Osteoarthritis

Hypertrophic osteoarthritis; Osteoarthrosis; Degenerative joint disease; DJD; OA; Arthritis - osteoarthritis

The goals of treatment are to relieve pain, maintain or improve joint mobility, increase the strength of the joints, and minimize the disabling affects of the disease. The specific treatment depends on which joints are involved.

MEDICATIONS

The most common medications used to treat osteoarthritis are nonsteroidal, anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve, Naprosyn, Naprelan, Anaprox).

Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding. In April 2005, the FDA asked manufacturers of NSAIDs to include a warning label on their product that alerts users of an increased risk for cardiovascular events (heart attacks and strokes) and gastrointestinal bleeding.

Other medications used to treat OA include:

• COX-2 inhibitors (coxibs). Coxibs block an inflammation-promoting enzyme called COX-2. This class of drugs was initially believed to work as well as traditional NSAIDs, but with fewer stomach problems. However, numerous reports of heart attacks and stroke have prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Rofecoxib (Vioxx) and valdecoxib (Bextra) have been withdrawn from the U.S. market following reports of heart attacks in some patients taking the drugs. Celecoxib (Celebrex) was still available at the time of this report, but labeled with strong warnings and a recommendation that it be prescribed at the lowest possible dose for the shortest duration possible. Patients should ask their doctor whether the drug is appropriate and safe for them.
• Steroids. These medications are injected directly into the joint. They may also be used to reduce inflammation and pain.
• Supplements. Many people are helped by over-the-counter remedies like glucosamine and chondroitin sulfate. There is some evidence that these supplements are helpful in controlling pain, although they do not appear to grow new cartilage.
• Artificial joint fluid (Synvisc, Hyalgan). These medications can be injected into the knee, They may relieve pain for up to six months.