The following are some of the interventions that are commonly used to treat osteoarthritis or to help alleviate pain caused by osteoarthritis.
Non-pharmacologic
Muscle strengthening - you want to strengthen your muscles to help stabilize your joints.
Heating pads
TENS unit
Cervical traction - for cervical spine osteoarthritis
Ultrasound therapy
Bracing - should be fitted by a qualified physical therapist or occupational therapist.
Acupuncture
Mindful meditation
Gentle massage
Chiropractic manipulation
Biofeedback therapy
Alternatives
Turmeric - I wrote a full article on my website regarding this topic[1]. The evidence to support the use of glucosamine-chondroitin or fish oil is very poor. However, omega-3 fatty acids (fish oil) as other healthy properties but simply isn’t great for osteoarthritis.
Healthy diet - I’m a big proponent of the Blue Zone lifestyle[2].
Non-surgical interventions
Steroid injections, preferably ultrasound/image guided for better accuracy.
Viscosupplementation injection (Euflexxa, Synvisc, Orthovisc, etc) are also approved for the treatment of osteoarthritis of the knee.
Nerve blocks
Neurostimulators
Topical Medications
Anti-inflammatory topical get like diclofenac gel. Typically between 1 - 2%.
Capsaicin cream - careful this is derived for hot chili peppers.
Lidocaine gel or lidocaine patches - these are getting very difficult to get approval for from insurance companies.
Medications
Acetaminophen - Probably the least effective
Non-steroidal anti-inflammatory medications (NSAIDS) - these include but are not limited to ibuprofen, naproxen, meloxicam, etodolac, sulindac, diclofenac, indomethacin, celecoxib, etc.
Duloxetine - this is technically an anti-depressant but it also has some pain relieving properties.
Neuropathic medications - gabapentin and pregabalin
Opiates - should be used as a last resort.
DMARDs - medications such as methotrexate has been studied in people suffering from severe erosive osteoarthritis. The results are mixed. About 4 - 5 years ago rheumatologists were trying this but now it is rarely done.
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