Treatment & Prognosis
To date, no medication has proven effective in halting or reversing progression of osteoarthritis. Instead, drug therapy is used to alleviate its symptoms, and increase motor functions of the joints.
NSAIDs (non-steroidal anti-inflammatory drugs), can reduce pain and any joint inflammation that may be present. However, due to the potential for harmful side effects of prolonged use of some classes of NSAIDs, specifically damage to the kidneys and gastro-intestinal tract, all patients – and older patients in particular – should consider alternative therapies.
Analgesics, such as acetaminophen, have also shown to be quite effective in combating joint pain.
Dietary supplements intended for physiological therapeutic use – so-called ‘nutriceuticals’ – have occasionally proven to be effective in relieving some symptoms of osteoarthritis, but should only be used following consultation with a physician.
Common dietary supplements used for osteoarthritis include two that can be used separately, or together; because they are not subject to the same regulatory standards as prescription-based medications, care should be taken with their use:
- Glucosamine, a common organic compound, and one which is extracted from the exoskeleton of shellfish. There is some evidence that glucosamine helps cartilage formation in the knee.
- Chondroitin, a structural component of cartilage, one which is extracted from the cartilaginous tissue of animals (often cow, pig, shark, fish, and bird)
Patients with moderate OA who experience little relief from standard medical treatment may consider a form of therapy called viscosupplementation, in which a viscous solution called hyaluronic acid is injected into affected joints, promoting lubrication and some degree of shock absorbency, both of which have been found to relieve pain and stiffness. Injections can be repeated every 6 months.
These injections can be effective in patients with mild osteoarthritis, but is less helpful if there is moderate or severe arthritis. No long-term negative effects of repeated use have been shown, although studies are ongoing.
Surgery is usually the last option, and can provide complete relief from osteoarthritis symptoms for those who opt for total joint replacement, typically for those who experience severe pain that is unresponsive to drug therapy, or in cases where loss of joint function is complete, impairing quality of life. Surgery for the hip and knee are most common, but is also possible in other joints. It should be noted that failure rates (in which a prosthesis received through surgery requires some form of revision), while viable, occur in up to 30% of cases after 10 years.