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Osteoarthritis

Osteoarthritis: What is it, Causes, Symptoms, Risk Factors and More | Singapore General Hospital

Osteoarthritis - How to prevent?

Osteoarthritis - Treatments

Osteoarthritis Singapore General HospitalThe goals for treatment for osteoarthritis are:

  • Pain relief
  • Maintenance of function
  • Prevention of associated deformities
  • Patient education

The treatment for OA depends on the severity of the disease and the patient’s own lifestyle expectations.

Early cases of OA can generally be treated with:

  • Rest and lifestyle modification, such as weight loss and cessation of smoking
  • Use of aid (e.g. a walking stick). Use of good shoes is also helpful for relieving symptoms in some cases of OA
  • Exercise and physiotherapy to strengthen muscles and improve joint flexibility
  • Medication

In OA of the hand, rest can be accomplished by selectively immobilising the joint in a splint. Splinting is initially done for a period of 3 - 4 weeks, during which the splint is worn continuously.

This is usually combined with non-steroidal anti-inflammatory medication (NSAIDs) taken at the same time. If there is improvement in symptoms, use of the splint during the day is progressively diminished over the course of the coming month/s.

Use of NSAIDS

Gastrointestinal intolerance remains one of the major factors limiting the prolonged use of NSAIDs and may require temporary or permanent discontinuation of the anti-inflammatory agent. Concomitant use of H2 blockers, omeprazole, or misoprostol, a prostaglandin analogue that counteracts the mucosal effects of NSAIDs, may mitigate some of the gastrointestinal effects. Nephrotoxicity is a well-known complication of NSAIDs, and patients with pre-existing renal insufficiency should not take NSAIDs for extended periods.

Types of medication

There is presently no medication that can cure OA or regrow the cartilage in osteoarthritic joints.

The most commonly prescribed medications are painkillers. The type of painkiller prescribed depends on the severity of the pain. For early disease with mild and occasional pain, simple painkillers such as paracetamol (Panadol®) can be effective, although more severe pain may require the use of non-steroidal anti-inflammatory drugs (NSAID’s) for relief. Analgesic (painkillers) creams and adhesive patches can also be used.

Glucosamine, with or without chondroitin, has also become a popular drug treatment in recent years. It can be purchased without a doctor’s prescription.

However, it is ineffective in many patients, especially those with severe OA. The duration of its symptomatic relief also tends to be temporary. There is no evidence that glucosamine or chondroitin is able to result in cartilage repair.

Injections

For the treatment of OA, your doctor may sometimes recommend a steroid injection into or around the joint if you have not responded to conservative treatment indicated above. While pain relief can be impressive, it is usually only temporary, and your doctor will limit the number of steroid injections that you can receive as repetitive injections can weaken tendons further worsening the already damaged cartilage.

Osteoarthritis SurgerySurgery

Surgery is usually only offered for severe disease that has not responded to conservative treatments mentioned. Both the type of surgery and the decision for surgery are made following careful discussions between you and your doctor.

For many joints in the hands, arthodesis or fusion of the joint is the method of choice. In joint fusion, the arthritic surface is removed and bones on either side of the joint are fused to eliminate movement from the problem joint.

There may be some loss of movement but the pain ablation and stability may functionally improve the joint that is severely affected by the degenerative joint disease.

Osteoarthritis - Preparing for surgery

Osteoarthritis - Post-surgery care

Osteoarthritis - Other Information

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