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Six strategies for osteoarthritis

Advice for managing symptoms and getting on with life

By Yasmin Maldonado-Stitt, MD, rheumatologist at The Portland Clinic.

Senior man fishing

Osteoarthritis is a painful fact of life for more than 32 million people in the United States. If you’re one of them, it may be of little comfort to know that you’re not alone. But let me assure you: there is comfort to be found. While we may not have a cure (yet), hundreds of studies are showing us which strategies really work to reduce pain, improve comfort and help you do the things you want to do. Here are six of them.

1. Step up your activity

Research has found that exercise can be as beneficial as medication in reducing pain and improving function. Aerobic exercise boosts circulation to your joints and helps with weight loss; resistance training strengthens the muscles that support your joints, and stretching improves your flexibility. A combination of all three has been proven to be especially helpful for osteoarthritis in the knees. Yoga and tai chi are two gentle activities that many people find helpful.

If concerns about pain are keeping you from being active, physical therapy is a great tool to ease you into it. A physical therapist can custom-design a routine that takes the severity of your arthritis into account and helps you get the most benefit, safely. The key to any activity is to start slowly and progress gradually.

2. Aim for a little weight loss

Losing just a little can mean a lot to an arthritic knee, because every pound of weight loss reduces the load on the knees fourfold. If you are carrying extra weight, losing just 5% of your weight can improve function in your knees by up to 24%. A weight loss of 10% can lead to a 50% reduction in pain! Many people can trim a few pounds by cutting just 200-300 calories a day and eating a healthy diet rich in vegetables and fish.

3. Be selective about supplements

Supplements are not regulated by the FDA, so there is no guarantee of their purity or potency. Turmeric (curcumin) has been shown to help with rheumatoid arthritis, but is less likely to help in osteoarthritis. Chondroitin and glucosamine are safe to try, but show little to no benefit over placebo in the most reliable studies, and the latest guidelines recommend against them. Studies do support CBD with a small percentage of THC, but I don’t recommend taking it orally — topical CBD appears to be more effective and safer for your liver.

4. Find pain relief at your pharmacy

Topical aspirin and ibuprofen are the recommended first line of treatment for osteoarthritis that’s limited to shallow joints (knees or hands), and for people who can’t take oral NSAIDs (non-steroidal anti-inflammatories). Other topical agents, such as Icy Hot, Arnica and capsaicin (avoid this one on your hands) also provide relief. For those with more widespread osteoarthritis in the deep joints (hips or spine), Tylenol or oral NSAIDs are the mainstay of treatment, but check with your doctor first, and take only the lowest effective dose.

5. Try these alternative therapies

For osteoarthritis in the knees, some people find acupuncture helpful. For painful hands, many find a paraffin bath (a warm wax treatment) soothing.

6. See a specialist

When physical therapy and over-the-counter pain relievers aren’t enough, it may be beneficial to see a specialist. A rheumatologist can diagnose and treat secondary causes of osteoarthritis, such as gout, and can consider other therapeutic options, such as cortisone injections. An orthopedist may suggest modified shoes, orthotics and taping/splinting techniques that can be of great benefit. If all these efforts fail, surgery may be the next option.

If your pain is getting in the way of your life, seeing a doctor and trying something new may be the best way to find what works for you. You might never feel like a teenager again, but living an active and happy life with manageable symptoms is a realistic goal, and one that you well deserve.