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What are the treatment options for arthritis?

The goals of treatment for arthritis are to relieve pain and improve function. Treatment options for arthritis include the following:

  • Nonsteroidal anti-inflammatories like Advil, Aleve, Motrin and the like can be very helpful with decreasing inflammation because as the joint wears, inflammation can be very painful.
  • Activity modifications. If a person is a jogger or a runner and his or her hip starts hurting, he or she should give up the running and jogging and learn about more hip-friendly and hip-unfriendly exercises. The trauma to the joint from running is what causes the pain. That activity needs to be modified so it does not hurt all the time.
  • Weight loss. Across the hip, in the single-legged stance, there's 3 pounds of body force for every pound of body weight. Even if people are 10 pounds overweight, with every step they take, that's 30 pounds of stress going across the hip. With the number of steps they take every day, every week, every year, it really adds up. Just losing some weight can really be beneficial.
  • Prescription anti-inflammatories. Once the arthritis progresses, there are some prescription anti-inflammatories that can be helpful.
  • Cortisone injections in certain joints can be very helpful. They're not very helpful with a hip probably because the force is so much greater across the hip, but for knees and the small joints, cortisone injections can be very, very helpful.
  • Walking aides like a cane to unload the joints can be beneficial.

Doctors can baby people along for a long time with these types of conservative measures, but ultimately if a person keeps using the joints, what's probably going to happen is that these measures are not going to be effective. That's when a person may need joint replacement surgery.

Arthritis treatment begins conservatively with medication, bracings, physical therapy and sometimes injections depending on the degree of arthritis and functional problems. Anti-inflammatory medicines can be given or, as the next step, injected in the joint. Bracing can take the pressure off of the joint.

With almost any joint, the muscles around the joint needs to be strong enough and prepared enough to take some of the stresses off the joint. A lot of the times, physical therapy plays a very important role in the management of osteoarthritis, in particular. Eventually a surgical procedure may be needed to replace joints. For example, in the knee, doctors can replace half a joint, or do a full replacement of the entire surface of both the tibia and the femur portions of the knee.

One of the most important things you can do if you have arthritis it to keep moving. Even though walking may be painful if you have arthritis of the knee, walking helps delays how fast the arthritis progresses. You can ease pain with ice or heat and Tylenol or ibuprofen. Sometimes, joint injections can help.

All medications have a risk of potential side effects. Acetaminophen (Tylenol) can cause liver damage if you take too much. Nonsteroidal ant-inflammatory drugs (NSAIDs) can cause gastrointestinal issues such as ulcers, upset stomach or heartburn. They can also damage kidney function and may raise your risk of heart attacks and strokes. Always talk to your doctor about your options and about the medicines you take to determine the best type of medication for your arthritis and the most appropriate dosage to limit any possible side effects.

Therapies for the pain of arthritis include medications like acetaminophen and a spectrum of anti-inflammatory drugs; exercise therapy is also recommended.

Watch rheumatologist Natalie Azar, MD, discuss medical and natural treatments for arthritis.

Dr. Peter Bongiorno, ND
Naturopathic Medicine Specialist

Watch as naturopathic doctor and licensed acupuncturist Dr. Peter Bongiorno suggests some natural treatments for arthritis.

Dr. Vonda Wright, MD
Orthopedic Surgeon

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.
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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.

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With many forms of arthritis, some of the most effective treatment options may include a combination of medications, physical therapy and surgery. A number of medications can be used to treat arthritis, ranging from painkillers to steroids to disease-modifying antirheumatic drugs. Medications may be taken by mouth, by injection or as a topical cream rubbed onto the painful joint. Medications are often used in combination with other treatments such as physical therapy, exercise, weight control and splinting or bracing. If medications and therapy don't work, surgery to replace damaged joints may be the best option. Your treatment will depend on your type of arthritis as well as your individual needs, so make sure you talk with your doctor about the best treatment options for you.

To treat mild symptoms of arthritis, stretching, light physical activity and heat will often suffice to relieve discomfort. Indeed, staying active can help keep your joints from getting stiff and sore during the cooler winter months. Keep warm and do gentle stretching activities, as appropriate for your age and fitness level. Directed exercise and, in some cases, physical therapy may be helpful for specific conditions such as spine, knee and shoulder arthritis.

If you have more severe pain or swelling in any of your joints, talk with your doctor. He or she may suggest an over-the-counter analgesic or prescribe another medication. In many cases analgesics can be used to control pain and discomfort. For mild or moderate pain, acetaminophen or acetaminophen combined with an anti-inflammatory drug is likely to provide some relief.

While medications for mild or moderate pain from arthritis are generally safe when taken at the recommended doses, older people are much more likely to have adverse effects than younger ones. They should be used with caution and your doctor’s knowledge and supervision. Anti-inflammatory drugs (ibuprofen, naproxen and others) can cause nausea, loss of appetite, gastrointestinal bleeding, swelling, high blood pressure and kidney impairment. Close medical supervision is necessary, particularly with continuous use.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.