Osteoarthritis: Four Major Therapies (Drug Therapy, Exercise Therapy, etc.) - Guidelines
Drug Therapy: Drug therapy for osteoarthritis should be limited to the painful phase. Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics are both effective. These drugs have similar effects on pain and function in knee osteoarthritis. NSAIDs are generally believed to reduce the inflammatory components in the affected joint. NSAIDs should be limited to the symptomatic phase when analgesics are insufficient to relieve pain.
Exercise Therapy: Exercise is an effective way to prevent and treat obesity, and it is also effective for osteoarthritis. Regular exercise can reduce lesions, dependence, and pain. Exercise has a good effect on pain and function in patients with knee and hip osteoarthritis. Exercise therapy requires a planned exercise program, including exercise time, type of exercise, and exercise content. Exercising in a warm swimming pool (30-34°C) is an excellent adjunct or alternative method. Walking, golf, Tai Chi, and yoga are all gentler exercise therapies.
Assistive Device Therapy: Using orthotics can prevent and control pain. Pain during weight-bearing can be prevented or relieved by using a walking aid on the opposite side. Shoes with wedge heels and viscoelastic insoles can reduce the impact load on affected joints and alleviate pain. Patients with knee pain sometimes use adhesive tape to immobilize the medial side of the joint or use knee orthotics. Similarly, patients with osteoarthritis of the hand can use various types of hand orthotics. Applying an orthosis to the base of the painful thumb can prevent pain, assist grasping, and enhance hand function. Regular use of joint protectors, home assistive devices, and tools can also prevent and reduce pain. Muscle relaxation techniques, stress relief, and acupuncture also have some therapeutic effects on this disease. Dietary guidance to reduce weight is also an important consideration when treating these patients.
Surgical Treatment:
1. Indications: Persistent pain at rest and at night is a common indication for surgical treatment of osteoarthritis.
2. Preoperative Examination: In addition to routine examinations, a detailed preoperative examination of the patient's peripheral vascular condition and cardiac, cerebral, and pulmonary function is necessary.
Surgical treatment of osteoarthritis mainly involves joint replacement. The success rate of knee and hip replacement exceeds 90%. Total joint replacement surgery in elderly patients usually yields excellent results, although a very small percentage experience mild pain and disability.
Prognosis: Most patients with osteoarthritis have a good prognosis; only a very small percentage develop severe, progressive joint damage. Many treatment methods, including moderate and regular exercise, acupuncture, and topical application of capsaicin, are effective, simple, and rarely cause adverse reactions. Drug therapy carries certain risks, and patients should be given proper guidance before its use.
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