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Multiple treatment methods may be needed to alleviate arthritis pain: exercise, various medications, and some alternative therapies can ease symptoms.

Osteoarthritis (OA) is considered by many women to be a normal part of aging, and many women feel its effects, such as creaky knees, sore hips, and throbbing fingers, after age 50. Unfortunately, you cannot stop OA once it begins, but you can take measures to slow its progression and ease pain.

"The sources and severity of OA can vary; since no one treatment always works for all patients we recommend a multi-faceted approach," says Lisa Mandl, MD, MPH, a rheumatologist at the Weil Cornell-affiliated Hospital for Special Surgery. In fact, research has shown that tag-teaming therapies is important for getting the best results. Here is a look at some of the most successful treatments for OA.

Exercise

The knees and hips are common sore spots, and strength training (also called resistance training or exercise) can reduce stiffness, strengthen the surrounding shock-absorbing muscles, and improve range of motion in joints.

One study found that women age 40 to 70 with knee OA who participated in 12 weeks of a progressive resistance exercise program reported less pain and improved function. See a physical therapist or exercise physiologist who has experience working with arthritis patients to help you create a program tailored to your specific needs and limitations.

A simple walking regimen may also be effective. Walking can be difficult if you have OA, but if you get moving and stick with it, it can help. One study found that walking 1,000 more steps than usual per day was linked with a reduction in functional limitations, such as having difficulty climbing stairs, and that taking 6,000 steps, or walking about three miles each day, provided the most benefits. You don't need to get all of your steps in one session: Walk for five to 20 minutes several times during the day, and the steps will add up.

Medications

A variety of over-the-counter (OTC) and prescription drugs are used to control arthritis pain.

Dr. Mandl advises caution when using medications: "Always try non-pharmacologic treatments before taking medications; drugs can have potentially serious side effects, such as stomach bleeding and ulcers, high blood pressure, and liver or kidney damage," she says.

If you are going to take medication, consult your doctor and discuss which drug (including OTC products) is best suited for your condition. Drugs commonly used to relieve OA symptoms include:

Analgesics: These reduce pain by blocking pain signals in the body; acetaminophen (Tylenol) is a common OTC analgesic. The recommended daily maximum is 3,000 mg per day. Long-term use can lead to liver damage or failure.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors: NSAIDs, including ibuprofen and naproxen, and the COX-2 inhibitor celecoxib are often very effective for OA pain. However, long-term use of these medications has been linked with risks of gastrointestinal bleeding, high blood pressure, and cardiovascular problems.

Topical analgesics: These include OTC gels, creams, and ointments that are applied directly to the joints and offer immediate, short-term relief. Side effects are rare, but may include skin irritation.

Corticosteroids: These drugs may be given either by pill or injection. An injection is prescribed for people who need quick relief from severe inflammation, and is given right into the joint. You can have injections in the same joint three times a year. However, repeated injections can cause worsening of arthritis.

Opioids: Narcotics such as hydrocodone (Vicodin) and oxycodone (Percocet) are sometimes prescribed for severe OA. Since opioid use is associated with a risk of drug dependence and overdose, opioids are not recommended for long-term pain control.

Acupuncture

Traditional acupuncture is performed with hair-thin needles; a less invasive approach uses electric pulses to stimulate the acupuncture points.

Studies have produced mixed results on acupuncture s effectiveness against OA. However, Dr. Mandl believes acupuncture is a viable choice, because it is easy to administer and has few or no side effects. "Acupuncture is a reasonable choice for patients who find it appealing and helpful," she says.

WHAT YOU SHOULD KNOW

* Osteoarthritis (OA) affects about 24 million women--twice as many women as men.

* OA is the most common joint disease among older adults.

* Excess weight puts more pressure on joints and worsens OA.

Caption: Although medications are the mainstay for some patients, walking, resistance exercise, and other treatment modalities can also help relieve joint pain.
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Publication:Women's Health Advisor
Date:Apr 1, 2017
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