Treatments for OA

            Osteoarthritis (OA) is the most common type of arthritis, and can also be referred to as degenerative joint disease.  Healthy cartilage in the joint permits the bones to move around one another, while also absorbing shocks from physical activity.  The breakdown of the joint tissues (the bones under the cartilage begin to come into contact and rub against one another) is what eventually leads to pain, stiffness, and swelling.  Over time you can get a loss of joint motion, bone spurs (small deposits of bone that grow on the edges of the joint), and pieces of bone/cartilage can detach and float inside the joint space; all of which can lead to increased pain and damage of the diseased area.  The most commonly affected areas are the knees, hips, and those associated with the hands and spine.  Onset of OA is usually after the age of 40 and there is currently no cure.  However, there are ways to relieve symptoms.

            The goals for OA relief include: controlling pain, improving joints function, maintaining normal body weight, and a healthy lifestyle.  The two most common forms of treatment include exercise and weight control.  Exercising will strengthen the muscles that support the affect area(s) while allowing your joints to stay limber.  Maintaining a normal body weight with a healthy lifestyle is also beneficial.  A healthy weight can ensure reduced stress on weight-bearing joints, decrease likelihood of further injuries, and increase mobility.  All of the above are inexpensive and easy enough for the average person to do to improve upon their condition.  However, what if this is not enough?  Are there other plausible options?  The answer is yes.

            There are additional nondrug therapies for OA.   The most interesting is acupuncture.  Scientists believe that the needles stimulate the release of natural, pain-relieving chemicals produced by our bodies.  A study with backing by the NIAMS and NCCAM found that acupuncture relieves pain and increase function in knee OA.  Another interesting therapy includes transcutaneous electrical nerve stimulation (TENS).  TENS is a technique which directs mild electrical pulses to nerve endings under the skin in painful areas.  It is believed that TENS functions by blocking pain messages to the brain and modifies pain perception.

            However, what if these nondrug therapies still aren’t enough?  OA is known for severe pain that can make everyday activities debilitating.  Besides the obvious over-the-counter pain relievers and NSAIDs (nonsteroidal anti-inflammatory drugs i.e. Aspirin, ibuprofen, etc.) is the use of corticosteroids (Cortisone shots).  Corticosteroids are powerful anti-inflammatory hormones naturally made by our body (or man-made for use in medicine).   These hormones are usually produced in your adrenal gland, and when you experience stress, they are released to minimize inflammation. These can be injected into joints to temporarily relieve pain.  However, this is only short term, and not recommended to be used more than two to four times a year due to the known side effects.  Since it is known to cause great relief, even if only for a short amount of time, it would be interesting to see if a new corticosteroid could be synthetically produced that could give longer lasting affects or was able to be used more frequently.

            As our population is living longer and experiencing OA to a long degree, joint replacements are becoming more prevalent.  However, the most extreme treatment for OA is joint-replacement with artificial joints called arthroplasty.  When OA becomes so debilitating and painful that causes normal functioning impossible, many patients become candidates for the procedure.  The most established replacement is with the hip followed by the knee.  In addition, surgeons are exploring new techniques for “minimally invasive” approaches for arthroplasty surgeries.  They are looking into these new methods to give patients a shorts recovery time and less post-op pain.  Also, total hip replacement is a severe surgery.  Hip resurfacing is a surgical alternative.  It consists of scraping the surfaces of the hip joint and femur and placing a metal cap over the bone.  Therefore more of the bone is able to be preserved (allowing for a hip replacement to be done later is needed).  This is a good option for younger patients who are physically active.  There are a variety of surgeries that can be done, the conditions for each depend on the needs of the patient.

            It can be seen that there are multiple ways of relieving pain for OA patients.   These treatments range from mild (exercising and healthy eating) to more intense (Cortisone shots).  Nonetheless, all types of treatment allow for there to be a reduction in pain due to less stress or even a decrease in inflammation which all allow the patient to live a more normal life.  This wide range of treatments allow the individual to choose the best option for them, and hopefully in the near future more will become known and available.

Sources:

McCoy, Krisha. "Pros and Cons of Cortisone for Osteoarthritis."

             EverydayHealth.com. Everyday Health, 10 July 2010. Web. 2 Nov. 2014. <http://www.everydayhealth.com/osteoarthritis/the-pros-and-cons-of-cortisone-for-osteoarthritis.aspx>.

"Osteoarthritis." Handout on Health: Osteoarthritis. National Institute of Arthritis and 

             Musculoskeletal and Skin Diseases (NIAMS), 1 Aug. 2013. Web. 2 Nov. 2014.   

            <http://www.niams.nih.gov/Health_Info/Osteoarthritis/>.

"Osteoarthritis." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 16 May 2014. Web. 2 Nov. 2014. <http://www.cdc.gov/arthritis/basics/osteoarthritis.htm>.

"Osteoarthritis." University of Maryland Medical Center. 25 Sept. 2012. Web. 2 Nov. 2014.<http://umm.edu/health/medical/reports/articles/osteoarthritis>.