Treatments for Osteoarthritis

Osteoarthritis is also known as degenerative arthritis or degenerative joint disease. Along with rheumatoid arthritis, osteoarthritis is one of the most common forms of arthritis. But unlike rheumatoid arthritis, none of the major drug treatments appears to actually alter the course of osteoarthritis.

Treatments Target Symptom Relief, Not Improvement

Due to the degenerative nature of the disease, drug treatments for osteoarthritis are aimed at symptom control. Tylenol and the simpler non-steroidal drugs (NSAIDs like Ibuprofen) are helpful for pain relief and temporary functional improvement. In a number of studies, the dietary supplements glucosamine and chondroitin sulfate, used together or alone, provided pain relief for many patients, but were not significant in slowing the expected loss of joint cartilage in osteoarthritis. Overall, however, the combination of glucosamine plus chondroitin sulfate did not routinely provide significant relief from osteoarthritis pain among all participants, but did so only in a smaller subgroup of study participants with moderate to severe pain.

Is it Possible to Prevent Osteoarthritis?

In addition to pain relief, major studies investigated whether medicines can change the natural course of osteoarthritis. The findings of these studies, which measure cartilage loss (a hallmark of the disease) have been difficult to interpret.

Preventing or slowing the expected loss of cartilage, the slippery material that cushions the joints, is the endpoint chosen for measuring success. Cartilage loss was measured on X-rays by trying to determine any reduction in the size of the joint space, or the distance between the ends of bones in a joint. Studies could not draw the conclusion that these drugs change the natural disease course of osteoarthritis. This result was true whether patients used chondroitin sulfate, glucosamine or celecoxib (Celebrex) each day. At two years, no treatment showed a significant reduction in joint space width loss, but researchers did find a trend toward reduced joint space loss only in those with more advanced osteoarthritis. Overall, patients with moderate osteoarthritis were the least likely to have progression of osteoarthritis compared to those found to have a higher grade more severe form of the disease.

In spite of treatment, twenty-four percent of participants taking the combination of glucosamine plus chondroitin sulfate showed disease progression over two years—and the combination of drugs had slightly worse results than either drug alone. In summary, researchers noted, there was no conclusive evidence that either drug had a major effect on influencing measurable damage to the joint in patients with osteoarthritis.

Author’s Note: References: www.prescribersletter.com, www.mayo.com, www.medscape.com, www.wikipedia.org.

Editor’s Note: For further reading, see Natural Treatment for Arthritis Pain and Using Acupuncture to Treat Arthritis, Back, Neck and Knee Pain.

Posted in Relieving Symptoms, Senior Health, Types of Arthritis