What is it?

Osteoarthritis is a progressive degenerative disease in which the articular cartilage that lubricates the bones involved in the joint gradually wears out.

As the condition progresses it narrows the intervertebral space, the bones in the area become thicker, and adhesions called osteophytes form. The synovial membrane that surrounds the joint also swells and becomes inflamed, while in the process the entire joint is deformed.

All this results mainly in pain in the area, stiffness and deformity of the joint.

There are several measures we can take to delay the progression of the condition and reduce the symptoms. These are mainly:

1. EXERCISE

If possible, exercise regularly. This helps:

• to strengthen the muscles around the affected joint
• be in good general physical condition
• maintain a good range of motion of the joint (do not have stiffness)
• Swimming is ideal for most joints, but any exercise you can do is better than no exercise at all. Most people can and do include walking.

2. WEIGHT CHECK

If you are overweight try to lose weight, as the extra pounds worsen the symptoms. Even a small weight loss can improve arthritis pain

3. SPRINGS AND SOLES

It has been shown that in some cases special orthopedic soles and splints can improve the symptoms.

The reason is that they distribute slightly better the loads exerted on the joints, which are partially discharged and thus less painful (eg knee or thumb).

4. WALKING AIDS

If you have osteoarthritis of the knee or hip try using a cane when walking. Hold it with the hand on the opposite side of the affected one (e.g. arthritis in the right knee, hold the cane with the left hand). This reduces the strain on the joint and sometimes relieves symptoms.

5. PHYSICAL THERAPY

The physiotherapist will show us:

• exercises to strengthen the muscles surrounding the affected joint, thus improving the symptoms
• general tips for exercise
• stretching, movement exercises and exercises that increase the range of motion of the joint which becomes stiff in osteoarthritis

6. OTHER TREATMENTS

• TENS (Transcutaneous Electrical Nerve Stimulator) help in some cases
• Acupuncture
• Cold (or in some cases warm) patches on the affected joints can offer some pain relief.

7. MEDICINES USED IN OSTEOARTHRITIS

Paracetamol

Paracetamol (Depon, Panadol) often reduces pain. The dose of 500mg 4 times a day can be used for a long time by an adult

Topically anti-inflammatory

Topical use of an ointment or liquid anti-inflammatory, which has far fewer side effects than oral pills, can often help, since,  much less active substance enters the bloodstream.

Systematic anti-inflammatory

These oral medications are less commonly used than paracetamol, due to the risks of side effects that occur mainly in people who take them frequently. However, they are especially useful when paracetamol or topical anti-inflammatory drugs do not help treat the symptoms. There are many different non-steroidal anti-inflammatory drugs used so one can easily find the right one for each patient.

Serious side effects include:

• Bleeding from the digestive system (especially in patients > 65 years of age, with an ulcer of the stomach or duodenum, or those taking aspirin). If there is discomfort from the digestive system, stop the treatment and visit your doctor who may recommend another treatment or also recommend a gastroprotective treatment.
• Some patients with asthma, hypertension, kidney or heart failure may not be able to take systemic anti-inflammatory drugs.
• Codeine
• Codeine is often combined with paracetamol for pain relief.

Steroid injections

Injecting steroids into the joint can help when there is inflammation.

Hyaluronic acid infusions

Injecting steroids into the joint can help in some cases of moderate arthritis.

Glucosamines

Glucosamine is classified more in dietary supplements than in medicines. It is a component of cartilage and probably plays a role in its creation and maintenance. Some studies have shown that in some patients with osteoarthritis there was an improvement in pain when taking glucosamine daily.

SURGICAL TREATMENT

Most patients with osteoarthritis do not need surgery. Of course, this condition can develop so much that surgery is the only solution to relieve pain. In these cases, osteotomy in some cases and joint replacement, are the most common surgeries.

Advises Mr. Petros Kyriazopoulos, Orthopedic Surgeon, Doctor of the University of Athens