Embarrassing Illnesses

Osteoarthritis cannot be cured, but treatment for the condition can ease your symptoms and prevent them from affecting your everyday life.

However, if your osteoarthritis is mild or moderate, you may not need to have any treatment. Your GP will be able to provide you with advice about managing your symptoms by making changes to your lifestyle, which may be enough to keep the condition under control.

Medical treatments for osteoarthritis

There are several medicines, treatments and pieces of equipment that can make living with osteoarthritis easier. Some of these are available from your GP, such as analgesics (painkillers), medicines that are injected into your joints and thermotherapy (warm and cold packs).

However, if your osteoarthritis is causing you severe pain and discomfort, or affecting your mobility, your GP may refer you for specialist treatment from a physiotherapist or an occupational therapist. In severe cases, surgery may be required.

The various medicines, treatments, and equipment that you need to have for osteoarthritis are outlined below.

Analgesics (painkillers)

The type of analgesic (painkiller) that your GP may recommend for you will depend on the severity of your pain and any other conditions or health problems that you may have.

Paracetamol

If you have pain that is caused by osteoarthritis, to begin with your GP may suggest taking paracetamol, which is available over the counter (OTC) in pharmacies without a prescription. It is best to take it regularly rather than waiting until your pain becomes unbearable.

However, when taking paracetamol, you should always make sure that you follow the dosage that your GP recommends, and that you do not exceed the maximum dose that is stated on the pack.

Non-steroidal anti-inflammatories (NSAIDs)

If paracetamol proves ineffective in controlling the pain of your osteoarthritis, your GP may prescribe a stronger painkiller. This may be a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, aspirin or diclofenac.

Some NSAIDs are available as creams (topical NSAIDs) that you apply directly to the affected joints. Some topical NSAIDs are available over the counter (OTC) without a prescription. They can be particularly effective if you have osteoarthritis in your knees or hands, and as well as helping to ease pain, they can also help to reduce any swelling that you have in your joints.

Sometimes, NSAIDs may not be suitable for you if you have certain conditions, such as asthma or a peptic ulcer. If you are unsure about whether NSAIDs are suitable for you, you should speak to your GP. They will be able to discuss any potential risks or benefits of taking NSAIDs with you. Children who are under 16 years of age should not take aspirin.

If your GP recommends or prescribes an NSAID to be taken by mouth, they will usually also prescribe a medicine known as a proton pump inhibitor (PPI) for you to take alongside it. This is because taking an NSAID can break down the lining in your stomach that protects against stomach acid. However, PPIs reduce the amount of acid by blocking the tiny ducts (or pumps) in your stomach that produce it, reducing the risk of damage to your stomach lining.

Opioids

Opioids, such as codeine, are another type of analgesic that may help to ease your pain if paracetamol does not work. Opioids can help to relieve severe pain, but they can also cause side effects such as drowsiness, nausea, and constipation.

If you need to take an opioid regularly, your GP may prescribe a laxative for you to take alongside it.

Capsaicin cream

If you have osteoarthritis in your hands or knees, and topical NSAIDs have not been effective in easing your pain, your GP may prescribe capsaicin cream.

Capsaicin cream works by blocking the nerves that send pain messages, although you may have to use it for a while before it has an effect. You should experience some pain relief within the first two weeks of using the cream, but it may take up to a month before the treatment is fully effective.

You should apply a pea-sized amount of capsaicin cream to your affected joints four times a day, but not more than every four hours. Do not use capsaicin cream on skin that is broken or inflamed, and always wash your hands after applying it.

You should also be careful not to get any capsaicin cream on delicate places, such as your eyes, mouth, nose and genitals. Capsaicin is made from chillies, so if you get it on sensitive areas of your body, it is likely to be very painful for a few hours. However, it will not cause any damage.

You may notice a burning sensation on your skin after applying capsaicin cream. This is nothing to worry about, and the more you use it, the less it should happen. However, avoid using too much cream or having a hot bath or shower before or after applying it, because it can make the burning sensation worse.

Intra-articular injections

If your osteoarthritis is severe, treatment using analgesics (painkillers) may not be enough to control your pain. If this is the case, you may be able to have a type of treatment where medicine is injected into the parts of your body that are affected by osteoarthritis. This type of treatment is known as intra-articular, because it is injected inside your affected joints.

If you need to have intra-articular injections, it is likely that you will have injections of corticosteroid, which is a medicine that reduces swelling and pain. However, the National Institute for Health and Clinical Excellence (NICE) do not recommend intra-articular injections of hyaluronic acid for osteoarthritis.

As too many intra-articular injections can damage your joints, you will have to wait at least three months between treatments, and each joint should not be treated more than three times a year.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a treatment method that uses a machine that may help ease the pain that is caused by your osteoarthritis. It works by numbing the nerve endings in your spinal cord that control pain, so that you can no longer feel it.

Treatment with TENS is usually arranged by a physiotherapist. Small electrical pads (electrodes) are applied to the skin over your affected joint, which deliver small pulses of electricity from the TENS machine. Your physiotherapist can advise on the strength of the pulses, and how long your treatment lasts.

Thermotherapy

Thermotherapy is a form of treatment that can be used for osteoarthritis. It uses warm and cold temperatures to help ease the pain and stiffness in your joints. A hot water bottle filled with either hot or cold water and applied to the affected area can be very effective in helping to reduce pain. Special hot and cold packs that can either be cooled in the freezer, or heated in a microwave oven, are also available, and work in a similar way.

Manual therapy

Not using your joints can cause your muscles to waste, and may worsen stiffness that is caused by osteoarthritis. Manual therapy is a treatment method that is provided by a physiotherapist and uses stretching techniques to keep your joints supple and flexible.

Assistive devices

If your osteoarthritis causes mobility problems, or performing everyday tasks is difficult, there are a number of devices available which may be able to help. Your GP may refer you to a physiotherapist or an occupational therapist for specialist help and advice.

If you have osteoarthritis in your lower limbs, such as your hips, knees or feet, your physiotherapist or occupational therapist may suggest special footwear or insoles for your shoes. Footwear with shock-absorbing soles can help to relieve some of the pressure on the joints of your legs as you walk, and special insoles may help to spread your weight more evenly. Leg braces and supports also work in the same way.

If you have osteoarthritis in your hip or knee that affects your mobility, you may need to use a walking aid, such as a stick or cane. Hold it on the opposite side of your body to your affected leg so that it takes some of your weight.

A splint (a piece of rigid material that is used to provide support to a joint or bone) can also be useful if you need to rest a painful joint. Your physiotherapist will be able to provide you with a splint and give you advice about how to use it correctly.

If your hands are affected by osteoarthritis, you may also need assistance with hand-operated tasks, such as turning on a tap. Special devices, such as tap turners, can make performing these tasks far more manageable. Your occupational therapist will be able to provide you with help and advice about using these devices in your home or workplace.

Surgery

Surgery for osteoarthritis is only needed in a small number of cases. It can sometimes be helpful for osteoarthritis that affects your hips, knees or joints, particularly those at the base of your thumb. Your GP may suggest surgery for your condition if other treatments have been ineffective, or if one of your joints is severely damaged.

If you need to have surgery for osteoarthritis, your GP will refer you to an orthopaedic surgeon before your symptoms become severe enough to cause permanent damage, or very severe pain.

There are a number of different types of surgery for osteoarthritis. You may have surgery to smooth the surfaces of your joints or restore cartilage (an arthroscopy), or you may have surgery to replace your whole joint, or to fuse it into position.

Arthroplasty

Joint replacement therapy, also known as an arthroplasty, is most commonly carried out to replace hip and knee joints.

In an arthroplasty, your surgeon will remove your affected joint and replace it with an artificial joint that is made of special plastics and metal (prosthesis). An artificial joint can last for up to 20 years. However, it may eventually need to be replaced.

Arthrodesis

If joint replacement is not suitable for you, your surgeon may suggest an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Having surgery for osteoarthritis can greatly improve your symptoms, mobility and quality of life, and can also help to prevent further damage to your joints. However, surgery cannot guarantee to get rid of your symptoms altogether, and you may still experience pain and stiffness as a result of your condition.

Osteotomy

If you have osteoarthritis in your knees, but you are too young for knee replacement surgery (arthroplasty), you may be able to have an operation called an osteotomy. This type of surgery involves your surgeon adding or removing a small section of bone either above or below your knee joint.

This helps to re-align your knee so that your weight is no longer focused on the damaged part of your knee. An osteotomy can greatly relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually.

Carers

 

 

 

If you are looking after someone who suffers from osteoarthritis that affects them so much that they need you to help them with their activities, Carers Direct can help you. On Carers Direct you can find out all about how to get help with caring for the person you look after, your legal and employment rights, and getting benefits on Carers Direct.

 

view information about Osteoarthritis on www.nhs.co.uk »