What drug and non-drug based treatments are recommended for osteoarthritis?

This article reviewed guidelines for management of osteoarthritis.

Osteoarthritis is the most common form of arthritis and affects more than 27 million people in the United States. Older individuals and overweight individuals have a higher risk of developing osteoarthritis. One common symptom of the disease is joint pain. Many guidelines exist for the management of osteoarthritis and the pain involved. However, despite the fact that these guidelines have a lot in common, they can be poorly followed.

Overall, 16 articles were included in this review. The articles related to management guidelines for patients with osteoarthritis. The guidelines included both drug and non-drug based treatments.

Non-drug based treatments

15 of the articles discussed non-drug related treatment strategies.

Educating patients in self-care, joint protection strategies and appropriate treatment plans was recommended. Low impact land or water based aerobic exercise and weight loss if patients are overweight were also recommended. Walking aids or other devices to improve daily activities should be used if needed. Heat packs placed on the joints can be also be helpful for relieving symptoms. Finally, joint replacement for appropriate patients with knee or hip osteoarthritis.

Not enough evidence exists to recommend the use of braces, lateral heel wedges for knee osteoarthritis, or splints for thumb based osteoarthritis. The use of acupuncture was controversial, as was Tai Chi and electrical nerve stimulation.

Drug based treatments

11 of the articles discussed drug-related treatment strategies.

Initially, acetaminophen (Tylenol, Panadol) is recommended for patients suffering from pain. Another option is non-steroidal anti-inflammatory drugs (ibuprofen [Advil], aspirin [Bayer, Ecotrin]). These can be applied to the skin surrounding the joint or swallowed. Opioids (hydrocodone [Vicodin]) are sometimes considered for pain management.

Corticosteroids, such as betamethasone (Diprolene), are anti-inflammatory drugs that are also recommended. Intra-articular corticosteroids (corticosteroids injected directly into the joint space) were generally recommended for hip and knee osteoarthritis. 

The authors concluded that there are good quality guidelines in place for the management of osteoarthritis. They recommend that future efforts should focus on proper implementation of the guidelines.