Treatment Options
How to Feel Better
You and you doctor can individualize your treatment to find what works
If you have OA of the knee, there are many ways to ease discomfort and provide relief—from the time-tested use of over-the-counter (OTC) pain relievers such as ibuprofen to total knee replacement."Twenty years ago we thought that osteoarthritis was the inevitable result of wear and tear on your bones," says Joanne M. Jordan, M.D., M.P.H., director of the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill. "But clearly not everyone gets osteoarthritis, and, although there are risk factors such as obesity, genetics or injury, a lot of folks develop OA without having any. So we are looking at the role inflammation plays, as well as other factors."
While it appears to be intermittent and at a different level of intensity than in rheumatoid arthritis (RA), the inflammation is there and, says Dr. Jordan, very relevant. "Understanding this opens up the possibility that disease-modifying drugs, or even biologics, [such as those used to treat RA] may be useful in treating or stopping the progression of OA," she explains. "Some people feel that for osteoarthritis, as opposed to RA, it's not justified to incur the risk of side effects that is associated with these drugs. But I think OA causes a lot of difficulty and trying these medicines may be worth the risks, particularly with multi-joint OA. Just because OA isn't rheumatoid arthritis doesn't mean it isn't associated with significant disability."
Although using disease-modifying drugs for OA is still in the future, treatments are changing in other ways. "Structurally, we're not just focusing on cartilage in the knee," says Dr. Jordan. "We are looking at the role of the meniscus—the cartilage pad between the thighbone and the shin—as well all the bone itself and supporting structures that contribute to OA."
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