There are millions of Americans walking around right now with arthritis in either one or both knees. Just because a person has arthritis does not mean pain will be present, but if it is bothersome what are the best ways to treat it?
Surgery for arthritis of the knee consisting of a joint replacement with an orthopedic surgeon is definitely a last resort. Artificial knee implants are not meant to last forever, and having one may last for 10 to 20 years before it needs a revision. In addition, a recent study performed at multiple VA hospitals throughout the country showed that knee arthroscopy for osteoarthritis were not as great as we once thought for pain management.
Here are 5 methods of treating the arthritis nonoperatively which can help tremendously.
1. Activity avoidance. When arthritis develops, significant stresses through the knee can be very painful either during the activity or for days afterwards. For instance, if you have been an avid jogger for many years, there may come a time where it causes too much pain in your knee which will affect your ability to exercise any walk. If this is the case, the best course of action is to avoid jogging and to switch exercises to something less stressful on the knees such as swimming for biking. That way you still continue to get the muscular and cardiovascular benefits of the activity but without the significant pounding stresses through the area of arthritis.
2. Over-the-counter pain medications- these may become simply a fact of life for individuals with arthritis. When taken properly according to the manufacturer recommendations, anti-inflammatory medications such as ibuprofen and naproxen along with Tylenol can deliver exceptional pain relief for arthritis. It is well-known that there is an inflammatory component to arthritis, so that may explain the beneficial effects of the anti-inflammatories. Narcotic medications for knee arthritis on a chronic basis is a bad idea. However, if taken for an acute flareup they may not be an issue.
3. Physical therapy- one of the well-known methods that has been proven to work well in research studies is physical therapy. This can strengthen the muscles around the arthritic knee and take some pressure off of the arthritic regions. This may allow patients the ability to walk more often, and participate in more recreational activities.
4. Injections- injections of steroids medication do not fix arthritis, and there is some animal research which shows that it may make the arthritis worse by deteriorating cartilage. But if a patient is heading towards a knee replacement anyway, then the injection may prolong the need for surgery and give months of pain relief. They can be repeated every few months. There also some injections of hyaluronic acid which is a large component of synovial fluid anyway. These injections have actually shown significant benefits in a patient's arthritic knee. One of the major studies for the treatment showed 65% good to excellent results at the one-year point.
5. Off loader bracing- knee bracing can work really well to alleviate pain. In the knee, arthritis is commonly affecting one compartment out of the 3 compartments of the knee. Because of this, the knee brace acts to offload that arthritic compartment and may be able to non-operatively relieve a patient's pain. These braces can be a little bit cumbersome but if it can avoid the need for surgery than often times these slight cumbersome nature of the brace is well tolerated compared with the pain relief that is achieved by them.
As mentioned, a knee replacement with an orthopedic surgeon for arthritis is a last resort. Most of these surgeries have excellent outcomes, but they do not last forever so the surgery should be put off as much as possible with these types of treatments.
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