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How To Treat Hip and Knee Osteoarthritis

osteoarthritis_knee_hip

Don’t let hip or knee osteoarthritis hold you back from doing the activities that you love to do. Implement a few of the 25 treatment options below every day to slowly get back to a pain free life.

1. Combination of drug and non-drug treatments 

Non-drug treatments:

2. Education and self-management. This should be your first mode of treatment when experiencing hip and knee arthritis. Educate yourself on osteoarthritis and why you’re experiencing the pain you’re feeling. Then, you can start to make changes to your daily life to help lessen the symptoms.

3. Regular telephone contact.  Studies have shown that daily phone communication with loved ones about healthy behavior strongly influences your ability to stay adherent to your health behavior change. It serves as a daily reminder of your health and fitness goals.

4. Physical therapy. Guidance of a health care professional such as a physical therapist can help decrease pain, increase range of motion, and help you to develop a home treatment program that you can continue to do on your own after you are done with therapy. Our physical therapists will create a personalized plan of care for you based on your day-to-day needs.

5. Aerobic, muscle-strengthening and water-based exercises. A well rounded exercise program can promote muscle strength, improve range of motion, increase mobility and ease pain. If you are having difficulty developing a program due to pain or lack of exercise knowledge, talk to a physical therapist or personal trainer to work up an exercise plan that is perfect for you! Several of our patients benefit from aquatic physical therapy because it allows them to do exercises in the water that they aren’t able to do on land.

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. The more weight that each joint must support, the harder you are making them work and the more pain you will likely experience.

7. Walking aids. Canes and crutches can reduce pain in hip and knee osteoarthritis. If both hips and/or knees are affected, wheeled walkers may be preferable.

8. Footwear and insoles. Special footwear can sometimes help decrease stress on the knees and hips. Generic inserts can be found at most drugstores. Podiatrists and many physical therapy offices can also provide you with a higher quality orthotic that is made especially for your foot. We have several strong relationships with a variety of podiatrists that we can recommend to our patients in need.

9. Knee braces. For osteoarthritis with associated knee instability, a knee brace can reduce pain, improve stability and reduce the risk of falling.

10. Hot and cold. Should you ice or heat for osteoarthritis pain? The answer is simple. Whichever feels best. In situations such as this where the pain is chronic, do whichever gives you the most relief. For some people, ice works best and for others it’s heat. Some people prefer alternating between the two. Experiment and find the best combination for you.

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. We offer this service at PROCare Physical Therapy, and a lot of our patients see great results because of it!

12. Acupuncture. Some studies have shown success with the use of acupuncture against osteoarthritis pain. Our patients have also benefited from Dry Needling.

13. Acetaminophen (Tylenol), can be an effective initial treatment for osteoarthritis in order to decrease pain. Be aware of your correct dosage and do not overdose yourself. Taking more than the subscribed dosages over an extended period of time can lead to other health complications.

14. Nonsteroidal anti-inflammatory drugs. These are great for initial inflammation or the occasional flair up but make sure to use them at the lowest effective dosages and avoid long-term use if possible.

15. Topical analgesics (NSAIDs and Capsaicin). Topical NSAIDs and capsaicin, an analgesic derived from chili peppers, can be used along with or instead of oral analgesics or NSAIDs for OA pain.

16. Corticosteroid injections. Injecting corticosteroid compounds directly into affected joints can be useful when there is localized inflammation and/or moderate to severe pain that doesn’t respond to oral pain relievers. The ACR recommends corticosteroid injections as an alternate initial therapy to acetaminophen for patients who have moderate to severe knee pain and signs of inflammation and who do not get relief from acetaminophen. You can have corticosteroid injections in the same joint three to four times per year.

17. Hyalruonic acid injections. A series of injections of hyaluronic acid, meant to supplement a natural substance that gives joint fluid its viscosity, may be useful in treating the pain of hip and knee arthritis, according to the experts. However, a recent study published in Arthritis & Rheumatism found a single intraarticular injection of hyaluronic acid for the treatment of hip osteoarthritis was ineffective in achieving significant pain relief in comparison to placebo.

18. Glucosamine and/or chondroitin for symptom relief. Treatment with one or both of these supplements may provide symptomatic benefit for some people with knee osteoarthritis. However, the experts advise discontinuing them if you don’t notice any relief within six months.

19. Glucosamine sulfate, chondroitin and/or diacerein for possible structure-modifying effects. There is some evidence that glucosamine or chondroitin may not only ease symptoms but may slow or halt cartilage breakdown in osteoarthritis. Similar effects have been seen with the osteoarthritis medication diacerein. (Diacerein is not approved in the U.S.)

20. Opioid and narcotic analgesics. The use of weak opioids and narcotic analgesics can be considered for patients who cannot tolerate other medications or for whom other medications are not effective, according to recommendations. Stronger opioids should be used only for the management of severe pain in “exceptional circumstances.”

Surgery Treatments:

21. Joint replacement surgery. When symptoms of knee or hip OA are not controlled with drug and non-drug treatments, replacing the joint with a prosthesis is often effective.

22. Unicompartmental knee replacement. Approximately 30 percent of people with knee osteoarthritis have disease that is largely restricted to one area of the joint. In these cases, unicompartmental knee replacement (also called partial knee replacement) may offer the same improvement and function as total knee replacement but with less trauma and better range of motion.

23. Osteotomy and joint-preserving surgery. For young, active people with hip or knee osteoarthritis, osteotomy (a procedure in which bones are cut and realigned to improve joint alignment) may delay the need for joint replacement by years.

24. Joint lavage and arthroscopic debridement. The roles of joint lavage (flushing the joint with a sterile saline solution) and arthroscopic debridement (the surgical removal of tissue fragments from the joint) are controversial. Some studies have shown short-term relief; however, a 2008 Cochrane Review by the Cochrane Collaboration – an international not-for-profit organization, providing up-to-date information about the effects of health care – shows that in people with osteoarthritis arthroscopic debridement probably does not improve pain or ability to function compared to placebo (sham surgery).

25. Joint fusion when replacement has failed. When knee replacement fails, joint fusion (a procedure in which the bones that form the joint are surgically prepared and then held in place with screws, pins or plates until they fuse into a single rigid unit) can be considered a salvage procedure.

These 25 tips are brought to you by the arthritis foundation.

If your hip and knee osteoarthritis is preventing you from doing the activities that you love, then call us today to set up an appointment and speak to one of our physical therapists. 

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