OSTEOARTHRITIS CARE
Dr. Bedford is dedicated to helping you manage your symptoms in a way that works best for you. Treatment for symptomatic osteoarthritis often begins with a combination of conservative measures such as physical therapy, anti-inflammatories, or injections. Read on and visit Dr. Bedford in the office to find out which treatment path is right for you.
If you've tried managing your symptoms conservatively without success, you may want to learn more about joint replacement surgery.
What is osteoarthritis?
arthritic knee
non-arthritic knee
Osteoarthritis is a condition in which the cartilage coating the ends of bones becomes thinned, worn, and soft. When this cartilage, called articular cartilage, degenerates, it is not able to take up load or force as before. This results in a joint that is stiff, creaky, swollen, painful, and may have clicking or grinding.
Anti-Inflammatories
There are several options that may help you manage the inflammation accompanying an arthritic joint.
-
Ice
Often overlooked, ice is one of the best remedies for inflammation. It may benefit you to begin icing the affected joint for 20 minutes at a time when you are having symptoms, such as at the end of a long day. Be sure to allow 20 minutes of time between icing sessions to allow your skin to warm up again before reapplying the ice.
-
Oral anti-inflammatory medication (ie. NSAIDs such as ibuprofen or naproxen)
Oral anti-inflammatories are also a means to combat inflammation; however, they may not be right for everyone. Be sure to consult your doctor before taking any anti-inflammatories as negative interactions with other medications or side effects can occur.
-
Cortisone Injection
Cortisone, or a steroidal anti inflammatory, is an injectable medication used to quickly bring down acute inflammation. Dr. Bedford may recommend a cortisone injection for new or severe swelling and pain due to a recent injury, trauma, or exacerbation of pre-existing arthritis. It is important to note that cortisone works temporarily, but quickly (most patients report feeling same-day relief).
Cortisone works most effectively in conjunction with other treatment measures such as physical therapy or wearing a brace. The injection itself is minimally painful and you will be able to walk out of the office and carry on with your normal daily routine. The procedure itself lasts less than two minutes.
Cortisone is not appropriate for every area of the body or every type of injury, and is not appropriate if you have an allergy to the components of the medication. A visit to the office is recommended to determine if cortisone is right for you.
Physical Therapy
Your body's muscles play an important role in supporting joints. Even slight muscle weakness or imbalance impacts the force seen by your bones. As your muscles fatigue, increased load is placed on your joints which can lead to inflammation and cartilage wear. Doing physical therapy to strengthen the muscle groups surrounding a painful or arthritic joint will alleviate symptoms by reducing stress placed on the joint.
In some instances, physical therapy may not be appropriate or may aggravate your symptoms. During an office visit Dr. Bedford will discuss with you whether or not a physical therapy regimen will benefit you.
Lubricant (Gel) Injections
Lubricant injections, or viscosupplementation, are injections of a gel-like solution used to treat knee osteoarthritis. Viscosupplementation injections are primarily composed of hyaluronic acid, a substance normally found in the fluid which lubricates joints (called synovial fluid). While lubricant injections may take up to four weeks to take effect (i.e. decrease symptoms of knee pain, swelling, and grinding), they are designed to last 6-12 months. They can safely be repeated for years on end every six or more months.
Lubricant injections are often, but not always covered by insurance. This will be determined prior to receiving an injection. If you are a patient waiting to receive your injections, our office will contact you once we have received your medication to help schedule your injection appointments.
Platelet Rich Plasma (PRP) Injections
PRP, or Platelet Rich Plasma, contains stem cell derivatives found in blood. Blood is drawn in the office from the front of the elbow (antecubital fossa). This blood is spun in a machine at a high speed for five minutes to separate its components by weight, and the plasma portion is then injected into the affected area. The procedure takes 15 minutes from start to finish.
A series of three injections, once weekly for three weeks, is the current standard of care. The healing effect of PRP is often felt 8-12 weeks (sometimes sooner) following completion of the series, and physical therapy following completion of the series is often crucial to healing. The duration of symptom improvement after PRP varies; however, PRP often lasts years at a time, with some patients never requiring a repeat series of injections.
Joint Replacement
If you've failed to find relief from the conservative treatment measures above, you may want to consider a total joint replacement. Joint replacement is the definitive treatment option for pain caused by severe end-stage osteoarthritis. To learn more about total joint replacement, click here.