What Is the Best Treatment for Osteoarthritis?
Osteoarthritis (OA) is the most common chronic type of arthritis and is sometimes called the wear and tear disease. OA occurs when the cartilage that cushions your joints wears down. This then causes bones to rub together. Due to these debilitating symptoms, some people may wonder, "What is the best treatment for osteoarthritis?"
This joint condition can happen at any age but is common in those over 50 years old; it also affects more women than men. I developed OA in my lower spine in my early 30s, and in my neck in my early 40s.
Many people who are diagnosed with OA may be asking, “what is the best treatment for osteoarthritis?” There is not one single treatment that will work for everyone, so in this article, we take a look at what OA is, and go over different treatment options that are available.
Areas and Symptoms of OA
OA can appear in any of your joints, but the most common areas are the neck, lower spine, hips, knees and hands.
My early lower back symptoms started with morning stiffness and a constant dull aching. Then, severity progressed slowly; I could barely walk, needed help getting out of bed and dressing.
My neck symptoms started at the same, but I also developed a crunching, grinding and cracking sensation when moving my head. Swelling around the joints is also common, such as the hands and knees. You may also struggle with moving around or performing simple tasks.
Common risk factors for developing OA:
- Older age: As you age your risk of developing OA increases.
- Sex: Experts think women are more susceptible due to hormones. After menopause, key hormones reduce naturally in the body, and this is thought to impact cartilage.
- Obesity: Carrying extra body weight contributes to extra joint stress. Fat tissue also produces proteins that may cause harmful inflammation in and around your joints.
- Joint injuries: Injuries can increase the risk of OA, even if they occurred many years ago. I had three back surgeries from two falls and developed OA.
- Repeated stress on the joint: Work or playing sports can place repetitive stress on a joint, which could eventually develop OA.
- Genetics: Some people will develop OA due to their genetic makeup. My father, for example, has spinal arthritis.
- Bone deformities: Some people are born with defective cartilage or malformed joints.
If the pain and stiffness do not improve and negatively impact your life, it is time to see your doctor for further investigation.
How Osteoarthritis Is Diagnosed
A doctor may feel the area for swelling, tenderness and inflexibility. If there is reason to suspect you may have OA, you will most likely be sent for further tests:
- X-rays: Shows any bone spurs around your joints.
- MRIs: Cartilage does not show on x-rays, but can be seen using this option, as can soft tissue and bones.
- Blood tests: OA cannot be detected this way, but other conditions can, such as rheumatoid arthritis.
- Joint fluid analysis: A needle can be used to drain fluid from a swollen joint, and can then be tested to rule out gout or infection.
Stages of OA
Stage 1 - Minor
Minor wear and tear begins, with little pain.
Stage 2 - Mild
If you are sedentary, stiffness will increase and become uncomfortable.
Stage 3 - Moderate
Cartilage can start to reduce, and it will hurt when moving around.
Stage 4 - Severe
Most or all of the cartilage may have eroded. The joint may become inflamed and suffer severe pain. Bone spurs may be evident and pressing on nearby nerves, or bones may be rubbing together.
What You Can Do to Manage Your Symptoms
Personally, from my own experiences, there is no one solution. However, there are many things you can try to reduce your symptoms. Often, using a combined approach will have better results. Your doctor will be able to help you determine the best options for your individual symptoms.
Medication can help relieve symptoms. Common over the counter and/or prescription options may help:
- Tylenol: Used for mild pain and causes minimal side effects. Larger doses can cause liver damage, therefore you must follow usage instructions.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Common examples include both ibuprofen and naproxen. These are for pain and inflammation. I have had to stop using these due to having stomach bleeds. These are not suitable for everyone.
- Duloxetine (Cymbalta): This is FDA approved for the treatment of chronic OA. It may not be suitable for everyone, and can cause uncomfortable side effects. I did not remain on this medication for more than a week.
- Topical creams and gels: These can be useful, and I can use ibuprofen cream without upsetting my stomach. They can reduce stiffness and pain.
- Opioids: Such as codeine, Vicodin, morphine and oxycodone. Be careful of long-term use causing tolerance. Addiction is a real possibility, and anyone with addiction issues should not take these.
Professional therapy is also an option. Two types are common for patients with OA:
- Physical therapy: The therapist teaches you exercise techniques to improve flexibility, which will reduce pain and stiffness.
- Occupational therapy: Assess any assistance you may need to improve your quality of life. For example, canes, shower handles, inflatable chairs and so on.
Surgeries and Procedures
These options are usually only given in severe cases. Depending on how far your OA has progressed, undergoing a procedure may be your best option to manage symptoms:
- Cortisone injections: I have nerve blockers and trigger point injections in my head and neck for pain. This is not a long-term fix, as steroids can cause immune system issues over years of usage.
- Realigning bones: Realignment of the knee can shift the weight away from the worn-out area. I have had three successful spinal fusions, to realign a collapsed lumber and cervical spine, with titanium cages.
- Joint replacement and/or strengthening: Fusions with plastic/metal cages/discs can strengthen damaged areas.
There are several home remedies that you can also try to alleviate symptoms. As always, be sure to consult with your doctor beforehand to ensure the treatment does not negatively affect any medication you are on. Some of the best home remedies for osteoarthritis are:
- Hot/cold compresses: I alternate between the two for pain flares, and it works better than any medication, for me.
- Tens machine: I use a tens machine on the painful areas, I get invaluable short-term pain relief.
- Exercise: It is important to exercise with OA. The less I move, the worse my symptoms become.
- Massage: I have read conflicting stories regarding massage with OA. Some medical practitioners recommend this, and others do not. I was told not to have chiropractic treatment on my spinal area due to the risk of further damage. But, I do have regular massage to my neck and lower back, which helps with pain.
- Mental health strategies: Neuroplasticity training has been life changing for me, and I use an app called Curable. Plasticity is the development of learning and memory, and helps you process pain in a healthier way.