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Treating Osteoarthritis

Treating osteoarthritis, the most common form of arthritis, depends a great deal on the joints involved. The disease causes the cushioning or cartilage between the bone joints to wear away and as the disease gets worse, the cartilage disappears and the bone rubs on the bone. Treatment seeks to increase the strength of the joints, maintain or improve joint movement, reduce the disabling affects of the disease, and to relieve pain.

Medications are one way that doctors seek to treat osteoarthritis. The most common medications used are nonsteroidal anti-inflammatory drugs (NSAIDs). They are pain relievers that reduce pain and swelling. Types include aspirin, ibuprofen, and naproxen. Although NSAIDs work well, long-term use of these drugs can cause stomach problems, such as ulcers and bleeding.

Other medications used to treat osteoarthritis include Cox-2 inhibitors (coxibs). Coxibs block a substance called Cox-2 that causes swelling. This class of drugs was first thought to work as well as other NSAIDs, but with fewer stomach problems. However, reports of heart attacks and stroke have led the FDA to re-evaluate the risks and benefits of the Cox-2s.

Steroids are another medication that is often used to treat osteoarthritis. These medications are injected right into the joint. They can also be used to reduce inflammation and pain.

Over-the-counter remedies such as glucosamine and chondroitin sulfate help many people. There is some evidence that these supplements can help control pain, although they do not seem to grow new cartilage.

Another medication that may offer some pain relief for up to 6 months is artificial joint fluid (Synvisc, Hyalgan).

In addition to prescribed or over-the-counter medications there are significant lifestyle changes that can be made to help treat osteoarthritis. Exercise is one way to help maintain joint and overall movement. Water exercises, such as swimming, are especially helpful. Other lifestyle changes include: applying heat or cold, eating a healthy balanced diet, getting rest, losing weight if you are overweight, and protecting the joints.

Physical therapy can also help improve muscle strength and the motion at stiff joints. Therapists have many techniques for treating osteoarthritis. If therapy does not make you feel better after 3-6 weeks, then it is likely that it will not work at all.

Splints and braces can sometimes support weakened joints. Some prevent the joint from moving; others allow some movement.

Finally, in some severe cases of osteoarthritis, surgery may be used to replace or repair damaged joints.