Symptom Finder - Treatment of Osteoarthritis
OSTEOARTHRITIS
1. Careful workup to rule out rheumatic fever, gout, pseudogout, septic arthritis, and rheumatoid arthritis.
2. A nonsteroid anti-inflammatory drug such as naproxen (Naprosyn) 500 mg bid or tid is tried first. Take after meals or with a large glass of water.
3. For patients with a history of peptic ulcer, gastroesophageal reflux disease, or other gastrointestinal problems give a COX-2 inhibitor like meloxicam (Mobic) 7.5–15 mg daily or treat simultaneously with a proton pump inhibitor daily or misoprostol (Cytotec) 100–
200 μg qid.
4. Do not give up on NSAIDs until several other alternative drugs have been tried
5. Non-narcotic analgesics such as acetaminophen may be useful to control acute exacerbations.
6. Alternate day prednisone 10–30 mg. may also be useful in the acute stages of the disease.
7. A Vitamin D3 supplement of 2,000 units a day should be prescribed.
8. Methylprednisolone acetate (Depo-Medrol) 80 units intraarticularly is often helpful but, it is unwise to use this more than once every 6–8 weeks. Repeated injections may hasten joint deterioration.
9. If the above medical treatments are unsuccessful, referral to an orthopedic surgeon for intra-articular hyaluronic acid injections, joint irrigation, or arthroscopic debridement is done.
10. Ultimately, total joint arthroplasty may be necessary
1. Careful workup to rule out rheumatic fever, gout, pseudogout, septic arthritis, and rheumatoid arthritis.
2. A nonsteroid anti-inflammatory drug such as naproxen (Naprosyn) 500 mg bid or tid is tried first. Take after meals or with a large glass of water.
3. For patients with a history of peptic ulcer, gastroesophageal reflux disease, or other gastrointestinal problems give a COX-2 inhibitor like meloxicam (Mobic) 7.5–15 mg daily or treat simultaneously with a proton pump inhibitor daily or misoprostol (Cytotec) 100–
200 μg qid.
4. Do not give up on NSAIDs until several other alternative drugs have been tried
5. Non-narcotic analgesics such as acetaminophen may be useful to control acute exacerbations.
6. Alternate day prednisone 10–30 mg. may also be useful in the acute stages of the disease.
7. A Vitamin D3 supplement of 2,000 units a day should be prescribed.
8. Methylprednisolone acetate (Depo-Medrol) 80 units intraarticularly is often helpful but, it is unwise to use this more than once every 6–8 weeks. Repeated injections may hasten joint deterioration.
9. If the above medical treatments are unsuccessful, referral to an orthopedic surgeon for intra-articular hyaluronic acid injections, joint irrigation, or arthroscopic debridement is done.
10. Ultimately, total joint arthroplasty may be necessary
