Standard Treatment

Stage 1: Minor

Standard Treatment

Lifestyle modification which includes healthy eating and regular exercise.

Side Effects

None.

Effectiveness

Excellent in symptom control. It will delay the progression of arthritis.

Stage 2: Mild

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

The most commonly used NSAIDs are aspirin, ibuprofen (Advil, Motrin), Toradol, Naproxen. Celebrex, Voltaren and indomethacin.

Side Effects

Stomach pain, stomach ulcers, bleeding, liver problems, kidney problems, high blood pressure, headache, dizziness, ringing in the ears and leg swelling.

Effectiveness

Mild pain relief with a lot of side effects.

Painkillers (Narcotics/Opioids)

The most commonly used are morphine, oxycodone (Percocet), hydromorphone (Dilaudid), codeine, and Tylenol with codeine (Tylenol 1,2,3 & 4).

Side Effects

Nausea, vomiting, constipation, dizziness, sedation, tolerance, dependence and addiction. Increases the risk of falling and injury.

Effectiveness

Mild pain relief. Increasing the intake of painkillers will provide more pain relief; however, it will reduce function. There is a high profile of side effects.

Steroid (Cortisone) Injection

It causes pain and flare ups at first but then helps reduce inflammation and possibly pain.

Side Effects

Pain at the site of injection (steroid flare), bruising and insomnia (trouble sleeping).

Effectiveness

Mild pain relief. The effect usually lasts 3-4 months. However, IT DESTROYS BONE AND CARTILAGE.

Physical Therapy

Physical therapy focuses on restoring joint function which promotes healing and recovery.

Side Effects

Minimal side effects. You may get pain in the initial phases due to joint stiffness.

Effectiveness

Very effective ONLY in conjunction with lifestyle changes.

Stage 3: Moderate

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

The most commonly used NSAIDs are aspirin, ibuprofen (Advil, Motrin), Toradol, Naproxen. Celebrex, Voltaren and indomethacin.

Side Effects

Stomach pain, stomach ulcers, bleeding, liver problems, kidney problems, high blood pressure, headache, dizziness, ringing in the ears and leg swelling.

Effectiveness

Mild pain relief with a lot of side effects.

Painkillers (Narcotics/Opioids)

The most commonly used are morphine, oxycodone (Percocet), hydromorphone (Dilaudid), codeine, and Tylenol with codeine (Tylenol 1,2,3 & 4).

Side Effects

Nausea, vomiting, constipation, dizziness, sedation, tolerance, dependence and addiction. Increases the risk of falling and injury.

Effectiveness

Mild pain relief. Increasing the intake of painkillers will provide more pain relief; however, it will reduce function. There is a high profile of side effects.

Steroid (Cortisone) Injection

It causes pain and flare ups at first but then helps reduce inflammation and possibly pain.

Side Effects

Pain at the site of injection (steroid flare), bruising and insomnia (trouble sleeping).

Effectiveness

Mild pain relief. The effect usually lasts 3-4 months. However, IT DESTROYS BONE AND CARTILAGE.

Physical Therapy

It focuses on restoring joint function which promotes healing and recovery.

Side Effects

Minimal side effects. You may get pain in the initial phases due to joint stiffness.

Effectiveness

Very effective ONLY in conjunction with lifestyle changes.

Hyaluronic Acid Injection

It works as a lubricant to the joint.

Side Effects

Pain at the site of injection for couple of days.

Effectiveness

Mild pain relief. Most people need to get weekly injections for 4-5 weeks to get the benefits which lasts on average of 4-6 months.

Joint Scope (Arthroscopy)

A scope is placed into the joint under sedation. The surgeon will clean and flush the joint.

Side Effects

May include infection, bleeding, artery damage, nerve damage, vein clots, allergic reaction to the anesthesia, and chronic leg and foot pain.

Effectiveness

Poor pain relief. According to “The New England Journal of Medicine”, arthroscope surgery for people suffering from osteoarthritis does NOT reduce pain or improve function. More recent studies show that shaving and debridement of the cartilage will accelerate the progression of arthritis.

Stage 4: Severe

Joint Replacement

Joint replacement Is indicated when there is great loss of the articular cartilage and joint space is very narrow. It is considered a last resort treatment for osteoarthritis.

Side Effects

May include infection, bleeding, artery and nerve damage, vein clots, allergic reaction to the anesthesia and persistent pain. The rate of complication can be up to 11%. Fifty percent of the patients will experience pain five years after surgery. Fifty percent of patients will continue to take painkillers.

Effectiveness

Mild-to-moderate pain relief. Despite all the possible side effects and complications, joint replacement is the best available treatment option for Stage 4 osteoarthritis.