As I have stated in previous blogs, osteoarthritis is a spectrum of disorders that range from mild symptoms, such as aching and swelling after activity to disabling pain which significantly impacts your ability to carry out many daily activities. The treatment for osteoarthritis clearly varies depending on where you are in the spectrum of the disease. Patients with mild-to-moderate osteoarthritis can often be managed nonoperatively for quite some time. The nonoperative treatment includes things that the patient can take responsibility for, such as weight loss, increasing low-impact exercise to improve strength and tone, modification of activity, and use of over-the-counter anti-inflammatory and analgesic medications such as acetaminophen and ibuprofen. Treatments that your physician can arrange include physical therapy to improve the strength and function of arthritic joints, use of prescription anti-inflammatory medications, and injection of either cortisone to decrease inflammation in the joint or viscosupplementation drugs which improve the lubrication and function of the joint. All of these modalities will decrease the symptoms from osteoarthritis. They will not alter the progression or “cure” osteoarthritis. The goal in the early-to-moderate stages of osteoarthritis is to decrease pain and improve function. Many patients state they cannot lose weight when they have arthritis because they cannot exercise as much. While an arthritic joint will impair your ability to exercise in certain areas, there are still many low-impact exercises that can be accomplished. More importantly, modification of diet, eating healthier, and eating less will lead to weight loss in the overwhelming majority of people. The less weight on an arthritic joint, the better that joint will feel and the fewer symptoms the patient will experience.
Once arthritis advances to a more severe state where there is loss of cartilage and bone-on-bone rubbing between the surfaces, these symptomatic treatments will often not suffice and surgical intervention will ultimately be an option. In subsequent blogs, I will outline how to go about finding a surgeon and preparing yourself for surgery and recovering from the operation.
William P. Barrett, MD