Patient education is particularly important. In spite of pain, it is important to keep active. Exercise maintains healthy cartilage and range of motion, and develops the stress-absorbing muscles and tendons. Daily stretching exercises are very important. Periodic partial or complete immobilisation of a joint for relatively short periods can accelerate osteoarthritis and worsen the clinical outcome.
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Interestingly, osteoarthritis of the hips and knees can be stopped from progressing and occasionally reversed by a well-planned exercise regime.
People should take care not to sit in soft chairs or sleep on soft mattresses, to avoid sitting in a slumped position and to continue to be as active as possible.
Medication
Drugs are the least important part of management, and should form only around 15 percent of a total programme.
Painkillers such as paracetamol and aspirin are often used, as are other non-steroidal anti-inflammatory drugs. Oral cortisone is not helpful in osteoarthritis.
Cortisone injections into the joint are useful when there are signs of inflammation and are usually only needed occasionally.
Surgery
Surgery for damaged joints is very successful, with hip and knee replacements now commonplace operations. Hip replacement restores mobility and relieves pain in at least 95 percent of cases. Hip replacements last for about ten years.
Other joints, such as the small joints of the fingers and even the shoulder joint are also being replaced with increasing success. The next few years should see these operations becoming increasingly common.
What is the outcome of osteoarthritis?
With the correct approach of remaining active and keeping a check on weight, osteoarthritis need not become a disabling condition. However, the damage to the joints usually starts before symptoms arise, making it difficult to act early and so prevent further damage. But there are cases in which the process stops and even reverses.
When to see your doctor
Consult your doctor if:
A joint is becoming increasingly painful and swollen.
You experience sudden extreme pain or immobility in a joint.
You have experienced pain and swelling in your knee(s) and it now starts to give way on movement, particularly when going up and down stairs.
You know that you have osteoarthritis of your weight-bearing joints, are overweight and would like some advice on weight loss and exercise.
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