Understanding Osteoarthritis: Part 2

Wisam S. Younis, PharmD
Published Online: Monday, April 1, 2002

Overview
Osteoarthritis is common in older adults and affects the joints. Unlike rheumatoid arthritis, in which the main symptom of the disease is inflammation, the main symptom of osteoarthritis is pain. Stiffness and crackling in the joints can also be a problem. In severe cases, osteoarthritis can lead to disability. Osteoarthritis lasts a lifetime and is degenerative, which means it gets worse over time. Although there is no cure for osteoarthritis, it can be controlled to allow you to do the things you want to do every day.

In general, treatment for osteoarthritis aims to relieve pain. The American College of Rheumatology guidelines recommend acetaminophen (such as Tylenol) as the first choice of therapy because it works, is safe, and is cost-effective. Used as directed, Tylenol Arthritis Pain provides the appropiate amount of medication for maximum efficacy. As with all medications, it is important to read all the labels to make sure you are taking it the right way. In cases where acetamino-phen is unable to control the pain, you may try non-steroidal anti-inflammatory drugs (NSAIDs), with or without acetaminophen.

You can also help manage your osteoarthritis by making certain lifestyle changes. This handout focuses on these nondrug approaches, which are important parts of managing osteoarthritis. Some of these approaches include exercise, weight management, and hot and cold therapies. Talk to your doctor or pharmacist to see which approaches are best for you.

The Benefits of Exercise
Patients with osteoarthritis tend to avoid exercise because of joint pain or fear of worsening their condition. However, exercise is very beneficial in patients with osteoarthritis. The benefits of exercise:

  • Keeps the muscles around your joints strong, which increases flexibility and range of motion
  • Reduces joint pain and stiffness
  • Keeps your joints moving properly
  • Helps you to control your weight
  • Improves your sleep
  • Gives you more energy
  • Improves cardiovascular fitness and endurance by making your heart stronger
  • Improves your overall mental health and well-being Three main types of exercises are recommended for people with osteoarthritis:
  • Range of motion exercises (yoga)
  • Strengthening exercises (water exercises, weight lifting)
  • Endurance or aerobic exercises (walking, swimming)

Before starting any exercises it is important to talk to your physician. When beginning, don?t work your muscles too long or too hard or you can hurt yourself. Remember that sharp pain is a warning sign that you may be trying to work too hard.

Healthy Exercise Tips
Make exercise part of your daily routine to keep your muscles as strong as possible:

  • Wear comfortable clothes and shoes while exercising.
  • Move your joints through their full range of motion every day.
  • Always do gentle warm-up range-of-motion and strengthening exercises before endurance exercises.
  • Gradually build up your endurance.
  • Be alert for warning signs, such as muscle pain or cramp.

Weight Management
Patients who are overweight have more trouble with osteoarthritis than those who have a healthy weight. Too much weight makes the joints, such as the knees and hips, work harder. This may cause the osteoarthritis to get worse a lot faster. Losing weight will help lessen the load on these joints and reduce pain felt during movement.

Cold and Heat Therapies
Applying cold or heat to painful joints may provide short-term relief of pain. Application of cold packs (such as a bag of ice or frozen vegetables) or moist heat (such as hot showers or baths; or a moist heating pad) may be helpful. It is important that you do not apply cold or hot therapies longer than 15 to 20 minutes to avoid burns.

Strategies to Protect Your Joints
It is important to learn how to make daily tasks easier and to protect your joints. These include the following:

  • Maintain good posture while standing, sitting, bending/lifting, and getting out of a chair to provide better support for your bones and muscles.
  • Use assistive devices (canes and walkers) to ease the load on your joints and improve movement.
  • Wear knee braces to provide additional support for patients with osteoarthritis of the knee.
  • Wear shoes that slip on or ones without shoelaces.
  • Do not carry heavy loads; instead, try to move them using a cart.
  • Ask your doctor about seeing an occupational or physical therapist to learn more techniques that will help protect your joints.

Conclusion
Although there is no cure for osteoarthritis, many non-drug therapies and drug therapies can help reduce the pain associated with the disease. It is important to know that most therapies require a period of time to work, so do not be discouraged if you do not see immediate results. Work with your doctor and pharmacist to learn as much as you can about the therapies available to you and take an active role in controlling your arthritis.



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