Osteoarthritis Management Guidelines

Osteoarthritis (OA) is the most common form of arthritis, and is a leading cause of disability among older adults. The knees, hips, and hands are the most commonly affected by osteoarthritis.

Osteoarthritis (OA) is characterized by pathology involving the whole joint, including cartilage degradation, bone remodeling, osteophyte formation, and synovial inflammation, leading to pain, stiffness, swelling, and loss of normal joint function.

Recommended therapies for the management of osteoarthritis (OA). Strongly and conditionally recommended approaches to management of hand, knee, and/or hip OA are shown below:


Factors Affecting Osteoarthritis

  • Age
  • Obesity
  • Genetics
  • Joint injury
  • Weak muscles


Symptoms of Osteoarthritis

  • Pain during activity
  • Joint stiffness
  • Swelling


Diagnosis of Osteoarthritis

Following tests help to make the diagnosis:

  • Joint aspiration
  • X-ray
  • MRI


Management of Osteoarthritis

A comprehensive plan for the management of OA in an individual patient may include educational, behavioral, psychosocial, and physical interventions, as well as topical, oral, and intraarticular medications.

Educational, behavioral, and psychosocial approaches:

  • Health awareness
  • Weight loss
  • Positive thinking

Mind-body and physical approaches:

  • Exercise
  • Yoga
  • Tai-chi

Pharmacological approaches:

  • Topical NSAIDs
  • Oral NSAIDs
  • Acetaminophen
  • Duloxetine
  • Tramadol

Advanced Therapy:

  • Surgery


No hierarchy within categories is implied in the figure, with the recognition that the various options may be used (and reused) at various times during the course of a particular patient’s disease.


Note:

  • Although a large number of trials have addressed the use of acupuncture for OA, its efficacy remains a subject of controversy.
  • Due to lack of data, no recommendation can be made regarding use of yoga to help manage symptoms of hip OA.


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References:

  • American College of Rheumatology (ACR)
  • Arthritis Foundation (AF)

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