Medical treatment of arthritis is mainly composed of medications and surgery. Acetaminophen (Tylenol) is usually the first medication recommended for arthritis pain. The next commonly used drugs are nonsteroidal anti-inflammatory drugs (NSAIDs) such aspirin, naproxen, and ibuprofen. NSAID side effects are usually gastrointestinal in nature. However, long term usage of NSAIDs can lead to kidney failure, liver failure, and ulcers. There is a class of drugs called Cox-2 inhibitors (such as Celebrex) that are often prescribed for arthritis patients. These are NSAIDs that don’t cause as much stomach irritation. However, Cox-2 inhibitor usage can lead to heart and stroke problems as well as ulcers.
Oral steroids such as prednisone and hydrocortisone are occasionally used for treatment, but they are more often used for rheumatoid and psoriatic arthritis than with osteoarthritis. Short term side effects of oral steroids include sleep disturbances, increased appetite, and weight gain. Powerful painkillers, such as codeine, and synthetic narcotics, such as Vicodin can also be prescribed. The chance of becoming addicted to these types of drugs is always a consideration.
Topical analgesics such as Ben Gay and Biofreeze can also be helpful.
If oral medications are not working sufficiently, a medical doctor may recommend injections of synthetic corticosteroids. These corticosteroids can be injected into the affected joint spaces. This helps minimize the use of oral forms of these drugs, which have a greater risk of causing such systemic effects as fluid retention and suppression of adrenal and immune function. However, it must be remembered that there are significant side effects to steroid injections. They are known to weaken tendons that can lead to tendon rupture. The injections can also weaken cartilage and thin bones. So in reality, their side effects can help contribute to the conditions they are trying to treat.
If you have problems with knee arthritis, your medical doctor may recommend an injectable medication called hyaluronan. Injectable hyaluronan is often referred to by its most commonly known brand name of “Synvisc”. Other brand names include Orthovisc, Euflexxa, and Supartz. Synvisc is typically administered as a series of three injections into the knee joint, each injection spaced about one week apart. Synvisc has been shown to help alleviate arthritis symptoms for 6 months, and to delay the need for knee replacement surgery. Hyaluronan is present in normal joint fluid and responsible for the lubricating properties of normal joint fluid. The lubricating effects of joint fluid allows for the cartilage surfaces of joints to glide upon each other in a smooth fashion. Most orthopedic surgeons will agree that there is likely a temporary benefit of Synvisc injections, but in the long-term additional treatments are probably necessary.
Ultimately your medical doctor may recommend surgery. They may do surgery to “clean up” the ends of the bones. If destruction progresses to the point that pain or lack of mobility becomes unbearable, joint replacement surgery may be recommended.