When it comes to treating osteoarthritis in your knees and hips, you may have more options than you realize. In February 2008, the Osteoarthritis Research Society International (OARSI), a nonprofit organization dedicated to promoting osteoarthritis research and treatment, published its first evidence-based recommendations for treatment of osteoarthritis of the hip and knee. The goal was to eliminate inconsistent treatment approaches by creating simple guidelines that would enable health care providers to determine which therapies would be most useful for an individual patient.
The committee took the scientifically proven commonalities it found in the international literature, evaluated the level of scientific evidence, proposed a strength of recommendation for each modality, and then condensed them into a comprehensive “playbook” of 25 treatment recommendations. The first of the 25 recommendations is to combine drug and non-drug treatments for optimal results. The remaining 24 fall into three categories: non-drug, drug and surgical. Following are the 25 recommendations with updates and links to further reading by Arthritis Today.
1. Drug and non-drug treatments. The optimal osteoarthritis (OA) treatment program should consist of both medications and non-drug treatments.
Non-drug treatments
2. Education and self-management. The initial focus of treatment should be on what patients can do for themselves, rather than on passive therapies delivered by a health professional. Learn about the Arthritis Foundation Self-Help Program.
3. Regular telephone contact. The best evidence for the benefit of phone contact came from a study of 439 OA patients in which monthly phone calls from lay personnel promoting self-care were associated with improvements in joint pain and physical function for up to a year.
4. Physical therapy. Studies consistently support the usefulness of an evaluation by a physical therapist and instruction in appropriate exercise to reduce pain and improve function. Physical therapists can also provide assistive devices to make daily tasks easier.
5. Aerobic, muscle-strengthening and water-based exercises. A rounded exercise program can promote muscle strength, improve range of motion, increase mobility and ease pain. Read this Arthritis Today articles on fitness and exercise.
6. Weight loss. Maintaining your recommended weight or losing weight if you are overweight can lessen your pain by reducing stress on your affected joints. Weight loss specifically helps ease pressure on weight-bearing joints such as the hips and knees. Arthritis Today’s special weight-loss guide.
7. Walking aids. Canes and crutches can reduce pain in hip and knee or OA. If both hips and/or knees are affected wheeled walkers may be preferable.
8. Footwear and insoles. If osteoarthritis affects the knee, special footwear and insoles can reduce pain and improve walking.
9. Knee braces. For osteoarthritis with associated knee instability, a knee brace can reduce pain, improve stability and reduce the risk of falling.
10. Heat and cold. Many people find the heat of a warm bath, heat pack or paraffin bath eases OA pain. Others find relief in cold packs. Still others prefer alternating the two. Learn more about using heat and cold.
11. Transcutaneous electrical nerve stimulation (TENS). A technique in which a weak electric current is administered through electrodes placed on the skin, TENS is believed to stop messages from pain receptors from reaching the brain. It has been shown to help with short-term pain control in some patients with knee or hip arthritis.
12. Acupuncture. A form of traditional Chinese medicine involving the insertion of thin, sharp needles at specific points on the body, acupuncture has been touted as a treatment for osteoarthritis pain. A recent trial of 352 patients with knee osteoarthritis showed small but statistically significant improvement in pain intensity two and four weeks after a course of acupuncture. Read more about acupuncture.
Please Give Us The Best Advice From Where Or What Type of Treatment Should i Take
is in my family. I am 71 and have had pain in my hip joints for the last several years.
I am about 25 pounds overweight, so know that may be one of the problems, but I do
stretches,bike riding and some weights 3 times a week. Unfortunately it seems to be getting worse. I take no perscription drugs, but just OTC pain killers. I take a regimine of vitamins C,B and multi every day.
I was wondering if sugar in my diet could be
a problem? Do you have any recommendations as to a type of diet to follow?
Abd the lack mobility of which you suffer.
What happens with me is that I let the pain get a head of me, then you are always struggling to get past it. Don't let it get the better of you. Take the meds like they say on the bottles - I'm sure they are like every 6 hours or twice a day, whatever. See if that doesn't give you some relief.
I'm as guilty as you at not taking all my meds correctly - I have too many that make me gain weight... but then they say "lose weight for arthritis pain". UGH
Good luck dear
it has ingredients like MUCOZAQ AND 5 LOXIN which i though were more effective than glucosamine.
Over the last year had attacks of OA pain on right side, sacroiliac joint mainly. (runs in the family) It came to stay last December and I was at the stage of treating it with as much Ibuprofen as recommended, ketoprofen gel (topical application) and icepacks, and wondering what the next stage was... then read an article on this stuff; 95% pain GONE in 3 days, stopped ibuprofen. No side effects.
For the record: age 74, also taking the following before this attack: augmented fish oil, glucosamine, devil's claw, and keeping very fit, none of which averted it.
Expensive but miraculous. Try it.
Anyone with joint pain try this CURAMIN..it is all natural!
Moving your joints in the full range of motion regularily is very important, to stop the bone fusing any more to the bone. Beginners yoga, for those that have good knees and wrists. Tai Chi is ideal. A good massage that helps you move each joint into its full range of motion. Fish oil daily, or flaxseed oil, and 1000 mg of vitamin C daily will make a huge difference to Osteo arthritic sufferers. Getting tight, stressed muscles loose, will take pressure off the joints and stop the pulling on the joints. So many sufferers are very unfit, have stiff tight muscles, and many are obese. These issue are never addressed properly with the suffererer unfortunately. I am speaking from the many, many people I have treated who suffer arthritis, and just think they have to put up with it. Many just can't be bothered to do anything about it, which is also really sad to watch.
For those of you that are overweight, and have osteoarthritis, your number one goal is to loose weight. This will make a huge difference to your poor joints that are struggling severely with the weight overload. So many of my clients, just ignore this fact, and joke "it must be old age". They seem to just ignore how grossly overweight they are.
Rhonda, the first thing you need to deal with in your life is STRESS. Consider booking yourself into a good health retreat for a week, no matter what the cost. This will be life changing for you in so many ways. I find in my practice, with many fibro sufferers, it is a certain type of personality type that suffers more from this. This is just my observation from treating thousands of clients as a remedial massage therapist.
Have you tried a one a day fish oil supplement, and 1000mg of vitamin C daily ? This made a tremendous difference to my arthritis. Also get some Brauer arnica ampules, and take several times a day. See how you go?
Cathy
I have recently started drinking green smoothies for osteoarthritis in my fingers, so far it is going well less swelling and pain. I decided to try this after reading about The Raw Family.
Thanks
Courtney
Thank you.
I am frustrated at the lack of faith from my doctor, I have proven over and over and over that I am a well minded responsible individual.
I feel for all those on here and can understand your frustrations of seemingly lack of effort on provider's part, government red tape and general disbelief of the levels of pain.
I also question....what can be done????
Can anybody help me.
My only hope appears to be stem cell treatment but at 50 years of age and clear indications that this is not mainstream medicine by any means and scepticism among the medical elite - I am inclined to think that this is fairy tale stuff! But hope reigns eternal - I will continue to investigate but the idea that damaged "hard" tissue can somehow grow back is a notion for the heart rather than the head - but then, can 75% of dogs be wrong?
(Stem cell treatment in dogs with hip arthritis has shown success for 75% of dogs treated)
I have made contact with a clinic in Dusseldorf Germany but they have been slow to come back to me even after I filled in a detailed medical history form.
Suggestions are that the treatment would cost euro9,750.
I had left hip replaced in nov 2007 went hru therapy and was fine until now....I am getting the same pain again... what is the next next?
I know what you are going through I was recently dignoised with OA after going to several doctor's and in so much pain I could not sleep or walk a block I would rest my legs and put a heating pad on every night while watching TV what a big difference it has made and I take Naproxen from a Dr.
and comfy sneakers do make a difference for
my legs and feet I have OA on my whole right side . taking Vit D does work and well as joint juice.
I still take glucosamin/condroitin combos, fish oil, ginger,wheat grass tablets. Vit. D, Naproxin when the pain is too great,
and try to maintain a fresh vegetable diet, eliminating anything that causes inflammation.
That seems to help the most. I really pray for a cure. Vegan diets help altho they have not been able to cure my problem. I am going to need a walker soon. Please recommend a great Arthritis Center.
Pain management without drugs comes from diet and meditation/breathing exercises, good posture and the right furniture. Check into dial-a-number beds, chairs with lumbar support at the right place for your height. Good shoes are also very important in alleviating low back and leg pain. But most important is to get moving!! Sitting there complaining about the pain just makes it worse, and lessens the likelihood of finding supportive friends. No one likes a whiner. I've learned that from experience!! Also, when the pain is bad and you don't feel up to the work of meditation, try reading or puzzles, or even a nice warm shower! Any thing to take your mind off of the pain.
Yes, it is work, it's not easy, but it definitely has it's rewards. Positive people achieve positive things...in this case they live happily without debilitating pain. (Notice I say without debilitating pain, NOT without pain.)
Good luck, be positive!
My only two complaints: 1) the brace they expect you to use is AWFUL - not a robust unloader, very impractical, and not comfortable. So I don't use it - I use the unloading brace I already had and an Ace bandage to keep the knee electrode in place. 2) The glue of the electrodes really irritates my skin by the end of the day, even w/ the Isopropryl Alcohol-based formula they provide to help, my knee and the patch on my thigh for the 2nd electrode look bug-bitten after an average 12-hour day of use.
I take Vicadin for pain and a mild antidrepressent. Methatrexate once a week, Lots of Calcuim with Mag and Vit D, Multi Vit, Vit B complex, Omegas, and Floic Acid. Almost all from Shaklee, which are very good and I know that they are tested and not junk stuff.
I feel that my arthritis will continue unabated if I do not go back to estrogen. (my mother had severe osteoporosis, and I do not want that problem as well as the arthritis.
What is your opinion?
I am looking into stem cells therapy for my right knee.
Could someone tell me if you or anyone you know
have had stem cell therapy and their results.
Many of you have asked, "What's the best exercise for arthritis?" The Arthritis Foundation offers several gentle yet effective exercise programs through its Life Improvement Series, including the Exercise Program, Aquatic Program, Walk With Ease Program and Tai Chi Program.
These programs have been studied by research experts – some in partnership with the Centers for Disease Control and Prevention (CDC) – and have been proven to reduce arthritis symptoms and increase mobility.
To find a program near you, contact your local Arthritis Foundation Chapter by visiting www.arthritis.org/chaptermap.php. Or to simply learn more about the programs visit www.arthritis.org/programs.php.
(Cut and paste the links above into your URL window.)
If the classes are full in your area, volunteer to be a program instructor to start a new class for you and others with arthritis to participate. But please remember always to consult your doctor, physical therapist and other members of your health-care team before starting any exercise routine.
All the best,
The Editors
Arthritis Today
Please recommend specific exercises that would alleviate the pain in the knee.
anyone have a problem like mine cannot queue
i can walk sit a bit but trying to standin one spot for more than a minute
its behind my knee.cant get anywhere with
gp or orthopedics. also have difficulty
keeping legs outstetched in bed tend to curl up in a ball.
anyone interested in this clinical trials surgeons or gps. have been refused an mri scan and its quite costly.
would be happy to hear of any other reader
with this experince. also have had 6 steroid and partof my coccyx shaved but still
experiencing pain on sitting. the two conditions are not related as the beingunableto queue have had foer 12 years
Fibromyalgia; osteoarthritis; degenerative disks; mild RA.
I have had two laminectomies and a hip replacement and am looking at the next hip replacement.
I started taking MSM (100 mg per 70 lbs body weight) for fibro and it actually reduced effects greatly. Take 1600 mg neurontin twice daily for extreme neck pain, which ultimately made it bearable. When the knees started, I began taking glucosamine in conjuction with the MSM, and after 10 years, I can finally kneel (although not for long).
It makes me tired when I hear of doctors that tell you to lose weight to help the hips and knees. Like DUH, if I could EXERCISE, hello! Docs that say that are useless , in my opinion. It's nor information you don't already know and you STILL need HELP!!!
Get a better doctor. I have really been blessed. I have a TENS unit, but take darvocet occasionally. Everyone's pain is different. The hip injection was the most horrible thing I have ever done in my life, to no avail.
To the fellow in India looking for glucosamine: mail order through Puritan's Pride (online) if you are able. Although I don't know what your country's issues are with incoming mail, they have the best prices.
It will take about 4 to 5 months to recoup depending how bad the knee was, but the second one will be easier. I was driving with the second one in about 6 weeks. Don't be foolish, have them done...you will never regret it.
I've suffered for many, many years with OA & RA.
I thought I was crazy as most PCP, do not offer
much help. I've lived on high doses of Celebrex for 10+ years. My stomach has develop
an ulcer. Sincerely appreciate the comments and the Foundation. When I can afford it, I would like to subscribe to the magazine. Do Not Give Up! We are in this battle together.
I was prescribed a pain medication, but learned of and asked my Doctor about glucosomine-chondroitin with msm. I understand the glu-cho are supplements and the msm is an anti-inflamatory. They can be purchased over the counter. My Dr. could not recommend it since it had not been FDA approved.
After much research I selected a brand and within three weeks began to feel so much better that I stopped taking the prescription pills. It has served me well for the past few years - I stopped limping!!
I would recommend that everyone check with their Dr., do research and decide if the product might be for you.
Jerry
please i want information of where i will get these medicine in India (Goa state) 1. Advantage of 4 uniflex, 2.Joint fluid Glucosamine, 3.Chondroitiu.
I am now experiencing knee joint pain. The Ortho.surgeon has advised: 1.Painkiller like
Combiflam 2. Omiprozol 3. Chymotrypsin 4. Physio exercises.
Would you kindly enlighten the role of chymotrypsin in the treatment ?
Thanks ®ds,
VBDeshmukh
In RA medications like metheltrexate and Humera actually prevent advancement of the disease. Are there medications like these that prevent advancement of OA?
If I am already in pain from OA, is my problem advanced and less likely to be relieved by medications?
DONE IN SEPT., LAST YEAR. THEY DID CHEMO ON
ME AND I HAD TO QUIT IT BECAUSE IT WAS KILL-
ING ME. AFTER I DID I WAS DIAGNOSED WITH
NERVE DAMAGE IN MY SPINE. I SEE A NUROSURGEON
IN AUGUST. I AM HOPING HE CAN RELIEVE SOME OF
THE PRESSURE. MY L-5, S-1 IS MESSED UP. I HAVE DEGENERATIVE DISC DISEASE ALSO ON TOP OF
EVERYTHING ELSE. I AM A MANAGER AT BOB EVANS
RESTURANT, AND I HAVEN'T BEEN ABLE TO WORK
SINCE JAN 5, 2009. AND IT HASN'T BEEN EASY.
THE ONLY THING THAT HAS HELPED ME THROUGH THIS, IS THE LORD. AMEN. MY INSURANCE IS VERY
GOOD THOUGH. I'LL BE GETTING A DIABILITY CHECK FROM MY JOB. I PRAY ONE DAY THEY WILL
FIND A CURE FOR ARTHRITIS, AND NONE OF US WILL EVER HAVE TO GO THROUGH THIS EVER AGAIN.
I take Naproxen, Tylenol 4's and Percocets to manage the pain.
I am also in physiotherapy 3 days, which helps a lot.
Today I had an injection of Synvisc directly into the knee joint. I hope this will help with some of the pain and loss of mobility that has happened. My surgeon seems hopeful though.
I just want to get back to being me.
My surgeon and doctor have said the most helpful things are:
Being thin/low BMI (I am of average weight currently, was advised to get down to the lower end of "normal")
Voltaren Gel
Synvisc Injections every 6-12 months
and low impact exercises
Fingers crossed it works!
I m 54, suffering form osteoarthritis. i have seware pain in my Knees . My ESR is 90.Please give me suggestion about my problem.
with regards
Rashmi
I am not aloud to take some med's because I'm taking plavix for my heart.
I'm still working although it is hard time to time. Just got yelled at yesterday at work for bring my cane. It's the type of work I have and I won't do that again, no matter what!
I have to work no matter how much somedays it hurts. Because I have no other way to pay for some of my med's.
I can't get up very easly out of bed and sitting in some chairs, etc. But right now once I get going, like oiling, I seem to be ok/ Except I do limp.
I get to go to Physcial Theapy and use the pool/ It does seem to help/
severe OA for several years now. I have bulging disks, and a herniated disk, from T4 to L4, and a dislocated sacrum from a 40 year old injury. My right hip, and whole back, are moderately damaged from OA. The OA pain pushes the Fibro, and vice versa. I am currently on Celebrex, 200 mg/day, and Darvocet, as needed, for pain breaks. Neither is working as well as they used to, and I was on Lyrica before, with disastrous side affects. Currently on mild, non impact "Silver Sneakers" aerobics to retrain my muscles, and rehabilitate my hip muscles. I can't walk well at all, lots of pain, but warm baths and cold packs to my hip and knee, help. I do take several supplements, Omega's, Oil of PRimirose, HA, Curamin, Ginger, Black Cohosh, Baxil, etc., from the health food store, and went on an anti imflammatory diet last winter. I think it helped. Weather changes hurt me worst, barimetric pressure is a killer here. Menopause pushed the OA badly, as well. I've not been able to work for over a year and am applying for SSI. Have no choice. Doctors are not very sympathetic so far.
naproxen, 250mg
ibufrofen400mg
paracetamal 400mg
i take two of each everytime i have a severe pain, my appointment has been canselled to see my surgion,hoping to have a steroid injection, as i have had one before, and it hepled me,
all i get from these tablets is side effects, and does not stop the pain when going into spasms,
i have now made appoinment to see a different gp. as i do not think this is good for me,
i am now on two crutches when going anywhere,
i have now been put on the waiting list, and that was a fight to get that far,
i feel like i have been ignored,i have advanced athritis, and i dont think i am being treated right,
Need physical and financial assistance. I have contacted an attorney. Do you have any other suggestions?
Leave a Comment