Osteoarthritis is also known as degenerative bone disease. It occurs as a result of a variety of patterns of joint failure and it is characterized by degeneration of bones and their articular surfaces. It is associated with the simultaneous proliferation of new bone, cartilage, and connective tissue.
Osteoarthritis most commonly affects the weight bearing joints of the body for example hips and knees. Osteoarthritis is different from rheumatoid Arthritis in the sense that there are no extra articular features and no systemic illness in osteoarthritis. Osteoarthritis treatment doesn’t reverse bone destruction however reduces the symptoms and signs of disease.
The joints most commonly involved in osteoarthritis are hands, knees, hips and spinal vertebrae. The disease is confined to one or a few joints and in the majority of patients, the disease may involve a single joint at a time. Sometimes it may involve more than two joints at a time. There is not a single drug to reverse the pathological changes in the bone but drugs for symptomatic relief of osteoarthritis may be used
- NSAIDs: no steroidal anti-inflammatory drugs are used for symptomatic treatment which decreases the joint pain, inflammation, and swelling of joints. No steroidal anti-inflammatory drugs are available as topical creams and ointments, oral drugs and in intravenous forms which can be injected over the painful joint surfaces. NSAIDs reduce inflammation at the joint surfaces and as a result reduce the pain of osteoarthritis. These are used as first priority for osteoarthritis treatment. The course of no steroidal anti-inflammatory drugs for osteoarthritis treatment is usually up to three months as long term disease treatment with no steroidal anti-inflammatory drugs can cause GIT symptoms and effect stomach leading to gastric erosions, upper GI bleed and vomit of blood. The patient is closely monitored when he is on therapy of no steroidal anti-inflammatory drugs for osteoarthritis treatment.
- Corticosteroids: intraarticular corticosteroids can be used for exacerbation of inflammation. Corticosteroids are given in the injection form, inside the joint surface when one joint is involved and if more than two joints are involved oral corticosteroids are given. These corticosteroids reduce the inflammation in the joint surfaces and reduce the pain. Steroids are also recommended for the short term used as they have any harmful side effect which includes hyperglycemia leading to diabetes like symptoms. The patients already suffering from diabetes need to increase the dose of insulin while taking the corticosteroids as it increases the blood sugar level. The other side effect of corticosteroid is hypertension, osteoporosis, and decrease in immunity leading to increased risk of infections.
- Opioids: Opioids including Morphine are a strong analgesic that can be given when pain is not controlled by simple analgesics. It provides a strong anesthesia effect and can be given twice daily to reduce the symptoms of osteoarthritis. It makes the patient numb and he cannot sense the pain and render the patient asymptomatic. There are a majority of side effects of opioids which include constipation and increased sleep. Constipation is the worst side effect of opioids as it can lead to difficulty in passing stools, anal fissure hemorrhoids, and anal fistula.
- Capsian cream: Capsian cream can be applied over the painful joint surfaces and if your pain is not treated by giving simple any steroidal anti-inflammatory drugs and other painkillers, osteoarthritis treatment will include this cream which can be applied over the joint surface, Four times daily. your doctor will recommend you take Capsian cream in your hand, massage it on both of your hands and then apply it on the painful joint surface and it will reduce the inflammatory process going on inside the joints and will give you pain relief.
- Surgery: in later stages of diseases when the osteoarthritis is not treated pharmacologically joint replacement and other surgical procedures may be performed to get rid of osteoarthritis. It may involve the joint replacement which is also called arthroplasty in which the whole of the joint is removed surgically to reduce the pain and inflammation and is replaced by a synthetic joint and prosthesis is given to the patient for improving mobility, in initial stages of surgery. Your doctor will also give you an option for arthrodesis, which means the fusion of the joint surfaces for osteoarthritis treatment. The doctor by surgery will fuse the joint surfaces and by this procedure, your joint will become painless. Although you cannot be able to move that joint in the future ever. It the permanent treatment for the pain of osteoarthritis.
- Trans Cutaneous electrical nerve stimulation (TENS): in the procedure of transcutaneous electrical nerve stimulation the doctor will place rods on your joint surface and will connect it to a source of energy. The energy transmitted to the joint with impulses will block the nerves present at your joint surface which will lead to a decrease in pain as it will numb your joint. It is given to the patient when the pain for osteoarthritis is not controlled by analgesics.
- Hot and cold packs: Hot and Cold packs can be applied on the joint surface these can give the soothing effect and can decrease the inflammation and swelling over the joint surfaces and will give the symptomatic relief of pain of the patient.
- Assistive devices: with the advancement in technology, various devices which are called as assistive devices are launched. They help you to get rid of the pain by doing daily work of your routine. For example, there are various devices for your hand if you suffer osteoarthritis of the hand, for example, devices to turn the fan on, devices to turn the tap on, etc. If you are suffering from osteoarthritis of the hip, your doctor will give you walking sticks and splints so as to assist you’re walking and reduce pain. If you are suffering from osteoarthritis of the foot, specially made shoes are available in the market and you will have to purchase them to decrease symptoms of osteoarthritis for osteoarthritis treatment.
GENERAL MEASURES FOR OSTEOARTHRITIS TREATMENT:
- weight loss in obese patients
- rest and reducing physical stress
- use of walking sticks
- change in occupation
- application of heat to relieve pain
- proper exercises and maintaining proper posture
- hydrotherapy for hip osteoarthritis
WHEN TO SEEK MEDICAL HELP?
Osteoarthritis is a chronic disease and one should seek medical help when the disease is associated with swear chronic pain, inflammation of joints, reduction in mobility and muscle wasting. Osteoarthritis treatment may not reverse the pathological disease but may decrease the exacerbations of disease and symptoms.