Treatment of Osteoarthritis

Avoid overweight. In the case of suffering from osteoarthritis in load-bearing joints (knee, hip, lumbar region, etc.). Occasionally, weight loss, however small, is sufficient to make an obvious improvement of the pain associated with osteoarthritis.

Do not make repetitive movements or make excessive use of the compromised joints. One example could be to avoid stairs whenever possible in patients with osteoarthritis of the knee.

Correct postural hygiene. For example, adjust the seating position in the workplace to preserve the anatomy of the region, or avoid spending too much time standing up if there is osteoarthritis in the lower limbs.

Physical exercise. This must be individualized for each patient, and should be performed regularly, without forgetting it in the phases when the symptoms improve. For example, swimming is a good sport for patients with lumbar, hip or knee osteoarthritis. Good physiotherapy can produce a significant improvement of the pain and joint stiffness.

Analgesics. They are the most used drugs. They produce a significant improvement in the pain and joint stiffness. Common analgesics like paracetamol are normally used.

Anti-inflammatory drugs. Many patients have pain despite the use of analgesics and can be treated with the so-called non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, naproxen, ibuprofen, aceclofenac, etc., especially on the days when the pain is more acute. In cases where there is no response to common analgesics or non-steroidal anti-inflammatory drugs, more powerful analgesics may be used, such as opiates (for example, tramadol).

Chondroprotectors. In the last few years, drugs have arrived on the market called chondroprotectors, which are constituent substances of the cartilage joint and that can alleviate the pain of osteoarthritis. However, their efficacy is still not widely accepted. Within this group are glucosamine and chondroitin sulphate. Other drugs, like diacerein could have a similar effect.

Intra-articular therapy or injections. Many patients may benefit from the administration of anti-inflammatory drugs within the joint. This is intra-articular therapy or injections. In the majority of occasions glucocorticoids, derived from cortisone, are injected, and more recently hyaluronic acid is also being used. Injections can be given in cases where the pain is not alleviated by the previous treatments. They are particularly useful in those joints where the inflammatory signs, especially joint effusion, are more evident. They should also be used as a one-off measure, and not be performed repeatedly, since the use of corticosteroids may sometimes be counter-productive in excessive doses. Their ideal use is in joints with unevolved osteoarthritis, where it is still possible to reverse certain processes. On the other hand, in very advanced osteoarthritis, where surgery is now the only option, its efficacy notably decreases.