Managing arthritis
This is information to help patients who want to manage their arthritis, but don't want or aren't ready for surgical treatment.
View the interactive slideshow below, a downloadable copy is also available.
Management Components
Reducing joint stress
Osteo-arthritis can be a predominantly mechanical problem. Worn out joints hurt when they are loaded.
A major component of non-operative management is to reduce stress on the joint by: reducing the load; avoiding certain activities; changing the way you do things; and using aids and orthotics.
Non-drug therapies
Pain relief does not have to mean tablets. There are a lot of modalities that utilise hot and cold, external supports, sleeping aids and other orthotics to provide relief.
These have the additional benefit of not having long term costs, and not having side effects and tolerance issues.
Safe medications
Pain medications are necessary. especially during flare-ups. There are some natural remedies that have active ingredients, as well as scientifically proven pharmaceuticals that are available from the chemist and supermarket.
Long term use of strong pain killers is not recommended for arthritis as side-effects, tolerance and addiction may become an issue.
Surgery
Most people want to avoid surgery if possible. Joint replacement is a large operation and commitment, and there are always risks with operations.
When all other treatments are exhausted however there are usually several surgical options ranging from: arthroscopic, joint realignment, partial or total replacement, and joint excision and fusions.
Joint stress and weight control
Hip and knee joints carry the weight of the entire body every step. Parts of these joints experience joint forces up to 5-10x body weight! This means that 20kg of extra weight can mean an extra 100kg of force through the hip.
Weight loss to prevent many conditions such as heart or lung disease decrease risk by a several percent but may not change an outcome. Every kg of weight loss however on a load bearing joint decreases the stress experienced. That decreases the pain on both hips and both knees - much better than 4 joint replacements!
Weight loss may not prevent the need to replace an already damaged joint, however it makes surgery safer and less invasive. There is a lower rate of infection, joint mal-position, operative fracture and early failure. In addition your anaesthetic will be safer and your therapy easier to manage.
See this slideshow below to see all of the non-operative management strategies to help with your arthritis. The slides will change automatically, but you can click left or right at any time if you want to see something again, or hover your mouse over the slides to pause to read at your own pace.
MUSCULAR EXERCISE
It is important to maintain muscle strength and joint mobility. Maintaining strength will improve joint control, bone density and decrease forces on the internal joint structures. Regular exercise will also help with avoiding obesity and improve fitness for surgery if required in the future.
Exercises that tend to be better tolerated include: swimming, cycling, walking moderate amounts, paddling, weights and hydrotherapy. Hydrotherapy is particularly good during flare-ups as natural buoyancy can decrease body weight on the joint by up to 90%