Treatments for osteoarthritis: Rheumatologist perspective
Professor David Hunter, rheumatologist
The best treatment for osteoarthritis really involves looking at the holistic management of the disease and there I mean specifically paying attention to why you developed lost yet others in the first place and paying particular attention to nonpharmacologic non-medical and non-surgical treatments in the first instance and that's what most guidelines would advocate for. So, I'm there thinking about trying to particularly focus on if you're overweight and obese losing ways particularly if you're sedentary or your muscles around your joints are not particularly strong trying to improve muscular strength aerobic or cardiovascular fitness as well, and again if you're depressed and/or if you've got significant psychological impairment either as a consequence of the disease or as a complete separate entity paying particular attention to the treatment and management of that as well. Following appropriate nonpharmacologic conservative management, weight loss, exercise, using braces, paying attention to psychological needs then it might be appropriate to use analgesic medication pain relieving medications such as anti-inflammatories, topical ointments that may help to facilitate the treatment of the disease. If they are also ineffective at managing that the symptoms that relate to the disease, then surgery may be an option
Exercise
The benefits of exercise for a person with osteoarthritis are multiple first and foremost you'll improve the strength of the muscles around the joints that are affected improve their stability emotion your ability to function with the joint that has osteoarthritis. In addition, aerobic and cardiovascular exercise, a helpful in improving a person's body weight their stamina and their ability to do exercise in addition to improving their cognitive status their ability to help deal with other aspects of the disease.
Weight loss
The benefits of losing weight for a person with osteoarthritis include meaningful improvements in a person's pain, improvements in function and improvements in the long term disease course there's a likelihood of a joint structurally changing over time and by so doing reduce your chance of requiring a joint replacement and in addition to that there are also mortality benefits so you're less likely to die if you lose weight in the context of osteoporosis but most important is those really critically and meaningful improvements in a person's pain. If you lose 10% of your body weight you can expect a 50% improvement in the pain coming from your knee with osteoarthritis.
Complimentary medicines
Complementary medicines in osteoarthritis are incredibly widely used about 50% of my patients and those in the community are taking complementary and/or alternative medicines. They're widely publicised, widely marketed and they've been also widely researched, and I think it's incredibly important for the person with osteoarthritis that they understand what they're putting into themselves and that have good evidence to support its efficacy for what you want it to do for your osteoarthritis pain or structure of the joint long term. Oftentimes the trials that have looked at the use of alternative or complementary medicines have found them to be no better than a placebo a sugar pill. In the context of taking a over-the-counter supplement such as glucosamine this has often been found to be the case. There's no problem if you're getting good relief of your pain with taking you're relatively safe and relatively inexpensive product like glucosamine for you to continue to take it and redeem the placebo related benefits associated with that.
