Medicine for Osteoarthritis: What's Hot, What's Not
If you watch any television, then you know there are a variety of products for easing the pain of osteoarthritis (OA). OA causes the cartilage to wear away in the joint. Loss of joint cartilage usually results in painful symptoms and loss of motion. OA most commonly causes pain in the hip and knee joints. Each therapy has its place, but often there are side effects.
Acetaminophen (TylenolTM) is the number one drug of choice for OA. It doesn't give complete relief of pain, but it works well for mild to moderate pain. There are some effects on the liver. Nonsteroidal anti-inflammatories (NSAIDs) all work about the same. Some are more toxic than others. The stomach and kidneys are affected the most.
Glucosamine and chondroitin sulfate are two supplements that are being studied. Both seem to help the joint while also relieving the pain. Side effects seem to be limited. Vitamins such as A, C, and E may protect the cartilage and nearby tissues. This is also under study.
Capsaicin, a topical cream made from hot chili peppers, can be used. It only gives short-term pain relief, so it must be used often. Some patients feel a burning sensation with this cream.
Injections into the arthritic joint have been used. Steroid injections have lost favor because of their side effects. These powerful anti-inflammatories are used only when other treatments have failed. Hyaluronic acid (HA) made from chickens can be injected into the knee. This helps increase the natural fluid in the joint. Using HA may delay the use of injected steroids or surgery.
Osteoarthritis can be treated with pain relievers, glucosamine and chondroitin, vitamins, creams, and injections. When these no longer work, surgery to replace the joint is an option. Joint replacement can reduce pain and improve function when other treatment fails.
References: Steven H. Goldberg, MD, et al. Pharmacologic Therapy for Osteoarthritis. In The American Journal of Orthopedics. December 2002. Vol. 31. No. 12. Pp. 673-680.
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