How Is Osteoarthritis Treated?

Osteoarthritis (OA) is an arthritis that causes the tissues in your joints to break down. The chronic (long-lasting) condition can lead to pain and swelling in the affected joints—most commonly the joints in your knees, hips, and hands.

Osteoarthritis can be managed with the help of healthcare providers. This may include a rheumatologist, a doctor who specializes in conditions of your joints, muscles, and bones. Physical and occupational therapists, nurses, primary care providers, and pharmacists may also be part of your care team.

Treatment options to help you manage your OA include lifestyle changes, mind-body therapies, medications, and surgery.

Lifestyle Changes

Several treatment guidelines strongly recommend changes in your daily routine as a first step in treating osteoarthritis. These changes may work as well as pain relievers used to treat OA.

Research shows that increasing physical activity and learning to self-manage the condition helps reduce joint pain and stiffness, increase flexibility, and improve awareness and understanding of OA. 

Examples of physical activity you can do include water aerobics, walking, and strength training. Being physically active can also help you manage your weight, which can improve OA symptoms. 

You can learn other ways to self-manage OA by attending educational sessions that cover topics like goal-setting, positive thinking, stress reduction, and fatigue management.

Mind-Body Therapies

Research shows that mind-body therapies can improve your strength and balance and decrease your risk of falling due to OA. These activities may also help elevate your mood.

Mind-body therapies attempt to relax the mind and body by working on mental focus, controlled breathing, and body movements. Examples of mind-body activities include tai-chi and yoga.

Tai chi, in particular, is recommended for people with OA, especially those with OA of the knee and hip. Further research is needed to recommend yoga more strongly in OA management, but it appears promising.

Medications

There are no medications that can stop, slow, or reverse the progression of OA. Instead, the goal of medication in OA is to manage symptoms.

Pain relievers, anti-inflammatory medications, and injections are commonly given to people with OA. These medications help by reducing joint pain and swelling.

Before starting medications, it's important to share your medical history with your care team. This will help them determine the most appropriate treatment for you. You may use OA medication in combination with lifestyle changes and mind-body activities.

Pain Relievers and Anti-Inflammatory Medications

Medications that relieve pain and reduce inflammation are the most frequently used drugs in the treatment of OA. The most common of these medications are nonsteroidal anti-inflammatory drugs (NSAIDs). 

NSAIDs can come in different forms, including creams and gels you apply directly on your skin (topical) or tablets you take by mouth (oral). Topical NSAIDs should be considered before oral NSAIDs in knee OA since the drug can be more directly applied to the affected area.

NSAIDs can be purchased over-the-counter (OTC) or with a prescription from your healthcare provider. NSAIDs that can help treat OA include Aleve (naproxen), Celebrex (celecoxib), ibuprofen (sold under brand names like Advil and Motrin), and diclofenac (sold under brand names like Voltaren Arthritis Pain Gel and Pennsaid).

These medications provide temporary relief and must be used regularly to help with pain and swelling. Check with your healthcare provider about how long you should take them; long-term NSAID use has been associated with an increased risk of stroke and heart attack.

NSAIDs are generally safe to take for most people. (Some people, including those with liver or kidney issues, may not be able to take NSAIDs.) Common side effects include stomach upset, gas, or reflux. Your healthcare provider may recommend adding medications to help with these effects or changing medication.

Injections

Corticosteroids and hyaluronic acid are the two injections used to help treat OA. Your healthcare provider may recommend this treatment for OA of the knee or hip that doesn't respond to other anti-inflammatory medications. Only a healthcare provider can give these injections. You may feel their results for as long as 12 weeks or more. 

Triamcinolone (available under brand names like Zilretta and Kenalog) is a type of corticosteroid injection. Hyaluronic acid injections are available under brand names like Durolane and Synvisc-One.

Corticosteroid and hyaluronic acid injections work by decreasing inflammation and pain. People may experience a reaction in the area of injection. 

Talk with your healthcare provider if you have diabetes, as the corticosteroid injection may raise your blood sugar (glucose).

Medications and supplements that increase bleeding risk, such as NSAIDs, vitamin E, and fish oils, can worsen side effects like pain and swelling at the injection site. Speak with your provider about whether you should adjust your medication regimen heading into your injection appointment. 

Surgery

Your healthcare provider may refer you to an orthopedic surgeon to discuss surgery options if your OA worsens or doesn't respond to conventional therapies. Surgery is usually reserved for people with severe OA who can no longer move or perform regular functions without assistance. 

The orthopedic surgeon will review your medical history and take radiographic pictures (X-rays) of your joints before recommending surgery. They'll also consider the location and damage of the affected joint. Surgery usually provides long-term relief, but total recovery can take several months to a year. 

Surgery options include osteotomy and arthroplasty.

Osteotomy

Osteotomy is usually performed for patients with OA of the knee. The surgeon makes a cut in one of the bones above or below your kneecap.

In a femoral osteotomy, the surgery is done on the thigh bone above the knee cap. In a tibial osteotomy, the surgery is done on the shin bone below the knee cap. Adjusting the bone above or below the knee joint helps realign the knee and relieve stress from the damaged joint.

Arthroplasty

Arthroplasty can be performed on the joints of the hip or knee. The surgeon replaces the damaged parts of these joints with an artificial joint. This improves joint function and movement, which can help restore your ability to participate in regular activities.

Prognosis 

The degree to which your osteoarthritis affects you depends on which joints are affected, your symptoms, and how greatly your function is decreased. While some people are mildly affected by OA, others have severe disability.

Although it can sometimes worsen quickly, osteoarthritis joint damage usually develops gradually. If you don't treat your OA, the joint damage can continue until your pain is severe and your mobility or ability to function is greatly impacted. Treating your OA can help reduce pain and loss of function.

Living With and Managing Osteoarthritis

While there's no cure for OA, you can manage its symptoms to improve or maintain your quality of life. Following your healthcare provider's treatment plan and keeping up with your appointments can help you better manage your OA. 

If you need them, assistive devices are available to make moving and performing tasks easier. Simple devices include jar openers, grabbers, and shoe horns. More involved devices that may require installation or cost more money include a raised toilet seat, tub bars, and handrails.

If you're looking for support from someone who's living with OA, ask your healthcare provider for recommendations of support groups either in person or online.

A Quick Review

Osteoarthritis is the most common type of arthritis. It's a long-term condition that causes joint pain and swelling, but it can be managed through a combination of treatments.

Osteoarthritis treatment options include exercise, mind-body activities, medications, and surgery. Sticking to your treatment plan can help you reduce pain and keep your mobility.