What are the treatment options for arthritis?

Once you have been diagnosed with arthritis, your doctor has many treatments at his disposal. Exercise, diet, and supplementation offer the most lasting benefit. However, more invasive therapies such as medications, injections, and surgery are also available, and are sometimes necessary. Medications and injections often provide significant pain relief and allow you to participate in appropriate exercises so that the pain does not recur.

Although it is the most invasive option, surgery has excellent results when used judiciously in the right circumstances and patients. It is helpful to understand your options, so you can have an educated discussion with your doctor about the different treatments available and make an informed decision about what would be best for you.

Arthritis remedies from your doctor include:

• Joint injections -- There are two categories of joint injections physicians use to relieve arthritis pain: steroid injections and joint lubrication. Steroid injections have been around for a long time and consist of injecting the joint with a mixture of numbing medicine, such as lidocaine or marcaine, and steroids. The point of this injection is to decrease the pain and inflammation of arthritis. These injections usually last an average of three weeks, and most physicians will give only three a year to any joint. I tend not to use steroids unless my patients have excruciating pain.

• Joint bracing -- Knee arthritis can cause legs, in particular, to move from straight to bowlegged or knock-kneed. This is because as one side of the knee wears down, the joint on that side collapses. Most people wear down the inside compartment of the knee first and end up with bowlegs. Braces can "unload" the affected side of the joint by pushing on the opposite side and effectively straightening the leg again.

• Alternative/complementary therapies -- Many patients ask me if using herbs or alternative therapies will help their arthritis. Although many people swear by products such as chondroitin sulfate, glucosamine, and shark cartilage, there is currently no convincing evidence in the medical literature that these remedies are better than a sugar pill. A recent study, however, shows that acupuncture can relieve arthritis pain.

• Arthroscopic joint debridement -- "Washing the joint out" by surgically removing loose tissue or debris in the joint using a small camera and instruments inserted through tiny incisions has not been found to be effective for long-term treatment of arthritis pain. The only true indication for arthroscopic surgery with arthritis is if the person has mechanical catching or locking (which feels like popping, snapping, or sharp pain) because of a torn meniscus.