The medical management of arthritis and joint degeneration may be handled by a family doctor, an internist, or a rheumatologist. However, when medical management is not effective, an orthopaedic surgeon should be consulted to determine if surgery is an option. In some cases, the orthopaedic surgeon may be the first physician to see a patient and make the diagnosis of arthritis.
Following an orthopaedic evaluation, the orthopaedic surgeon will review and discuss the results with you. Based on his or her diagnosis, your treatment options may include:
- Medication
- Physical therapy
- Joint fluid supplements
- Lifestyle modifications
- Non-surgical interventions
- Surgery
- Total joint replacement
Medication
Many different medications are used to treat the pain and stiffness of arthritis. One of the most commonly prescribed types of drugs are the non-steroidal anti-inflammatory agents, or NSAIDs, which can be taken to reduce both the pain and swelling caused by arthritis.
Acetominophin (Tylenol) may also be used to relieve pain. Before starting any medication you should discuss with your Primary Care Physician.
Corticosteroid injections are sometimes used to provide quick, effective pain relief for knee pain. However, they can be used only a few times a year because they weaken bone and cartilage. Also, corticosteroids can cause other potentially serious side effects; their use must be monitored by a physician.
Physical Therapy
Physical therapy can be helpful in the management of OA and RA. For example, a physical therapist may recommend:
- Isometric (“pushing”) exercises to help build muscle strength without subjecting inflamed joints to excessive wear
- Isotonic (“pulling”) exercises to further increase muscle strength and help preserve function
- Daily walking, using a cane or other assistive device as needed
Total Joint Replacement
Total joint replacement is usually reserved for patients who have severe arthritic conditions. Most patients who have artificial hip or knee joints are over 55 years of age, but the operation is being performed in greater number on younger patients thanks to new advances in artificial joint technology. Circumstances vary, but generally patients are considered for total joint replacement if:
- Functional limitations restrict not only work and recreation, but also the ordinary activities of daily living
- Pain is not relieved by more conservative methods of treatment, such as those described above, by the use of a cane, and by restricting activities
- Stiffness in the joint is significant
- X-rays show advanced arthritis or other problems