The development of osteoarthritis is linked to two types of factors: those that we cannot modify because they are genetic (age, sex, race), and those in which we can act upon such as lifestyle habits (obesity, type of work, sports activity), alterations in joint alignment, previous joint injuries and surgeries, among others.
Treatments
The primary goal of osteoarthritis treatments is to reduce pain, inflammation and disability by slowing down cartilage wear and disease progression. The treatment can be tackled through prevention, with non-pharmacological measures, and also with pharmacological, surgical and rehabilitative measures.
Preventive measures and non-pharmacological treatments for osteoarthritis
- Information is key. An informed person is a person who feels better and is more independent. Knowing the disease will help you understand what to do in order to prevent it or to improve your quality of life if you live with it.
- Take care of your weight. Obesity is one of the factors that influences the onset of osteoarthritis. Numerous studies have shown that weight loss relieves joint overload and, therefore, slows down the development of osteoarthritis. It is highly recommended to control your body mass index and to follow a balanced diet allowing you to maintain a good joint health. Also, some data suggests that consumption of vitamins C (citrus, pepper, broccoli), D (fish, dairy, eggs) and E (nuts, oregano and basil, avocados) may be beneficial in tackling osteoarthritis. Although it is a controversial use because there is not enough scientific evidence to conclude. However, it is advisable to maintain normal levels of all of these elements in our body.
- Practice sports, but in moderation. Exercising gently and moderately is good for your joints. It is important that you train at a level that is appropriate for your physical condition and according to the advice of a specialist. Also, in order to have good joint health, it is essential to respect warm-up and cool down exercises when practicing any physical activity. It should also be remembered that those exercises in which the joint is not subjected to a lot of pressure such as walking, cycling or swimming, are more advisable than those considered to be impact sports like basketball, soccer and athletics, among others.
- Avoid walking on uneven terrain. Standing without resting for an extended period of time and walking on uneven terrain is not advisable.
- Pay attention to the type of shoes you wear. High heel shoes do not properly cushion the tread correctly and has little impact absorption when walking. It is preferable tat you wear a thick-soled and rather flat footwear that stabilizes your steps. The use of templates can help reduce pain.
- Avoid heavy loads and repetitive joint movements. Certain professions predispose to the onset of osteoarthritis. For example, in 1952 it was shown that the prevalence of knee osteoarthritis was almost six times higher in miners. Similarly, professionals who use their hands a lot also had a higher frequency of illness in this location.
- Rest and relax your joints. Rest is a key factor in controlling the pain of inflammatory outbreaks of osteoarthritis. If you feel pain, rest your joints and you will be taking care of your joint health.
Pharmacological treatments for osteoarthritis
Please, always consult your doctor and remember that this article is merely informative.
- Analgesics. As for example, Paracetamol, does not modify the natural course of the disease but is used in the treatment of mild osteoarthritis and it can be taken in the long term. However, it must be said that reconsiderations have recently appeared both in terms of efficacy and safety.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and COX2. They are commonly used for the treatment of osteoarthritis, mainly because of their analgesic, antipyretic and anti-inflammatory properties. This type of medication would be contraindicated in patients with: hepatic, renal alterations, arterial hypertension, heart failure, coronary ischemia/myocardial infarction and stroke. They do not modify the natural course of the disease.
- Sysadoas-DMOAD. This is a slow symptomatic osteoarthritis treatment that influences the course of the disease by delaying it. It consists of: chondroitin sulfate, glucosamine hydrochloride or sulfate and the combination or association of chondroitin sulfate and glucosamine. They are highly safe drugs, especially indicated in patients with co-morbidities.
- Local intra-articular agents. On the one hand, we have intra-articular corticosteroids, which have been used for decades. In this case, the treatment consists of an injection of cortisone with an anesthetic, which reduces inflammation and provides short-term pain relief. On the other hand, we have intra-articular hyaluronic acid, which is used in clinical practice to relieve osteoarthritic pain in patients who do not respond to NSAIDs and for whom replacement of the joint is not a viable option.
In addition, there are surgical and rehabilitative treatments that are performed according to the state of the pathology and the recommendations of health professionals.
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MERCÈ ALLUÉ
Member of the OAFI Patient Advisory Committee
Help us improve the quality of life of osteoarthritis patients.