Osteoarthritis is to older adults what ear infections are to children: common, frustrating, painful, a rite of passage. Genes play a role in causing joint-cushioning cartilage to break down, but past injuries, too much or too little exercise, and even a crooked gait can speed up arthritis symptoms. There’s no cure yet for osteoarthritis, but research is zeroing in on what brings relief. Here are a few treatments to try.
1. Lose a few pounds
Losing weight is one of the best things you can do to prevent arthritis and reduce the pain, swelling, and disability it causes. Excess weight puts excess pressure on joints. It doesn’t take much weight loss to see your condition improve: Each pound you lose reduces the stress on your knees by 4 pounds. In one major study, it took only about a 10 percent weight loss to significantly improve participants’ knee and hip function. They were able to walk farther in six minutes and climb stairs faster than those who didn’t lose the weight.
2. Stick with exercise
No matter how hard it is or how much it hurts initially, you need to keep moving if you want to improve your joint function. Study after study shows that exercise is an important and successful therapy for relieving the pain and limited function that arthritis can cause. The smart approach—endorsed by most doctors, arthritis organizations, and researchers—is a gentle mix of three types: range of motion exercise like stretching and dancing to help maintain your joints’ full range of motion and flexibility; strength exercise to keep the muscles that protect and support your joints strong; and aerobic or endurance exercise to control weight, reduce inflammation, and maintain joint function. Ideally you should work with a physical therapist or trainer who understands arthritis and can develop a program tailored for you.
3. Take acetaminophen
Cheap, relatively safe when taken as directed, and with little risk of causing gastrointestinal bleeding the way other painkillers can, acetaminophen should be your first choice for treating mild to moderate arthritis pain. One review of seven trials found that people taking acetaminophen scored about four points lower on a pain scale than those taking placebos—a statistically significant difference. Meanwhile, evaluations of studies comparing acetaminophen with aspirin found that both provided similar pain relief, though ibuprofen appeared to work better than either. Acetaminophen is less likely than aspirin, ibuprofen, or naproxen to cause stomach bleeding, however. Doses up to 4,000 milligrams a day may be safe in people who don’t have kidney or liver damage, but talk to your doctor first.
4. Try acupuncture
The simple act of inserting a needle into the skin and underlying tissue of your knee can help relieve the pain of arthritis. Over and over again, whether researchers were comparing real acupuncture to fake acupuncture or even to conventional arthritis treatments, they found that the ancient Chinese treatment not only relieved arthritis pain but in some instances also improved joint function. For instance, in one study, 283 participants received either education about arthritis or 26 weeks of either fake or real acupuncture. Those who received the real thing improved 23 percent more on pain scores, 150 percent more on physical function scores, and 74 percent more on their overall ability to function compared with the other groups.
5. Experiment with glucosamine and chondroitin
Although his own research concluded that glucosamine/chondroitin had no effect on joint pain or function, Allen D. Sawitzke, MD, recommends it for moderate pain anyway. “Some people do really well on it, even though others don’t,” says Dr. Sawitzke, an associate professor at the University of Utah Hospital and Clinics in Salt Lake City and an investigator for the national Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT). Experts think these chemicals, which occur naturally in joints, help build cartilage and supporting tissue and work best as a duo. The trial, which compared the supplement with an anti-inflammatory pain reliever and a placebo, showed that, on average, people experienced no benefit from either treatment after two years. But Dr. Sawitzke points out the fine print: Glucosamine/ chondroitin didn’t help everyone universally, but some people who took it lost ten times less cartilage. And the compounds significantly eased pain for 79 percent of participants during the first two months. Consider trying glucosamine/chondroitin for two to three months. If you don’t see a benefit by then, you’re prob- ably not going to, Dr. Sawitzke says.
6. Rub on capsaicin cream
Capsaicin is the substance that gives hot peppers their bite. As an ingredient in a cream to rub over painful joints, it can also relieve your arthritis pain. One study randomly assigned people with arthritis to receive either the real thing or a placebo cream. They graded their own levels of pain and stiffness the week before the treatment started, then applied the cream daily for 28 days, ranking their pain and stiffness over time. The results: Pain levels dropped by about 16 percent in the placebo group but by 77 percent in the capsaicin group, with major differences beginning in the second week. Even better, stiffness fell by 18 percent in the placebo group but by about 86 percent in the capsaicin group, beginning the first week. Interestingly, another study found that even if researchers told patients that capsaicin was less effective than other medicines, patients still preferred the cream to any other pain relief option. The main reason? Fewer side effects.
7. Feel better with corticosteroid injections
Injecting corticosteroids directly into an arthritic joint helps reduce pain and stiffness by reducing inflammation. An analysis of 10 studies found that people who received the injections were 66 percent more likely than a control group to have less pain and greater function in their arthritic knees up to 24 weeks after the treatment. Similar positive results have been documented for shoulder injections.
While these shots can relieve underlying inflammation that’s responsible for the pain, they can’t do anything to improve the bottom-line cause of the pain: degenerating cartilage. And their effects are generally short-lived. They also have to be used judiciously, since long-term use can lead to thinning skin, weight gain, facial puffiness, increased blood pressure, cataracts, and osteoporosis.
8. Sip ginger tea
There is evidence that this anti-inflammatory herb, best known for soothing nausea, can help with the pain, swelling, and stiffness of osteoarthritis, particularly in the knee. In one study of 261 people with knee osteoarthritis, volunteers received either a sugar pill or ginger extract. Sixty-three percent of the ginger group experienced pain relief compared to 50 percent of the placebo group. Even better: Unlike some painkillers, ginger causes few if any stomach problems. Use fresh ginger liberally in your cooking, make tea by boiling several slices of fresh ginger, or for maximum benefit, take 500 to 1,000 milligrams of powdered ginger root daily.
9. Consider devil’s claw
This anti-inflammatory herb seems to work similarly to prescription painkillers known as COX-2 inhibitors, such as celecoxib (Celebrex). However, they don’t have the potential COX-2 inhibitor side effects, including increased risk of ulcers, stomach pain, and heart attack. Studies in which participants took a daily dose containing 60 milligrams of harpagoside (the active ingredient in devil’s claw) found the herb helped reduce the pain of arthritis in the hip, knee, and spine.
10. Consider willow bark
White willow bark—the original source of salicin, the active ingredient in aspirin—appears to provide some relief from arthritis pain, though it won’t work as well as traditional painkillers.
11. Ask about SAM-e
This somewhat controversial supplement has a fair amount of scientific support as an arthritis pain reliever. SAM-e is short for S-adenosyl-methionine, a naturally occurring chemical in the body that has many functions. In test-tube and animal research, it protects cells that produce cartilage and stimulates them to produce joint-lubricating chemicals. Sold as a drug in some countries and as an over-the-counter supplement in others, it has proven as effective as some COX-2 inhibitors for relieving arthritis pain, but takes longer to act. An analysis of 14 SAM-e studies showed it is also effective for improving mobility in people with osteoarthritis. However, high doses of SAM-e can cause several side effects, and it interacts with many medications. Use it only after talking with your doctor.
12. Research hyaluronic acid injections
Hyaluronic acid is injected to replace a natural substance called hyaluronan that works like motor oil in the joint to let the cartilage surfaces of bones glide over each other smoothly. For some people, injections of this thick liquid can help reduce pain for a year or longer. And clinical studies show that the therapy is as effective in providing pain relief as nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen. But these injections don’t work for everyone, must be given relatively frequently, and are expensive. For this reason, most doctors consider the injections (also called joint fluid therapy) only as a backup plan if other remedies don’t work.