Osteoartritis

Although there is no single test for osteoarthritis, your doctor may do the following to diagnosis you with the condition:

• Medical history to learn about your symptoms, any other medical problems you and your close family members have, and about any medications you are taking.
• Physical exam to check your general health, reflexes, and problem joints.
• Take pictures of your joint.
  • X Rays can show things such as cartilage loss, bone damage, and bone spurs. Early damage may not show on x rays.
  • Magnetic Resonance Imaging (MRI) can show damage to connective tissues.
• Blood tests to rule out other causes for symptoms.
• Joint fluid samples to look for other causes of joint pain, such as infection or gout.

Treatment for osteoarthritis can include medications ¹ or surgery to reduce pain and improve functioning.

• Medications commonly used in treating osteoarthritis include:
  • Over-the-counter pain relievers such as acetaminophen.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) ² to treat pain and inflammation. Ibuprofen and naproxen sodium, are available over the counter, whereas other NSAIDS are available by prescription only.
  • Creams, rubs or sprays that are applied to the skin over sore joints to relieve pain.
  • Prescription opioid pain relievers are sometimes prescribed when over-the-counter medications don't work or a person may not be able to take NSAIDs.
  • Corticosteroids are strong inflammation-fighting drugs that can be injected into the joint to temporarily relive pain. This type of treatment is usually not recommended for more than two to four treatments per year. These types of drugs are not typically given by mouth to treat osteoarthritis, unless treating inflammatory flares.
  • Hyaluronic acid substitutes (viscosupplements) are injected into the knee to replace a normal component of the joint involved in lubrication and nutrition.
• Surgery may be a factor after considering a variety of factors, including your age, occupation, level of disability, pain intensity, and the degree to which arthritis interferes with your lifestyle. Surgeries can include one or more of the following:
  • Arthroscopic debridement: Removal of loose pieces of bone and cartilage from the joint.
  • Osteotomy: Repositioning of bones.
  • Joint resurfacing: Smoothing out bones.
  • Prostheses are artificial joints that replace affected joints. The artificial joints can be made from metals, high-density plastic, or ceramic material. Artificial joints can last 10 to 15 years or longer. In some cases, your surgeon may replace only the damaged part of the knee joint, leaving undamaged parts of the joint in place.
• Transcutaneous electrical nerve stimulation (TENS) directs mild electric pulses to nerve endings that lie beneath the skin in the painful area. It seems to work by blocking pain messages to the brain and by changing pain perception.
• Alternative therapies for osteoarthritis can include:
  • Massage can increase blood flow and bring warmth to a stressed area. However, arthritis-stressed joints are sensitive, so the therapist must be familiar with the problems of the disease.
  • Acupuncture uses thin needles to relieve pain and restore health. Scientists think the needles stimulate the release of natural, pain-relieving chemicals produced by the nervous system.

Footnote

^1.All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects. Go to reference

^2.Warning: Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a person is being treated with NSAIDs, because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. NSAIDs should only be used at the lowest dose possible for the shortest time needed. Go to reference

Treating osteoarthritis requires a team effort involving you and several types of health care professionals. These may include:

• Primary care doctors, such as a family physician or internal medicine specialist, who coordinates care between the different health providers and treats other problems as they arise.
• Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
• Orthopaedists, who specialize in treatment and surgery for bone and joint diseases.
• Physical therapists, who help improve joint function.
• Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
• Dietitians, who teach about good diets and maintaining a healthy weight.
• Nurse educators, who help you understand your condition and help start treatment plans.
• Physiatrists (rehabilitation specialists), who supervise exercise programs.
• Licensed acupuncture therapists, who reduce pain and improve physical functioning by inserting fine needles into the skin at specific points on the body.
• Psychologists or social workers, who help with social challenges caused by medical conditions.
• Chiropractors, who focus treatment on the relationship between the body's structure—mainly the spine—and its functioning.
• Massage therapists, who press, rub, and otherwise manipulate the muscles and other soft tissues of the body.