Signs and Symptoms of Osteoarthritis
Since the weight-bearing joints are the ones most commonly affected, stiffness and discomfort in the knees and hips
are likeliest to occur first, especially in the overweight person or in someone whose life style involves long stretches
of standing or walking. A visit to the doctor for diagnosis normally includes close inspection of painful areas as well
as X-ray examination of the joints in question. (when X-ray pictures are taken for diagnosis of some other condition in
younger patients, they usually reveal the beginnings of cartilage erosion in the weight-bearing joints at a stage that
does not yet produce associated symptoms.) Other than X-rays and visual examination, there are no other diagnostic tests
for osteoarthritis.
Treatment of Osteoarthritis
Where overweight exists as a contributing
factor, efforts should be made to lose the extra pounds and keep them off. Application of warm, moist heat, slow and gentle
massage of the affected joints and a reduction (not a total cessation) of normal activities are ways in which patients can
help themselves when there is an intensification of discomfort. Where pressure on the weight-bearing joints can be
diminished through postural adjustments, special exercises may be recommended.
Drug Therapy
Although inflammation is not one of the initial symptoms of osteoarthritis, as the joint degeneration progresses, swelling,
redness and other signs of inflammation may occur. When this happens, anti-inflammatory drug therapy may be recommended.
Aspirin. Patients who can tolerate high doses of aspirin may be treated with this drug alone. However, patients on
anti-inflammatory aspirin therapy, which may involve taking 16 or more tablets a day, should be aware of possible side
effects, among which the most common are ringing in the ears, heartburn and other gastrointestinal upsets. To minimize
gastrointestinal complications, the aspirin should be scheduled after meals. Acetaminophen, in smaller dosages, may be
recommended as an alternative to aspirin.
Non-steroidal anti-inflammatory agents. These are relatively new drugs that relieve the pain and joint inflammation
of osteoarthritis. It is the physician's role to match the patient with the particular drug that will be most suitable and
effective without adverse effects. Sometimes drugs are used in combination, but whatever the procedure, supervision by the
doctor is usually indicated if maximum benefit is to be achieved.
Steroids. In those few cases where other measures fail, steroid drugs (cortisone) may be injected into the damaged
joint for temporary relief. However, long-term treatment with steroids is not recommended for osteoarthritis.
