Therefore, recommendation of acetaminophen as first-line analgesic medication should be reconsidered. Intra-articular corticosteroid injections provide short-term pain relief (1–2 weeks in randomised controlled trials) and improved function for patients with osteoarthritis. They can be considered in patients who present with acute exacerbations with joint effusions and local inflammation. However, intra-articular injections given more frequently than once every four months can result in cartilage and joint damage,32,33 as well as increased risk of infection. Weight loss is often promoted in tandem with exercise therapy and the combination of both interventions has been shown to be more effective.
Physical antalgic therapies, similar to minimally invasive interventional treatments (i.e. intra- or extra-articular injections), represent an integral part of the rehabilitative approach, with its rationale built into the individual rehabilitation project. In case of atypical presentation, imaging is recommended to confirm the diagnosis of OA and/or make alternative or additional diagnoses [4]. This allows monitoring of potential benefits and possible interactions with other medications. An awareness of the medical literature also permits physicians to provide evidence-based recommendations for individual patient therapeutic trials. It is through such assessments that a medication such as capsaicin, which is derived from the red pepper plant, has become part of conventional medicine. The purpose of intra-articular injections of HA in OA is primarily to improve these viscoelastic properties.
Osteoarthritis is a common form of arthritis that affects millions of people worldwide. It primarily affects the joints, causing pain, stiffness, and swelling. The first line treatment for osteoarthritis aims to reduce pain and improve function in the affected joints.
They concluded that walking may have cardiovascular benefits without relieving knee pain. However, it must be noted that the patients recruited had grade III or IV osteoarthritis and hence walking might not have significant benefits at a severe stage. In addition, excessive recreational physical activity might lead to worsening outcomes. In a clinical study assessing the dose response of walking for patients with severe KOA (Grade III and IV), Wallis et al[14] found that there was a higher risk of adverse events leading to worsening knee pain beyond 70 min per week of supervised walking. However, in a RCT of patients with mild to moderate KOA, Alghadir et al[15] concluded that a 6-wk walking program of 30 min a week resulted in greater pain relief, physical function and quadriceps muscle strength. Farrokhi et al[16] recommended shorter interval bouts of walking over continuous and longer sessions due to reported knee pain and undesirable knee loading when patients walk continuously for 30 min or more.
Medications
The guideline recommends against glucosamine alone or with chondroitin because treatment does not improve knee and hip OA in studies without industry funding. Hand orthoses appear to improve pain and function for OA in the first carpometacarpal joint. Affecting more than 300 million people worldwide, osteoarthritis (OA) is common and difficult to manage. Although OA can involve any joint, the knee, hip, and hand are most commonly affected.
There are several medications commonly used as first-line treatments for osteoarthritis:
Delivery of the electrical currents can be of varying frequencies and intensity. Clinical studies examining the effectiveness of TENS therapy have shown that it is mostly ineffective with little clinical benefits for patients. Prescription of an exercise regime can also be further complicated by the large number of exercises available and variable dosage in terms of frequency, sets and repetition. In addition, there have been far less research done that directly compares different exercises due to the cost and sheer number of exercises available. In a recent systematic review and network meta-analysis, Goh et al[18] classified exercises into aerobic, mind-body, strengthening, flexibility/skill and mixed types.
- Acetaminophen: This over-the-counter medication can help relieve pain associated with osteoarthritis.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can help reduce pain and inflammation in the affected joints.
- Corticosteroids: Injections of corticosteroids directly into the affected joint can provide relief from pain and inflammation.
Physical Therapy
Physical therapy is an important component of the first line treatment of osteoarthritis. A physical therapist can create an individualized exercise program to help improve joint flexibility and strength. They may also use techniques such as hot or cold therapy to reduce pain and inflammation.
Lifestyle Changes
There are several lifestyle changes that can help manage osteoarthritis symptoms:
- Weight management: Maintaining a healthy weight can reduce stress on the joints, improving symptoms of osteoarthritis.
- Regular exercise: Low-impact exercises such as swimming or walking can help improve joint function and reduce pain.
- Use of assistive devices: Devices such as braces or shoe inserts can help support the affected joints and reduce pain.
FAQs
What are the goals of first line treatment for osteoarthritis?
The goals of first line treatment for osteoarthritis are to reduce pain, improve joint function, and increase quality of life for individuals with the condition.
Are there any side effects associated with first line treatments for osteoarthritis?
Some medications used to treat osteoarthritis may have side effects, such as stomach upset or increased risk of cardiovascular events. It is important to discuss potential side effects with your healthcare provider.
