Osteoarthritis and Treatment Options

by: Pritee Dalvi Coulianidis, MSPT
Staff Therapist, New Brunswick

Millions of adults suffer from arthritis pain, but many of those are not aware of the treatment options available. Read on to find out more about arthritis and alternatives to the traditional oral medication to help relieve pain and increase joint mobility.

What is Arthritis?
Osteoarthritis or Degenerative Joint Disease (DJD) is the most common type of arthritis and it occurs when a joint's articular cartilage begins to break down. This cartilage functions as a cushion for movement and joint force and as it deteriorates, it causes the bones to rub against each other, which results in pain, stiffness, and loss of movement.

Signs and Symptoms of Osteoarthritis
  • joint soreness after periods of overuse or inactivity
  • stiffness after periods of rest that goes away quickly when activity resumes
  • morning stiffness, which usually lasts no more than 30 minutes
  • pain caused by the weakening of muscles surrounding the joint due to inactivity
  • joint pain is usually less in the morning and worse in the evening after a day’s activity
  • deterioration of coordination, posture and walking due to pain and stiffness
Traditional Treatment May No Longer be Safe
Osteoarthritis has long been treated by pain medication to address the inflammation and increase daily mobility. However, new studies revealing very negative side effects of popular medication have left osteoarthritis sufferers scratching their heads for treatment options. Though medication can address the pain and functional immobility caused by osteoarthritis it does not often address the underlying disease process.
Physical Therapy Often Overlooked
Physical Therapy (PT) is an intervention often overlooked due to basic lack of knowledge. Physical therapists are fully trained
and qualified to evaluate and treat musculoskeletal disorders and pathologies. PT cannot cure osteoarthritis; but can be an extremely effective treatment. PT will address the causes of osteoarthritis such as muscle weakness, musculoskeletal imbalances, obesity, and injury. Through a customized therapy program designed by your Physical Therapist, you can increase muscle strength, joint mobility, improve daily function, and most importantly decrease arthritic pain.
New Treatment Approved by FDA
A new treatment called viscoelastic supplementation was recently approved by the FDA for the treatment of osteoarthritis of the knee. Hyaluronan (hyaluronic acid, hylan) is given as a series of weekly injections into the affected joint  (viscosupplementation) over three to five weeks. It has multiple effects in the joint. First, the large molecules of hyaluronan overlap with each other to form a continuous mesh that helps increase joint stability. Second, hyaluronan reduces the response of pain fibers in the joint membrane by coating the pain receptors. Third, it combines with other joint cells to form a strong base for cartilage to give it more elasticity and compressibility. This results in pain relief and improved joint mobility and ambulation. Effects can last for several months up to one year, although it is not clear how hyaluronan relieves the symptoms of osteoarthritis for such a long period of time. Within a few days after injection, hyaluronan can no longer be found in the joint, but it is thought that the it promotes long-lasting changes by stimulating the lining cells of the joint to actually create more hyaluronan to continue the positive effects.

Know Your Options
It is important for osteoarthritis sufferers to remember that effective treatment is available to them. Patients should seek out diagnosis and treatment from qualified medical professionals such as orthopedic physicians and physical therapists. Osteoarthritis can be a debilitating and disfiguring disease, but it does not mean the end of functional mobility and patients should not settle for this option.

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