"My doctor said to exercise and lose weight, but I can't exercise because it is too painful!" This scenario highlights one of the difficulties of treating osteoarthritis. We know that lifestyle changes can help, but they can be difficult to make when in pain. As anyone who has dealt with chronic pain can attest to, pain can have a negative effect on your mood and motivation level. For people who don't sleep well because of pain, they may have less energy to make the lifestyle changes they need. If you find yourself in this situation, the goal is to break the negative cycle that osteoarthritis and pain are having on your lifestyle.
The last article listed some of the initial treatments for osteoarthritis, such as physical therapy, weight loss, activity modification and medications - it may take several months to see the full benefits of some of these treatments. If symptoms are not improving, then some of the following advanced treatments can be considered:
- Pool Therapy - if conventional physical therapy and exercise are too painful, pool therapy can be worth trying, since there is much less stress on the joints.
- Changing Medications - If you have tried acetaminophen (Tylenol) or an NSAID (non-steroidal anti-inflammatory drug) without success, your doctor may recommend a different medication. Common over-the-counter NSAIDs include ibuprofen and naproxen, and stronger ones are available by prescription. Make sure to discuss possible side effects with your doctor.
- Glucosamine and Chondroitin - There is controversy over whether these supplements are beneficial. A study published in the New England Journal of Medicine last year found glucosamine hydrochloride to be of little help for knee osteoarthritis. Research from the Arthritis Foundation also found that a combination of glucosamine and chondroitin didn't help knee pain. Still, some people have found relief. If you think you want to try these supplements, you can discuss taking them with your doctor but you can discuss taking them with your doctor.
- Cortisone Injections - These are given into the joint, and have a strong anti-inflammatory effect. Doctors may limit the number of injections they will give because of the possible risk of cartilage damage with too many injections.
- Viscosupplementation - A series of hyaluronic acid injections
may improve lubrication in the joint, allowing patients to return to normal activity. The injections may also reduce inflammatory cells and reduce the nerve impulses that cause pain. Like any other treatment, though, results vary widely from person to person.
In is also important to maintain any positive lifestyle changes you have made, as these will help with the long-term management of osteoarthritis. In the next article we will discuss surgical options for osteoarthritis.