Osteoarthritis is the most common joint disease and its prevalence increases with age (Peak incidence after age 60). 0.5% to 1% of the world’s population suffer from osteoarthritis (about 400 to 800 thousand people in Iran). Osteoarthritis is more common in women. The joints involved are generally the knee, hip and wrist. Cervical and lumbar spine joints are the next most commonly involved joints. In this disease, the cartilaginous tissue of the joints is gradually destroyed and degraded, which shows itself by reduced flexibility and pain in the joints. The symptoms of the disease lead to decreased range of motion and ultimately a significant reduction in the quality of life of the patients. Osteoarthritis is a chronic and progressive disease. Sufferers may eventually need joint replacement surgery.
Non-pharmacologic treatments of osteoarthritis
Non-pharmacologic treatments are of importance in the treatment of osteoarthritis. These treatments include weight loss, exercise, strengthening muscles supporting the joint, and physiotherapy. In this disease, the kind of physical activity or sport should be determined carefully. Many activities may exacerbate joint damage and pain. Hydrotherapy and swimming are useful in osteoarthritis. Correcting excess weight plays a significant role in improving the disease. Sometimes a few kilos of weight loss reduce the pressure on the joint significantly.
Pharmacotherapy of osteoarthritis
Drug treatments are usually not able to definitively cure arthritis and often have a palliative effect and in the best they may prevent the progression of the disease. Palliative treatments for pain control, in order and based on the severity of the disease, are:
– Acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs): Those with fewer side effects are used first including ibuprofen in doses below 1200 mg per day, naproxen in doses equal to or less than 500 mg per day
– Adding weak narcotics such as codeine or Tramadol to the above drugs (usually used for short periods).
– If the affected joint is close to the surface (such as knees or wrists), topical medications may be effective and should be used in preference to oral treatments. For example, topical forms of diclofenac, piroxicam or capsaicin
– Intra-articular injection of corticosteroid
– Intra-articular injection of hyaluronic acid