Medications

• The best types of pain medications are anti-inflammatory medications such as over-the-counter medications like aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), meloxicam/mobic (prescription), Voltaren (diclofenac, topical ointment), to help reduce pain and swelling in the joint. The pain in your joint is often due to inflammation, so the anti-inflammatory medications actually help your pain by helping the problem. Like all medications, these can have side effects - so take them with food to avoid irritating your stomach, and patients with a history of gastrointestinal, kidney, or heart issues should avoid taking them.

• Many patients try to incorporate anti-inflammatory foods and spices into their diet. A list of these supplements can easily be found on the internet. A commonly used one is turmeric

• Other simple pain relievers, such as acetaminophen (Tylenol), are available without a prescription and can be effective in reducing pain.

• We highly recommend against using narcotic pain medications for treatment of arthritis – these medications (Norco, Vicodin, Oxycodone, Dilaudid) are dangerous and less effective at treating arthritis pain than other medications and have serious problems when used chronicalliy

Injections

• There are several types of injections that are commonly used to provide temporary relief from a flare-up of arthritis pain.

• Cortisone injections can provide you with pain relief and reduce inflammation. However, it is important to know that they are temporary and do not treat the underlying problem. They can be very useful if there is significant swelling, but are not very helpful if the arthritis affects the movement of your joint. How long the injection works before it wears off is variable, and there is a limit to how many your doctor can give you per year. For some lucky people, these injections last 6 months and for others, they last 6 hours. In general, most patients get some relief for about a month.

• Other injections include “gel” injections such as hyaluronic acid (HA). is injected into the joint. It can help joints to work properly by acting like a lubricant. It isn’t clear how helpful these injections are, but some patients do get a significant amount of relief from them. There are several different types that your doctor will give in various treatment regimes. Due to anatomy around the hip joint, injections into the hip are more complicated and therefore less frequently prescribed. Examples of such medications include Synvisc, Orthovisc, Supartz, Hyalgan, etc.

Weight Loss

• Many people with osteoarthritis are overweight. Simple weight loss can reduce stress on your weight-bearing joints, such as the hip or knee. You put three to five times your body weight across these joints throughout the day – especially during stair climbing and getting in and out of a chair.

• Every pound you carry puts a force of 5 lbs on the hip and knee. So even losing 5 lbs results in 25 less pounds that your hip or your knee is feeling. Losing weight can result in reduced pain and increased function, and also decrease your risk of complications after surgery.

• The first thing to achieve weight loss is to be in a caloric deficit. You must take in fewer calories than you are putting out. A fantastic app to help people track their calories, their activities, and provide motivation is Noom

Exercise

• An exercise routine can help increase your range of motion and flexibility as well as help strengthen the muscles in your legs. Exercise is often effective in reducing pain and improving function. Unfortunately, in the setting of advanced arthritis (bone-on-bone), exercise can sometimes increase pain in your hip and knee joints. Your physical therapist can help develop an individualized exercise program that meets your needs and lifestyle. Consider daily protein supplements/shakes to help build muscle.

• You may be discouraged that you are not performing at the levels you may have previously. But the best exercise is the one you are willing to do. So start small and build up accordingly

Physical Therapy

• Physical therapy to strengthen the muscles around your joint may help absorb some of the shock imparted to the joint. Physical therapy can help to reduce the pain, swelling, and stiffness of osteoarthritis, and it can help improve joint function. It can also make it easier for you to walk, bend, kneel, squat, and sit. For some people with bad arthritis already, physical therapy can often cause more pain than it relieves.

Braces and Splints

• Braces have not been proven to be very helpful for knee arthritis. However, in some patients who do not want surgery or are not good candidates for knee replacement, they may be helpful in relieving some of the symptoms.

• If you have pain predominantly only on the inside or the outside of the knee, then a brace may be helpful in ‘offloading’ the stress

Alternative medicines

• Examples of alternative therapies include acupuncture, chiropractic medicine, massage therapy, stem cell injections, PRP injections. At this time, there is no great evidence to suggest these are helpful for arthritis. However, as long as these therapies are not dangerous (i.e. no manipulation of the back and spine), there is usually no harm to try them (asides from cost) and some patients have benefitted from these.

List of Useful Exercises:

• A list of useful exercises to maintain your range of motion, flexibility, and slowly improve your strength can be found here on the website of the American Association of Hip and Knee Surgeons

**The above information was obtained and edited from the American Association of Hip and Knee Surgeons (AAHKS) website. For more education from this resource, go to www.aahks.org and click on the link at the top “For Patients”.