Arthritis Archive

The American Academy of Orthopaedic Surgeons (AAOS) in June released updated guidelines for treating osteoarthritis of the knee. Most of the recommendations are the same as those in the AAOS' 2009 guidelines, although the organization no longer recommends hyaluronic acid injections, which haven't been found to offer much pain relief.

The AAOS also isn't recommending glucosamine and chondroitin supplements or acupuncture for knee arthritis. Recommended treatments that are better supported by research include low-impact aerobic exercise and weight loss (in overweight individuals) to reduce excess pressure on the joint. For pain relief, the organization advises the use of acetaminophen (in doses of less than 3,000 mg daily) and NSAIDs.

NSAIDs can help relieve pain and reduce inflammation from arthritis and other chronic aches and pains. However, you want to use the lowest dose for the shortest time.

Nearly a third of Americans will develop osteoarthritis of the knee before age 70. With no “cure” beside knee replacement on the horizon for this painful joint condition, relief often has to come from pain pills. Assistive devices such as wedge insoles are often prescribed as a less drastic, side effect-free treatment option. But do they really work? A review of research published today in JAMA indicates that these shoe inserts do little—if anything—to relieve arthritis pain. The findings echo new osteoarthritis treatment guidelines released by the American Academy of Orthopaedic Surgeons (AAOS) in May. Based on current research, the AAOS said it couldn’t recommend lateral wedge insoles for people with medial knee osteoarthritis.

When pain strikes, it’s human nature to avoid doing things that aggravate it. That’s certainly the case for people with arthritis, many of whom tend to avoid exercise when a hip, knee, ankle or other joint hurts. Although that strategy seems to make sense, it may harm more than help. Taking a walk on most days of the week can actually ease arthritis pain and improve other symptoms. It’s also good for the heart, brain, and every other part of the body. Yet a new survey from the Centers for Disease Control and Prevention shows that more than half of people with arthritis don’t walk at all for exercise, and only 23% meet the current recommendation for activity—walking for at least 150 minutes a week. Walking is good exercise for people with arthritis, but it isn’t the only one. A review of the benefits of exercise for people with osteoarthritis (the most common form of arthritis) found that strength training, water-based exercise, and balance therapy were the most helpful for reducing pain and improving function.

Just over the horizon, therapies are being developed to relieve osteoarthritis. But there's a lot you can do to feel better today.

There's a 50-50 chance that, at some point in your life, you'll develop osteoarthritis (OA). Not great odds, considering how much this joint condition can hamper your activity.

A mindfulness meditation program may help reduce a stress-induced inflammatory response, which could improve symptoms of diseases such as rheumatoid arthritis.

Q. I'm 52 years old. Should I take glucosamine and chondroitin to relieve my osteoarthritis pain and maintain cartilage?

A. Glucosamine and chondroitin are compounds found in healthy cartilage. Because osteoarthritis involves the degradation of normal cartilage, it would seem to make sense that taking supplements of these compounds could help maintain cartilage in people with the condition. Early anecdotal reports and small studies did suggest that the two compounds held great promise for relieving pain related to osteoarthritis. However, glucosamine and chondroitin—either together or alone—did not pass muster when they were studied in large controlled clinical trials. Their effect on pain and cartilage was no better than that of a placebo (inactive treatment) in patients with osteoarthritis of the knee or hip.

Tiny shock absorbers in the knee (each one is called a meniscus) provide a key cushion between the thighbone and the shinbone. They are prone to tearing, and sometimes just wear out. A torn meniscus can cause pain or other symptoms, like a knee that locks. But sometimes they don’t cause any symptoms. In a youngish person, when a knee-wrenching activity like skiing, ultimate Frisbee, or slipping on the ice tears a meniscus, the damage is often repaired surgically. But a torn meniscus is often seen in the 9 million Americans with knee osteoarthritis, and for them the best course of action hasn’t been crystal clear. Results of the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial published yesterday in the New England Journal of Medicine indicate that physical therapy may be just as good as surgery. Both therapies led to similar improvements in knee function and pain at six and 12 months.

Your hands perform countless small and large tasks each day—from pouring coffee, brushing teeth, and buttoning shirts to raking leaves or kneading bread.

But aching hands can transform the simplest task into a painful ordeal. Hands can hurt for a variety of reasons, from the mechanical to the neurological. Arthritis—which affects one in five American adults—and other persistent joint problems are by far the most common cause of hand pain and disability.

When it comes to relieving the pain of achy joints, many people reach for a pain-relieving pill like aspirin or ibuprofen. There may be a better way. When the source of pain is close to the surface, applying a cream, gel, patch, or spray that contains a pain reliever right where it hurts can ease pain and help avoid some of the body-wide side effects of oral pain relievers. These so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. The active ingredient in most topical analgesics is a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen, naproxen, aspirin, or diclofenac. These medications target inflammation, which contributes to pain, swelling, and stiffness. The advantage of using a topical analgesic is that the medication works locally. Targeting pain more precisely using a medication applied to the skin can help skirt the side effects of oral drugs. This can be a boon for people whose stomachs are sensitive to NSAIDs.