It is important that you get your osteoarthritis (OA) diagnosed and treated as early as possible. Early diagnosis and treatment is the first step in successful management of osteoarthritis. Your doctor may start you on a drug therapy regime, but ultimately you are the key factor in living successfully with OA. In addition to, and maybe more important than, medications you may take, making healthy lifestyle changes, managing stress and depression, avoiding joint damage, and balancing rest and activity will play a key role in battling the pain and limitations that can come with OA.

The goals of any treatment plan for OA include:

• Controlling pain and other symptoms
• Improving your ability to function in daily activities
• Slow the disease’s progress

Most treatment plans will include a combination of the following elements:

• Exercise
• Weight control
• Joint protection
• Physical and occupational therapy
• Medications

In severe cases, when the therapies above don’t work, surgery may be considered.

Medications
Most people with osteoarthritis will use drug therapy to ease the symptoms of the disease. Most drugs focus mainly on relieving pain, but some are targeted at other symptoms and slowing disease progression. You and your doctor should work together to find the combination of medications that works best for you. Following are examples of medications your doctor might consider.

Analgesics - Analgesics relieve pain without relieving inflammation or swelling. If you are only interested in pain relief, these drugs tend to have fewer side effects. They are recommended for people with mild-to-moderate pain. Examples of analgesics include acetaminophen, propoxyphene hydrochloride, and tramadol.

Topical Analgesics - Topical analgesics include creams or rubs that are applied directly over the painful area. These are available over-the-counter and often can be used in combination with oral medications to relieve pain. Never use topical analgesics with heat treatments; the combination can cause serious burns. Active ingredients include counterirritants (wintergreen oil, camphor, eucalyptus), which stimulate nerve endings to distract the brain from joint pain; salicylates, which hamper the activity of prostaglandins, which are chemicals in the body involved in pain and inflammation; and capsaicin, which uses the natural ingredient found in cayenne peppers to relieve pain by depleting a neurotransmitter that sends pain messages to the brain.

Nonsteroidal anit-inflammatory drugs (NSAIDs) - NSAIDs reduce inflammation and swelling as well as aid in pain relief and are recommended for people who have moderate-to-severe pain and signs of inflammation associated with OA. Examples of NSAIDs include aspirin, ibuprofen, ketoprofen, naproxen, naproxen sodium and meloxicam.

Cox-2 Drugs - Cox-2 drugs are targeted NSAIDs that don’t cause the stomach irritation associated with traditional NSAIDs. Examples of cox-2 drugs are celecoxib and valdecoxib.

Injectable glucocorticoids - Injectable glucocorticoids are steroids that are injected into the joint for fast, targeted pain relief. They are recommended as an alternative initial therapy for people with moderate-to-severe knee pain and signs of inflammation who do not get relief from acetaminophen. You may only have these injections in the same joint three or four times a year.

Viscosupplements - Viscosupplementation is used specifically for knee osteoarthritis and must be administered by an orthopaedic surgeon. It involves a series of injections over a period of weeks into the joint of hylauronic acid, a substance found in the body that gives joint fluid its viscosity. Examples are Synvisc and Hyalgan.