Ask the Expert: Dr. Lisa Vasanth, Rheumatologist, Answers Your Questions on Managing Osteoarthritis
Q1. I have osteoarthritis and it causes pain in my hips. What can I do to manage the pain?
Osteoarthritis is the most common form of arthritis, affecting approximately 27 million Americans. The pain is often disabling, especially when the hip or knee is affected. The first step is a doctor’s visit for a physical exam and possibly x-rays to confirm that the problem is related to the hips and not the back. Management of pain related to hip osteoarthritis includes non-pharmacologic therapy such as physical therapy, aerobic exercise programs and weight loss when indicated. Pharmacologic treatment includes acetaminophen, non-steroidal anti-inflammatory drugs such as ibuprofen, and possibly glucosamine/chondroitin sulfate. Consult with your physician about the best course of treatment.
Q2. I have osteoarthritis in both knees and can’t bend down or stand too long. I want to stay active though. Are there any exercises I can do?
Staying active is very important. Many people with osteoarthritis of the knee limit their physical activity due to pain. Without regular exercise, muscles get weaker. Physical therapy programs for knee osteoarthritis focus on strengthening the quadriceps muscles, the main muscle in the front of the thigh, and stretching the hamstring muscles in the back of the thigh. Strong quadriceps muscles help to stabilize the knee and take pressure off worn cartilage. Another good way to strengthen the quadriceps muscles is to swim with a kickboard, kicking from the hips while keeping the legs straight. Consult with a physician before starting an exercise regimen.
Q3. Do you have any advice for managing back pain caused by osteoarthritis?
Management of back pain caused by osteoarthritis includes non-pharmacologic therapy such as exercise programs (core strengthening, flexion/extension, yoga, pilates), acupuncture and massage therapy. Pharmacologic therapy includes acetaminophen, non-steroidal anti-inflammatory drugs or skeletal muscle relaxants. When pain does not improve with conservative therapy, patients are often referred to physiatry or pain management to see if injections (epidural or facet injections) are indicated. Talk with your physician about the best course of treatment.
Q4. I have osteoarthritis—are there any foods I should avoid to decrease the pain?
There is no compelling scientific evidence that any diet (other than a healthy balanced diet which keeps weight stable) is effective in the prevention or treatment of osteoarthritis.
Q5. Is there anything I can do to stop my osteoarthritis from getting worse?
Joint trauma and obesity are known to increase the risk of progression of osteoarthritis. The prognosis for osteoarthritis is improved when a diagnosis is established before there is structural damage or functional impairment. The goal of treatment is to control symptoms and maintain or improve function.
Dr. Lisa Vasanth is a rheumatologist at Hospital for Special Surgery.