Thursday, September 5, 2013

Osteoarthritis Pain Relieved by Viscosupplementation

Aging affects everyone differently. Some people live well into their eighth and ninth decades without experiencing anything more serious than a few aches or pains, while others start to feel the impact of years of use on their joints as early as their 30s and 40s. Osteoarthritis, also known as “wear-and-tear” arthritis, is one of the most common ailments of older adults — more than 27 million people live with some form of the disease — and it’s most common in the weight-bearing joints, particularly the knees and lower spine.
While osteoarthritis is technically a breakdown of the cartilage of the joints — as the cartilage stiffens, it wears down like a tire tread and causes swelling and — it is associated with a loss of water content in the cartilage and also a loss of the hyaluronic acid lubricant in the synovial (joint) fluid surrounding the joints. This thick fluid helps to serve as a shock absorber, lubricating the joint so that the bones can move more smoothly over each other. Lacking this vital fluid, and combined with the breakdown of the cartilage, in time the cartilage wears done leading to bone on bone contact which at the end can cause debilitating pain. During the early stages of osteoarthritis, treatment often consists of over-the-counter pain relievers, anti-inflammatory medications, reduced activity and physical therapy. However, there is another treatment that can be effective for managing the symptoms of osteoarthritis: viscosupplementation.

Viscosupplementation Basics

While some osteoarthritis sufferers respond to corticosteroid treatment, those drugs are generally reserved for rheumatoid arthritis patients who need relief from the pain and inflammation caused by their immune systems attacking their joints.  While corticosteroid treatment is very effective in reducing pain and swelling early on, it may also weaken the cartilage and add to the wear of the cartilage over time, especially if given on a repetitive basis.   
As an alternative osteoarthritis patients may respond favorably to viscosupplementation (injections of the hyaluronic acid that is lost due to the disease’s progression). With this treatment, approximately every six months the patient receives an injection of the hyaluronic acid directly into the site (most commonly the knee). Within a few days to weeks of the injection, the patient typically has less pain and a greater functional range of motion.
Viscosupplementation is generally most effective with patients who are in the early stages of osteoarthritis but who aren’t responding well to the traditional treatments. While the treatment will not replace cartilage that has been lost to time, some evidence shows the injections encourage the body to produce more hyaluronic acid. This, in turn, can help reduce the symptoms of osteoarthritis.

Important Considerations

Viscosupplementation has helped thousands of osteoarthritis patients find relief from their pain, but it’s not effective for everyone. Also, the injections do not provide immediate pain relief — it can take up to a few weeks for the benefits to be noticeable — and there can be some redness, pain and swelling at the local injection site immediately after the treatment. In some cases, the injections can cause increased pain and swelling, and very rarely the complication of infection. Patients who are considering the treatment will have the opportunity to discuss with a medical professional the benefits and risks that are associated with viscosupplementation.
Osteoarthritis, when left untreated, is painful and can seriously impact a person’s quality of life. Anyone looking for relief from the pain and stiffness should talk with their doctor about viscosupplementation and how it may improve their condition.


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