Therapy of Osteoarthritis


Adequate therapy of arthritis should have a multimodal approach:

Physical therapy

Cold effectively reduces pain in active osteoarthritis. Weight reduction is effective with pain in obese patients, and significantly improves pain in gonarthritis.

Pharmacotherapy

Symptomatic treatment with non-opioid analgesics (e.g. coxibes), opioid analgesics or tapentadol is possible. Symptomatic slow acting drugs in osteoarthritis (SYSADOA) are supposed to have an effect on pain and joint function. As yet, a clear mode of action has not been established.

Other treatment procedures

Intra-articular injection of glucocorticoids is only indicated in flares of osteoarthritis.

 

Motivation and compliance

Patients should be motivated to actively take responsibility for their treatment. They should not be forced to assess their pain regularly themselves, but should accept the documentation of the course of therapy as being useful.

For motivation, it is important to inform patients of the advantages of continuous documentation and to question their willingness to participate in ‘self-observation’. If they agree, the method of pain assessment as well as the expected difficulties in its practical use should be discussed with them.

Compliance is more likely achieved when patients

  • are actively involved in the process of treatment.
  • keep a pain diary.
  • identify themselves with the goals of therapy.