Answer
First, you should follow a step-wise approach starting with the least invasive treatments.
- Patients should initially try supplements such as glucosamine and chondroitin as they have been found to decrease pain when taken for four to six weeks consecutively.
- A low impact exercise program such as cycling, swimming, elliptical trainers, and rowing machines can decrease pain because of the natural lubricating effects of exercise on the joint.
- A strengthening program and physical therapy are also very beneficial to decrease arthritis pain.
- Tylenol (acetaminophen) is recommended for pain if the supplements and the exercise program are ineffective.
- Anti-inflammatory medication (NSAIDs) such as Motrin, Advil, Celebrex, and Aleve are also very helpful for arthritis pain but must be used cautiously due to potentially serious side effects.
- A variety of braces can be used to give some relief as well. Weight loss and avoidance of impact activity can also be beneficial.
If a patient has failed the above treatment options then consider injections as the next step. Two types of injections exist for the knee, cortisone and viscosupplementation injections. Cortisone works essentially as a potent anti-inflammatory within the knee and will typically give temporary and partial relief of pain within 3-5 days. Cortisone should be limited to a maximum of three injections per year because of potential harmful effects to the joint cartilage. Typical use of cortisone is when a patient presents with an acute exacerbation of their pain and is in need of rapid relief. The duration of it's effect is unpredictable.
Viscosupplementation is a term used to describe a series of "lubrication" injections administered once a week for 3-5 weeks consecutively, depending on the manufacturer. The active ingredient within all of the medications is hyaluronic acid which is a building block of our joint cartilage and our joint (synovial) fluid. Normal joint fluid is fairly viscous (thick like cooking oil) as compared to the fluid in an arthritic knee which loses it's viscosity and elasticity, becoming more water-like.
This information was originally included in a GoodHealth article, "Lubrication" Injections for the Knee.
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