Glucosamine and chondroitin are substances found naturally in the body. Glucosamine stimulates the formation and repair of cartilage. Chondroitin sulfate prevents other enzymes from breaking down the building blocks of joint cartilage. While these two supplements are commonly used to treat osteoarthritis, the research has not shown that glucosamine and/or chondroitin are helpful for most people. If you are interested in taking these supplements, talk with you doctor first. Your doctor will help you decide if they are right for you and what your proper dosage is.
With TENS, a doctor or a physical therapist places electrode patches on your skin, connecting you to a small machine. This machine sends painless electrical signals through the skin to the nerves. In people with knee osteoarthritis, TENS may decrease pain and improve function.
If you have knee osteoarthritis, manual therapy, including massage therapy and manipulation, may be helpful.
Heat improves blood circulation to the affected area. Applying heat via warm soaks, paraffin, or heating pads can be very soothing. Most recommend that you apply the heat for about ten minutes at a time, 3-4 times a day.
Cold can help decrease inflammation in an affected joint, relieving pain, and improving stiffness and movement. Apply an ice pack for 20-30 minutes at a time, several times each day. Cold packs after exercise can be very helpful.
Shoes with shock-absorbing in soles may provide some relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports. Canes , crutches , walkers , and orthopedic shoes can help with advanced osteoarthritis in the lower body.
Your doctor may choose to inject the affected joint with a solution containing a corticosteroid medicine such as:
The steroid injection can help decrease inflammation and pain in the joint. Sometimes, excess joint fluid will be removed from the joint just before injecting the steroid medicine.
Steroid injections often have to be repeated every several months. Most doctors believe that no more than three or four such injections should be given in a year. More than that number may itself cause damage to the articular cartilage.
Viscosupplementation involves injecting the affected joint with a fluid containing a substance called hyaluronic acid. Hyaluronic acid is a chemical found in normal cartilage and in normal joint fluid, which is vital to the lubrication of the joint surface.
Viscosupplementation is thought to:
Osteoarthritis. Arthritis Foundation website. Available at: http://www.arthritis.org/conditions-treatments/disease-center/osteoarthritis. Accessed July 23, 2013.
Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Osteoarthritis/default.asp. Updated July 2010. Accessed July 23, 2013.
Sinusas, K. Osteoarthritis: Diagnosis and treatment. Am Fam Physician. 2012;85(1):49-56.
Transcutaneous electrical nerve stimulation. InteliHealth website. Available at: http://www.intelihealth.com/IH/ihtIH/wsihw000/8513/34968/363973.html?d=dmtContent. Updated May 2008. Accessed July 23, 2013.
12/11/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Rutjes WJ, Nuesch E, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009;(4):CD002823.
10/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Wandel S, Jüni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ . 2010;341:c4675.
11/29/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : French HP, Brennan A, White B, Cusack T. Manual therapy for osteoarthritis of the hip or knee: a systematic review. Man Ther . 2011;16(2):109-117.
Last reviewed June 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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