Glucosamine and chondroitin
These supplements which are widely used for osteoarthritis are compounds which are naturally found in the human body. For example, gucosamine stimulates the repair of cartilage, but chondroitin prevents enzymes interfering the development of cartilage. Usage of these supplements can slow the loss of cartilage and repair the damage already caused. These supplements are obtained from shellfish or synthetically made in the laboratory. Scientists have found that patients who are taking these supplements experience pain relief, enhanced movement and reduction of arthritis symptoms. These supplements are best for those who have mild to moderate osteoarthritis joint pain.
All of gels have painkilling properties – gel version of painkiller such as ibuprofen is rubber directly on the knee joint, easing its pain. Unlike oral medications, which pass through the liver, diluting the drug, gels provide quicker pain relief right on the affected area. Researches have shown, that older people who are likely to take bigger doses of oral medications should use rub-on treatments such as gels. It should be mentioned, that sometimes gels are not as effective as painkillers which are taken orally, but anyone should try rubbing on painkilling gels before taking tablets, because they can reduce the pain without long-term side effects. Gels are best for those who suffer from mild to moderate osteoarthritis pain.
There are three widely used painkillers – paracetamol, non-steroidal anti-inflammatory drugs, called NSAIDs, and drugs which contain opioids. Paracetamol is used for osteoarthritis pain, but NSAIDs and opioids are used for osteoarthritis pain. Paracetamol and NSAIDs, used in long-term, can damage the stomach lining and cause bleeding, and increase the risk of stroke. Opioids have side-effects such as constipation, drowsiness and confusion in the eldery. Researches have shown, that paracetamol and NSAIDs reduce pain and increase mobility in cases of osteoarthritis, but opioids reduce the pain as much as NSAIDs do, but they have less effect on functions. Comparing all of these painkillers, NSAIDs and opioids are very effective in reduction of osteoarthritis pain, but they have a lot of potential side-effects. Paracetamol is safer than NSAIDs and opioids, therefore it should be tried first. These painkillers are best for those who have general knee pain and who have tried paracetamol and gels with no effect.
These are drugs which are very similar to those corticosteroid hormones which are naturally produced in human body by adrenal glands. One of the functions of corticosteroids is reduction of inflammation. Synthetic corticosteroid is injected directly into the affected area. Researches have shown, that this drug has powerful pain reductive properties, especially three weeks after the injection of corticosteroids. Usage of this drug is an effective way of relieving severe osteoarthritis pain in knee joints for few weeks or months, but it is not suitable for long-term use. These injections are limited to 2 of 3 times a year because of possible side-effects, for example, thinning of the skin or damage of the cartilage. Injections of corticosteroids are suitable for those who have flare-up of knee pain or who need some time of pain relief for muscle strengthening therapy.
People who have osteoarthritis usually have low levels of hyaluronan – a protein which is naturally found in joint fluid. Because of osteoarthritis this protective joint fluid is thinner and more watery, therefore it is less effective as a shock absorber and lubricant. Hyaluronan injections have three benefits – replacement of missing material, stimulation of natural hyaluronan production and reduction of inflammation. Researches have shown, that these injections have positive effect on treatment of osteoarthritis, showing beneficial effect on pain and functioning of the knee joints. What is more important, hyaluronan injections could maintain their effect for up to a year.
Knee tapping / bracing
Tapping is performed by bandage-like tape which is strapped around the knee, improving functionality of the knee joint, lessening the pressure on inflamed tissue and thus reducing pain of knees. Knee braces are wrapped around the kneecap and they have similar functions as tapes have. Knee braces are widely used in cases of osteoarthritis and patella femoral. Researches have shown, that knee braces and tapes are reducing knee pain and instability, and what is more important, these benefits continue after interruption of treatment. Tapes and braces are suitable for those who have problems with the alignment of their knees because of patellofemoral osteoarthritis, who have arthritis behind the kneecap and who have weakness of ligaments (but not weakness of muscles).
Physiotherapy includes strengthening of muscles around the painful joint with purpose to reduce the pressure on painful joint, thereby reducing pain. The quadriceps muscles at the front of the tight become weaker in cases of osteoarthritis, therefore they are a main target in exercise therapy. Researches have shown, that physiotherapy has beneficial effects on knee pain and disability, but strengthening of quadriceps muscles is one of the most important ways of lessening of knee pain, because it not only reduces knee pain, but also improves mobility. The best exercises for strengthening of quadriceps muscles are swimming, walking and cycling. Everyone who has knee pain should do proper exercises and physiotherapy.
Lidocaine patch is a knee patch which contains the local anaesthetic lidocaine numbs the nerve endings, thereby blocking pain signals. Researches have shown, that usage of lidocaine patches for 6 weeks reduces osteoarthritis knee pain for 30%, and what is more important, it maintains this effect for up to 12 weeks after treatment.
The acupuncture is based on traditional Chinese medicine and it includes inserting of needles into certain parts of the body, stimulating healing processes. The acupuncture can relieve the knee pain by production of neurotransmitters and endorphins which are natural painkillers within human body. Researchers have not noticed any beneficial effect on knee pain and functionality in cases of osteoarthritis during acupuncture, saying that it is similar to placebo. Acupuncture is also compared with exercise-based physiotherapy, because both of them have the same effectiveness.
Magnets are enhancing healing, easing inflammation and thus relieving pain. Researchers are not impressed with effectiveness of magnets, because not a single experiment has not shown any benefit of pulsed electromagnetic field therapy, therefore, the only benefit of magnetic field might be the placebo effect. Considering that magnets are harmless, they are suitable for those who have knee pain and who want to try something alternative.
Some of creams which are intended for relief of knee pain are made from several fatty acids, for example, omega three which is thought to reduce inflammation. Some of creams claim to cushion bones and joints by lubricating cell membranes. Many of these creams contain hot compound which is found in peppers, so they are reducing inflammation and relieving pain. Researches have shown, that many of these creams are improving functionality, balance and strength, and are relieving arthritis pain, therefore, these creams are suitable for people who have mild to moderate osteoarthritis pain.
Special shoes and insoles
Orthopedic shoes are designed for strengthening of muscles which surround the knee, but wedge insoles are designed for resolving alignment problems of knee joint. Special shoes and insoles get muscles to work efficiently and take the pressure off the knee joint. For this purpose shock-absorbing insoles can be helpful. Researches have shown, that wearing of these shoes and insoles lessens knee pain during walking and improves movement of the knee joint for about 30%, because they support and amortize the knee joint. Orthopedic shoes and insoles are suitable for people who have painful feet caused by osteoarthritis or rheumatoid and who have foot, knee or lower back pain.