Healthy Aging

What’s New in Osteoarthritis Pain Relief?

osteoarthritis-pain-imaging

 

Sorry for the bummer news, but if you don’t have osteoarthritis now, you may soon. This ”wear-and-tear” arthritis, as it’s called, affects less than 14 percent of adults age 25 and older, but by the time your Medicare birthday rolls around and after, that stat creeps up to about 34 percent, the CDC cays. For individual joints, the percents can be higher, with the knee a vulnerable target.

Despite those numbers, treatment options aren’t plentiful or effective. “This really is an area that is not well understood or studied,” says Kenneth Kalunian, MD, professor of medicine at the University of California San Diego, who recently published a paper on current advances in OA.

There are the old standbys — weight management to reduce stress on the joints, stretching, pain and anti-inflammatory medicines taken orally as well as topical pain-relieving creams and rubs applied right at the skin over the joints.

And…?

While researchers haven’t paid much attention to the quest for new OA drugs, Kalunian says, recently there have been some advances in possible treatments, and there is research in the pipeline that sounds promising.

Tried & True Arthritis Relief

First, some recent studies pointing to the value of remedies that your doctor may have recommended.

  • Exercise. Yes, it’s the last thing you want to hear when you hurt, but it will help, as your doctor may have said repeatedly. In a study of nearly 1,800 men and women, with knee OA or at risk of it, researchers found walking more than 6,000 steps a day (about 3 miles) were protective against developing mobility problems, whether people had OA re already or were at risk of getting it. The average age in that study? 67.
  • Needle it. Hyaluronic acid, which occurs naturally in joint fluid as a shock absorber and lubricant, breaks down with age. But your doc can inject more. Researchers who injected it into 376 patients found it was effective.
  • Patch it. Not everyone agrees, but some researchers have found that topical ginger via a compress or patch reduced pain and fatigue and improved functioning.

Remember: Experts say that just because a tried-and-true remedy didn’t work for your neighbor or co-worker, it may work for you. Like other diseases, osteoarthritis can have different subsets of patients; there’s also an online information source and support group.

New Osteoarthritis Treatments

Next, the ”watch” list — advances under study that are worth keeping an eye on, Kalunian and other experts say.

  • Methotrexate. A drug that’s widely used in treating rheumatoid arthritis, which is an inflammatory form of the disease, may also help a subset of OA patients, Kalunian says. In one recent study, researchers gave 72 knee OA patients up to 25 milligrams of the drug weekly, while another 72 were given a placebo. Those on the drug had more pain reduction and improved physical function. (While the drug can have serious side effects when used in cancer treatment, the far smaller doses used for arthritis are relatively free from adverse effects.)
  • Platelet-rich plasma. Injecting platelet-rich plasma works to reduce pain, researchers found. They evaluated 102 patients with moderate knee OA, trying a single injection, two injections two weeks apart or three injections two weeks apart. Two injections or more work best, they report. The product is produced from a patient’s own blood. Experts say the growth factors it contains reduces inflammation and can thus reduce pain.
  • Botox. The infamous wrinkle remover doesn’t just promise a smoother face. Several studies have used injections of botulinum toxin, as it’s formally known, to ease OA pain. In a recent review of six studies, researcher concluded that the research looks good — the botulinum injections improved pain in adults with OA. It works by blocking the release of pain mediators.

Natural Osteoarthritis Treatments: Worth a Try?

Research has produced conflicting results about the effectiveness of several natural remedies that have been gaining attention recently. Since these routes to relief haven’t been linked with adverse side effects, they might be worth a try.

  • Tai chi. Researchers assigned 204 patients with knee osteoarthritis either to go to tai chi for 12 weeks (two one hour sessions a week) or to physical therapy (two 30-minute sessions for 6 weeks, then 6 weeks of home-based monitored exercises). Both groups reported similar reductions in pain and improvement in physical functioning at 12 weeks—and the results held at one year. The tai chi group had more improvement in depression symptoms and quality of life. (See our article about the health benefits of tai chi, “Tai Chi for Older Newbies.”)
  • Acupuncture. Instead of taking analgesics, you might find that acupuncture can improve your quality of life and mobility, say researchers who reviewed 12 studies.
  • Turmeric. When researchers compared 2 grams of the spice turmeric a day with 800 milligrams of ibuprofen a day for six weeks, they found pain levels improved in both groups. The turmeric group had more reductions in pain than the ibuprofen group when climbing stairs; the pill group was better at remembering to take the daily dose.

Someday, Someday

In OA of the knee, the cartilage gradually wears away — that’s what brings on the pain. Someday, your doctor may be able to fix you up by using a 3-D printer and a bio-ink made from your own cells to create new cartilage. Find out more info about the experimental procedure in this video.

 

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