The pain and stiffness from osteoarthritis can be life-altering. Arthritis in the fingers might mean you can’t so easily open a jar or turn a doorknob, while in the knees it could be an obstacle to playing your favourite sport. An arthritic hip makes it challenging to walk, climb stairs and get into and out of a vehicle, among other daily activities.
Fortunately, certain medications and therapies can offer some relief. The most commonly-taken forms are over-the-counter medications such as acetaminophen, which relieves arthritis pain. Your doctor or pharmacist can help you choose which might be most effective.
“Different people respond differently to pain medications, in particular in different parts of the body,” says Dr. Sol Stern, a family physician in Oakville, Ont., and a member of the Canadian Pain Society. “When choosing a medication, pain relief and safety should be the top considerations.”
Dr. Stern adds that people often don’t take enough medication to relieve their arthritis pain. It’s important to follow the dosage instructions on the bottle’s label, to ensure that you’re taking an adequate amount but not going over and above the recommended daily dose.
Topical treatments
Pain-relief creams, gels and ointments may offer some relief; they may be non-steroidal anti-inflammatory drugs (NSAIDS) or contain an active ingredient such as rutin, a plant pigment that is often used to make medicines that treat osteoarthritis. “Some people respond to these and some don’t,” says Dr. Stern. “Typically they work better on smaller joints such as those in the hands and feet, rather than the larger knee and hip joints.”
A hot-wax hand treatment may be soothing, but if that isn’t an option, Sue MacQueen, a physiotherapist with The Arthritis Society, recommends rubbing hands with mineral oil, then donning rubber gloves and soaking in warm water for 10 minutes.
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Heat and ice
The general rule is that heat promotes circulation, while ice limits it. Therefore, ice is likely more suitable to soothe occasional arthritis flare-ups, while heat is preferable for relieving long-term, regular, baseline pain. Still confused whether to grab the heating pad or ice pack? “If it feels better to apply one over the other and doing so is relieving the pain and not limiting your mobility, use whichever you prefer,” says Dr. Stern.
For painful, swollen joints that feel hot due to inflammation rather than simply stiff and achy, MacQueen advises applying ice for 10 minutes.
Supplements
While there isn’t a lot of scientific evidence that supports taking preventive supplements such as glucosamine sulfate, there is anecdotal evidence. “Some of my patients tell me that their symptoms improve while taking glucosamine,” says Dr. Stern. “It seems to be better for the bigger joints—the elbows, knees and hips. It’s relatively safe, but to have any effect it has to be taken on a long-term basis, for weeks or even months.”
Alternative therapies
Therapies such as massage, physiotherapy, chiropractic and acupuncture have benefits too. “I’m a big believer in them,” says Dr. Stern. “I think they can provide tremendous help, especially in combination with over-the-counter pain relief; this is called a multi-modal treatment.” People will respond differently to each type of physical therapy, especially considering their type of arthritis and the joint or multiple joints it’s affecting, so trial and error is necessary.
Physiotherapists develop exercise programs to encourage more movement of affected joints. In addition, to relieve pain and promote better function of an arthritic thumb, for example, they may suggest using a splint or a brace, while wearing compressive gloves can offer relief to fingers.
Exercise as treatment
Generally, making healthy lifestyle changes such as swimming, biking or practicing gentle yoga or tai chi regularly and losing weight can be beneficial. “Being overweight is a huge contributing factor to arthritis symptoms, so being a healthy weight is key,” says Dr. Stern. “And you have to move your body to help mobilize the affected joints.”
Many arthritis patients complain that it hurts when they walk, so they can’t lose weight. But Dr. Stern points out that they need to differentiate between “hurt” and “harm” when it comes to their pain level, and to find ways to move that won’t be harmful.
Knees will benefit from range-of-motion exercises and strengthening the muscles around them. It’s best to avoid high-impact activities such as running; swimming and cycling are ideal because they put no stress on the knees.
Injections and surgery
When arthritis pain is no longer being managed sufficiently by traditional treatments and therapies, cortisone or steroid injections into the arthritic joint every three to six months may help. If an X-ray shows clinical signs of deterioration, however, surgery to replace the joint may be the sole solution.
“The best candidates for surgery are those with arthritis in their knees and hips who have tried everything else to improve their pain and function,” says Dr. Stern. The patient and his or her physician should make the decision together whether or not to proceed with surgery; contributing factors include the patient’s age, overall general health and weight.
As with any surgery, there are risks associated with joint replacement, such as post-operative infections and blood clots, and the physician and patient must weigh them carefully against the benefits.
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