The website of the German Osteoarthritis Forum lists 229 therapies for osteoarthritis – but by far not all of them are medically recognized, helpful and useful. No matter what miracle therapies are touted, according to current knowledge, osteoarthritis is not curable, because damaged cartilage cannot heal or regrow. Quite important for the affected patients, however, is that the course of osteoarthritis can be slowed down, pain can be treated very well in some cases.
Common treatments for osteoarthritis
Physical therapy, heat and cold applications, exercise, and medications are among the nonsurgical therapies and often provide relief.
Most commonly, doctors prescribe cortisone-free pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs). They work well against inflammation and pain. But with prolonged use (and in sensitive patients), they sometimes lead to serious side effects.
Side effects of NSAIDs
Commonly observed side effects while taking NSAIDs include stomach and intestinal problems such as stomach pain, loss of appetite, and diarrhea. However, stomach ulcers and complications such as gastrointestinal rupture and bleeding may also occur.
Other possible side effects include kidney dysfunction and blood pressure elevation. This particularly affects patients with pre-damaged kidneys, cardiovascular disease and liver disease. It is therefore advisable to use long-acting NSAIDs with particular caution in older people. This is because long-acting NSAIDs are less controllable, as they need to be taken less frequently, but have a more long-term effect. It is also important to check kidney and blood levels regularly.
In addition, NSAIDs lead to an increased tendency to bleed. Also, such drugs can trigger an asthma attack.
COX-2 inhibitors a better alternative to NSAIDs?
COX-2 inhibitors are agents used for the symptomatic treatment of pain and inflammation in osteoarthritis and rheumatic diseases. Such drugs have a more targeted effect in the body, but they are still not significantly better tolerated than NSAIDs.
Some drugs from the COX-2 inhibitor group have had to be withdrawn from the market due to severe cardiovascular side effects. Other common side effects may include headache, dizziness, gastrointestinal distress, and skin rashes.
Nonpharmacologic options for treatment
Nonpharmacologic treatment options for knee osteoarthritis include physical therapy, physical treatments, and orthopedic procedures.
- Physical therapy can maintain and improve the mobility of the knee joints. At the same time, the muscles are strengthened and pain is relieved.
- Many osteoarthritis patients do well with heat treatment. In osteoarthritis, where in addition the joint is inflamed, but it can also be the other way around: instead of heat, patients feel cold as pleasant.
- In electrotherapy and electrophysical therapy, electrical currents prevent or slow down the transmission of pain signals. In addition, the currents stimulate tissue regeneration and promote blood flow. One of the best-known procedures from this field is the Transcutaneous Electrical Nerve Stimulation (TENS therapy).
- In patients in whom NSAIDs do not have sufficient effect or cannot be administered due to contraindications, injections with hyaluronic acid come into question as a treatment option. In arthritic joints, the amount of hyaluronic acid is significantly less than in healthy joints. Hyaluronic acid preparations are injected directly into the interior of the joint. The joint fluid enriched with hyaluronic acid in this way is better able to compensate for irregularities in the cartilage surface and the joint glides more easily again. However, the study situation on the effect of this treatment option is contradictory.
- Acupuncture can be used to reduce pain and stiffness in the knee.
