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Treatment for Osteoarthritis Remains a Challenge
9/23 14:00:22

Osteoarthritis is the most common form of the inflammatory joint disease arthritis, affecting over 21 million Americans, including most people over 60. There are currently over 100 arthritis medications used to treat the condition, but no "magic bullet" to slow its progress.

There are over 100 types of arthritis, defined as the breakdown and wearing away of cartilage (protein-like cushion) between the joints caused by inflammation. Osteoarthritis arthritis, also called degenerative arthritis or just OA, is the most common form of arthritis, affecting over 20 million Americans. Osteoarthritis is more common in women than in men as we age, and over 30 percent of American females have some form of it by 65.

Osteoarthritis usually affects the hands, feet, spine, knees and hips, and is largely related to aging, although heredity, injury and overuse can also play a role. The most common osteoarthritis symptoms are pain, swelling, warmth and stiffness in the effected joint.?Affected joints may "crunch" or lock as the bones rub together. As the condition progresses, the joint becomes enlarged, and may develop bony spurs. Symptoms vary between individuals and may come and go, with some people experiencing years between flare ups.?Some people experience little pain despite obvious joint degeneration on x-rays, while others experience severe arthritis pain from the onset.

Osteoarthritis diagnosis can be made through simple identification of typical hard, bony enlargements of the joints, such as the top joint of the finger (called a Heberden's node), or through x-rays, bone scans, 爅oint fluid analysis, or a surgical technique called arthroscopy which uses a viewing tube to look inside of the joint.

Unfortunately, there is no specific osteoarthritis treatment to halt or reverse this progressive disease. Patients are advised to rest sore joints to decrease stress and swelling and the resulting pain. Moderate exercise can be helpful in retaining movement of the joint and strengthening the muscles around it. Swimming is an excellent exercise as it minimizes stress on the joints.

There are now over 100 arthritis medications being used to treat arthritis. Patients with mild to moderate OA are usually advised to use over-the-counter arthritis medications like acetaminophen or NSAIDS (non-steroidal anti-inflammatory drugs) to combat the pain and swelling. Topical pain relieving creams containing capsaicin, salycin, methyl salicylate or menthol can also provide relief, as can applying heat and/or cold. Fish oils appear to have some anti-inflammatory properties. There is conflicting evidence on the effectiveness of the supplements chondroitin and glucosamine.

Celebrex is a form of NSAID called a COX-2 inhibitor which specifically targets an enzyme (COX-2) responsible for arthritis inflammation and pain.?Celebrex is commonly prescribed for osteoarthritis, and is less likely to cause stomach problems than traditional arthritis NSAIDs, although it does have occasional side effects.?It is also available as generic Celebrex (celecoxib).?Mobic (generic meloxicam) and Voltaren (generic diclofenac) are other popular prescription arthritis medications. Voltaren is also available as a topical diclofenac gel.

The next level of treatment could involve injecting a corticosteroid into the affected joint, which can help ease inflammation and pain for weeks or months. Durolane (hyaluronic acid) is another arthritis injection prescription medication approved by the FDA for the treatment of mild to moderate arthritis of the knee. It is a viscosupplementation (lubricating) arthritis medication sold in a pre-filled single use syringe, and provides up to six months of pain relief.

Arthritis sufferers who fail to achieve relief through more conservative medical treatments like weight loss, moderate exercise, NSAIDS, topical creams and corticosteroid and hyaluronic injections may be candidates for surgery such as hip or knee replacements.

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