MEDICAL MANAGEMENT OF OSTEOARTHRITIS

Osteoarthritis is a common problem of the major joints. Typically, the patient feels pain (especially with weight bearing) and stiffness when having been still for a period of time and loss of movement of the joint. Looking inside the joint one sees loss of joint lining cartilage, remodelling of bone, thickening of surrounding tissues and swelling of the joints.

The principals of treatment are:

• Weight loss.
• Exercise.
• Mechanical aids.
• Simple pain killers.
• Non steroidal anti-inflammatory tablets.
• Drugs such as Glucosamine or Chondroitin Sulfate.
• Narcotic drugs.
• Intra-articular injections of steroid or synthetic joint fluid.
• Surgery.

Points To Remember:

Even losing as little as 5kg of weight can significantly reduce your long term symptoms.

Inactivity from pain leads to reduced muscle bulk around the joint, instability and loss of shock absorption ability of the muscles. Restoring these muscles can improve range of movement, strength and stability and reduce pain. This exercise is best performed in a non weight bearing fashion such as swimming or hydrotherapy. Low impact exercise is also beneficial.

Simple interventions such as shock absorbing footwear, adequate arch supports and heel cushions and use of a walking stick in the hand opposite to the affected leg, typically reduce pain significantly.

Surgery is a last resort for patients with osteoarthritis and most people will manage very well without surgical intervention.