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(HealthNewsDigest.com) – Small aches and pains are a reality most people come to expect. In fact, pain affects more people in America than diabetes, heart disease and cancer combined. But chronic pain caused by knee osteoarthritis (OA) requires medical care and infringes on long-term quality of life.
Anecdotally, I have seen patients with knee OA whose lives have been severely limited. Whether it be an elderly woman who can’t walk up a flight of stairs, or a newly retired individual who can’t enjoy taking a walk with their spouse or spending a day in the garden or on the golf course, the patients I see often experience debilitating pain.
What is OA?
A degenerative joint disease, OA is the most common form of arthritis. OA is characterized by the breakdown of joint cartilage, whose weakening causes bones to rub against each other, leading to stiffness, pain and loss of movement in the joint.
Knee OA by the Numbers
Knee OA is one of the five leading causes of disability. , In fact, data suggest that nearly one in two people will develop knee OA before they reach the age of 85 compared to one in nine adults being diagnosed with type 2 diabetes in his/her lifetime.
Ten million OA sufferers have knee OA which, in 2004, accounted for $14 billion in hospital charges.8 Because symptoms of knee OA tend to progress as the condition worsens, many of these costs are associated with OA going unnoticed until the disease has progressed.8 While the senior population (65+) is currently most at risk for developing knee OA, the condition typically affects patients more than 45 years old – an age range including today’s baby boomers (ages 46-64).4
Aside from economic repercussions, disease progression among an aging population can result in depression, decreased socialization, sleep disturbance, and impaired ambulation. These consequences combined create a strong incentive for exploring knee OA treatment options.
Current Treatments and Diagnostic Goals
Alleviating knee OA pain may require a combination of lifestyle changes and pharmacological treatments. One element belonging in every treatment plan is physical activity. Being active is essential to optimizing both physical and mental health and can play a vital role in the management of knee OA.
The at-risk knee OA population already knows the importance of exercise and leading a healthy life – according to an AARP survey, 87 percent of boomers want to take better care of their physical health. And while those with knee OA may be reluctant to begin a traditional exercise program for fear of making symptoms worse, regular physical activity has actually been shown to improve some arthritis symptoms and promote general health.
Sometimes exercise is not possible or not effective alone in relieving knee OA pain. In these cases, OA sufferers need to reduce pain before they can attempt to improve their physical function. For this reason, physicians and other healthcare providers need innovative treatment options to better address their patients’ knee OA.
Assessing Treatment Options
The mainstay for management of inflammation and pain associated with arthritis has been oral non-steroidal anti-inflammatory drugs (NSAIDs). Recently, a growing number of guidelines and review committees have suggested the use of topical NSAIDs in the treatment of knee OA offers potential significant gastrointestinal safety benefits for certain patients. , ,
Topical NSAIDs are a viable option for knee OA pain relief, providing physicians and patients the opportunity to create a treatment plan leading to restored physical function. Some of the latest advances in topical pain drugs include new diclofenac applications. Beginning in 2007, a doctor-prescribed diclofenac patch, gel, and topical solution were approved separately for use in the United States.
Breaking the pain cycle requires a multidisciplinary approach. Pain alleviation can increase the likelihood that patients will return to physical activity. Once sufferers are able to reduce knee pain, living an active lifestyle can help keep the muscles around affected joints strong, decrease bone loss and may help control joint swelling and pain.11 Finding the right treatment regimen will help knee OA sufferers stay on track and get to the heart of long-term chronic knee pain relief.
Dr. Joseph Markenson is an attending physician at the Hospital for Special Surgery in New York City and professor of clinical medicine at Weill Cornell Medical College.
Editor’s note: The author acknowledges receiving honoraria from Covidien, the supplier of PENNSAID®, as a consultant and speaker
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