Managing Osteoarthritis – Information for patients and their carers

Simon Coffey Health Comments Off on Managing Osteoarthritis – Information for patients and their carers
  • Non Drug Management
    • Land Based Exercise
      • Pooled research shows that regular, guided exercise with strength training can have benefits similar to Non Steroid Anti-inflammatory medication
    • Weight Loss
      • Obesity is the single most important modifiable risk factor for knee osteoarthritis
      • Even a 5% loss of weight can have a beneficial effect
      • A 10% loss of weight has been shown to relieve pain in knee OA by 50%
    • Hydrotherapy
      • To relieve weight bearing pain, targeted water based exercise is beneficial
    • Education
      • Knowledge and understanding of the condition helps you understand the short and long term progress
      • Can reduce anxiety by better use of analgesia and exercise strategies
    • Topical Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
      • Suitable for knee and hand OA
      • Reduces gastrointestinal side effects
      • Requires regular application
    • Oral Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
      • Is now recommended as first line oral therapy for osteoarthritis
      • Cardiovascular, Kidney and gastrointestinal side effects need to be monitored
      • Addition of a Proton Pump inhibitor (eg Omeprazole-Losec) can reduce GI side effects
    • Paracetamol
      • Safety concerns have recently reduced the use of Paracetamol as first line therapy
      • Maximum dosage of 4g daily are occasionally exceeded with gastrointestinal and multi organ side effects
      • One study has shown it is no better than placebo when used for osteoarthritis
    • Glucosamine and Chondroitin Sulfate
      • Have not been shown to better than placebo (20% response)
      • Evidence for disease modification is weak
    • Fish Oil
      • Symptom improvement has been seen in low (.45g/day) and high (4.5g/day) doses
      • No evidence of disease modification
    • Surgery
      • Arthroscopy for the management of Osteoarthritis is not effective
      • Arthroscopy for new onset mechanical symptoms (locking, catching, localised joint pain) in the absence of significant OA may be of assistance
      • Knee replacement is an effective treatment for end stage knee OA that has failed non operative therapies