Another category of medications is what I call injectables. Steroid injections have been a mainstay for decades. They can be quite effective for acute flairs of joint pain that can occur. It is prudent to space out these injections as their overuse can lead to further joint and soft tissue breakdown. A newer class of medication, viscosupplementation, involves injecting the joint with a gel. This gel is hyaluronic acid, a natural protein found in human joint fluid. Multiple brand names exist, and treatments can range from one to five injections. These injections can provide some with longer term relief than cortisone and may have fewer side effects in the long term. The newest injection utilized is PRP, or platelet rich plasma. This involves processing blood drawn in similar fashion to a blood test one may have performed to monitor things like cholesterol levels. It is then processed to form a concentrated fluid of platelets and growth factors. This is then injected in to the joint. Studies have shown this treatment to be at least as, and for some, more effective than viscosupplementation. At Floyd Memorial Orthopdic Group we can perform this as an office procedure to help minimize the costs until insurance companies agree to reimburse for its use.
If these options are not working, minimally invasive surgical management can then be discussed as an option. For the shoulder, some patients with arthritis can benefit from procedures to address bone spurs and painful soft tissue conditions such as biceps tendon tears. In the hip, early surgery to address bone spurs can slow down the progression of arthritis that appears to stem from these spurs. And in the knee, a new procedure called subchondroplasty can be done in conjuction with a standard knee arthroscopy can offer some patients relief of their knee pain in an outpatient setting. These surgeries aren't for everyone though. Many patients will still be best served by traditional joint replacement options so a consultation in our office is still the best way to find what will work for you!