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HealthInfo Canterbury

Treatments for osteoarthritis

Losing weight and increasing activity

Being overweight puts more strain your joints and will make arthritis – especially of your knee – get worse more quickly. Losing weight can reduce your pain and also slow down the rate at which your arthritis gets worse.

Keeping active can help you manage your weight. It will also keep the muscles around the affected joint strong and flexible, and can reduce your pain. Water-based activities such as aqua-jogging can be good because the water supports your weight.

If you are finding it difficult to lose weight, speak to your GP about what services and options could help.

Physiotherapy and podiatry

A physiotherapist can assess your joints and work with you to develop a programme that strengthens and stabilises your joints. If you are eligible, your GP can refer you to the physiotherapists at Burwood Hospital, who will try to see you within four months.

You may prefer to pay to see a physiotherapist privately.

Podiatrists and physiotherapists can look at how you are moving and walking. If your joint is in an abnormal position, joint supports or orthotics in your shoes might to help to reduce the load you are putting through your joints. This might help you to walk longer distances.

Medications

There are many types of medications available for osteoarthritis, such oral pain relievers (painkillers such as paracetamol, non-steroidal anti-inflammatories or NSAIDs, codeine products), topical (rub on) pain relievers, steroid pills, and other specialist medications. Some are available over the counter at the pharmacy, and others you can only get on prescription from your doctor.

Paracetamol is the simplest and safest oral pain reliever and is usually recommended as the medication to try first. Never take more than the recommended or prescribed dose.

Your health professional will discuss medications and advise what is most appropriate for you.

Corticosteroid injections

In some people with severe osteoarthritis flare-ups, a steroid injection can provide long-term pain relief (for up to three months). However, steroid injections are not suitable for many people and it is not common to recommend them for people with osteoporosis. If you do need a steroid injection, your GP may be able to do it or refer you to a another GP or to the Community Based Musculoskeletal Service.

Capsaicin cream (Zostrix)

This cream blocks the nerves causing pain. Usually, you will first feel a warm, almost burning, sensation but this quickly eases. The cream irritates some people's skin, so stop using it and see your GP if this happens to you. See DermNet NZ – Capsaicin for more information about capsaicin cream.

Supplements

Supplements such as chondroitin sulphate and glucosamine are popular but it's not proven that they are effective. Other complementary therapies are often used by people with arthritis. These are often widely promoted but can be expensive and have not be proven to help arthritis. Check with your general practice team before spending a lot of money on these treatments.

Surgery

Some people with osteoarthritis will eventually need to have surgery, such as a hip or knee replacement. If your osteoarthritis pain can no longer be controlled by medication and lifestyle changes, your GP will refer you to be assessed for joint replacement surgery. First assessments are carried out by a physiotherapist, normally at Burwood Hospital. This determines whether you need a further assessment by a surgeon, or if joint replacement surgery is not suitable for you.

You may also wish to pay to see an orthopaedic surgeon privately.

Written by HealthInfo clinical advisers. Updated October 2016.

On the next page: More information about osteoarthritis

See also:

Hip & knee replacement

Sources

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Review key: HIOST-35589