What’s Causing these Aches and Pains?

Contributed by: Davina Dell, Pharm.D. Candidate

KU School of Pharmacy

Text Box: What is Osteoarthritis? Osteoarthritis (OA) is a disease of the cartilage in joints. OA causes progressive breakdown of cartilage until the bones rub against each other. This results in damage to the tissue and underlying bone causing the painful symptoms of OA. OA is the most common joint disease and it affects nearly 50% of those over 65 years old. OA affects 1 out of every 6 people. OA usually affects the weight bearing joints causing pain, limitation of motion, deformity, and progressive disability. Other names for OA are osteoarthrosis, degenerative joint disease (DJD), and hypertrophic arthritis. What causes Osteoarthritis? OA results from the cartilage breaking down faster than it is produced. Risk factors for Osteoarthritis · obesity · trauma to the joint · genetics · osteoporosis · participating in activities involving repetitive motion Symptoms of Osteoarthritis · pain · stiffness after inactivity that last less than 1 hour · limited motion of joint · tenderness and occasional swelling · deformity of joints · cracking or “creaking” of joints Treatment Options Nonpharmacological Therapy · Education is the first step. It is important to understand your prognosis and what can be done to control the symptoms of OA. The Arthritis Foundation has programs to help learn about living with OA.

Text Box: There website is www.arthritis.org. · Exercise is important. Exercise prevents stiffness and weakness. It also helps you maintain a healthy weight. When you do not exercise muscle strength can be lost and OA will progress faster. Exercising will not “wear our” the joint that has OA. · Weight reduction- excess weight puts extra stress on the joints. Weight loss is especially encouraged in patients with hip or knee OA. · Surgery is sometimes recommended for OA patients with severe pain that is unresponsive to conservative therapy. Pharmacologic Therapy · Topical Analgesics- are sometimes used for non-severe pain or for people who have arthritis in just a few joints (i.e. the joints in the hands). Examples of topical analgesics are capsaicin or methylsalicylate. · Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) - relieve joint swelling and pain. These can be hard on the stomach. Examples of over-the-counter NSAIDs are ibuprofen, naproxen, and ketoprofen. Examples of NSAIDs that require a prescription are diclofenac, indomethacin, piroxicam, and nabumetone. · COX-2 Inhibitors- are NSAIDs that are not as hard on the stomach and they require a prescription. Examples of COX-2 inhibitors are Celebrex®, Vioxx®, and Bextra®. · Acetaminophen (Tylenol) - is comparable in efficacy to NSAIDs for controlling mild to moderate OA pain. · Intraarticular injection of glucocorticosteroids- this is used for

Text Box: patients with OA who have moderate to severe pain and joint inflammation. · Nutritional Supplements- Glucosamine and Chondroitin may relieve OA symptoms and possibly slow disease progression. Its effects on OA are still being studied. · Intraarticular hyaluronan injection- this is only for patients who have not achieved symptomatic relief from nonpharmacologic therapies or NSAIDs. Hyaluronan takes longer to achieve effects than glucocorticoids, but the effects may last longer. Hyaluronan cannot be used in the treatment of hip OA. · Opioids and Narcotics- tramadol, acetaminophen plus codeine, or other opioid or narcotic agents may be considered for patients with severe pain that do not achieve relief from all of the above therapies. For additional information talk with your pharmacist or visit www.arthritis.com/osteoarthritis.asp.