Introduction
Aches and pains can sometimes persist despite implementing consistent lifestyle changes. As discussed previously, there are numerous treatments for worn-out knees and hips which don’t require you to see a doctor. These include exercise, weight loss, and external aids. If pain continues to affect your quality of life, however, you might consider consultation with a medical professional to discuss medical interventions. Some medical interventions require a prescription, others do not. All have risks and benefits, which require consultation and monitoring by a doctor. Therapies which do not require a prescription are sometimes called alternative treatments. Read on to learn more about alternative treatments for osteoarthritis.
What is osteoarthritis (OA)?
OA is a common cause of pain and altered joint function in adults.(1) The knee is the most common joint affected.(2) OA was previously considered to be the result of ‘wear and tear’, but current research suggests that underlying inflammation affects all components of the joint, including joint surface cartilage, nearby bone, the joint capsule and surrounding soft tissues.(3) Damage to the joint organ manifests as worsening pain, tenderness, reduced range of motion, bony swelling, joint deformity and instability.(4) Fortunately, lifestyle changes, such as weight loss, exercise and external aids can improve joint pain and function. In some cases, additional medical treatment or alternative treatments are required to reduce symptoms from OA.
Alternative treatments for OA
It is important to note that additional treatments work best in conjunction with lifestyle measures.(5) Treatments for OA are often used to increase mobility and reduce pain, so that patients can maintain active, healthy lifestyles. Often, they do not treat the disease itself, but instead help you to manage the symptoms of OA. The below section discusses a number of alternative treatments. All of these treatments are hypothesised to modify pain signals from the body and the perception of these signals in the brain.
Acupuncture
There is a small body of evidence surrounding acupuncture in knee OA. A trial involving over 1000 patients with chronic knee OA revealed that acupuncture alongside physiotherapy and anti-inflammatory medication was more successful than physiotherapy and anti-inflammatory medication alone at improving knee pain and function.(6) There is inconclusive evidence that acupuncture is more effective than ‘sham’ acupuncture in knee OA.(7, 8) Sham acupuncture describes the use of needles at points and depths not traditionally considered useful in the treatment of OA. Overall, more robust clinical trials are needed in this area.
Transcutaneous nerve stimulation
There is a need for higher quality clinical trials before transcutaneous nerve stimulation (TENS) will be used widely for pain in OA.(9, 10) One trial found that TENS and other similar treatments were no more effective than education and exercise in the treatment of OA.(11)
Psychological strategies
While tissue damage often plays a role in the development of chronic pain, there are a number of factors that affect the experience of pain.(12) Pain in OA is often ascribed to the damaged joint organ, but it is likely that psychological and environmental factors also play a role. Personality, coping skills, treatment expectations, previous pain experiences and mental health can all impact how patients perceive pain.(13) Therefore, some patients may benefit from psychological interventions focused on acceptance of pain and coping with some degree of pain.
Recommendations
At Surecell, we recommend trying a variety of lifestyle measures to manage your OA. Following adherence to lifestyle changes, patients may benefit from a discussion about medication options and alternative therapies.
Support available at Surecell
If you are looking for tailored lifestyle and medication advice, we offer exercise physiology, personal training and gym facilities, psychological services, as well as medical support. Surecell is a specialist provider of regenerative medicine treatments, including platelet-rich plasma (PRP) injections. Feel free to contact our friendly staff on 03 9822 9996, or simply fill in your contact information here.
References
Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69.
Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2163-96.
Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697-707.
Zhang W, Doherty M, Peat G, Bierma-Zeinstra MA, Arden NK, Bresnihan B, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010;69(3):483-9.
McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22(3):363-88.
Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, et al. Acupuncture and knee osteoarthritis: a three-armed randomized trial. Ann Intern Med. 2006;145(1):12-20.
Foster NE, Thomas E, Barlas P, Hill JC, Young J, Mason E, et al. Acupuncture as an adjunct to exercise based physiotherapy for osteoarthritis of the knee: randomised controlled trial. BMJ. 2007;335(7617):436.
Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. 2005;366(9480):136-43.
Rutjes AW, Nuesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009(4):CD002823.
Vance CG, Rakel BA, Blodgett NP, DeSantana JM, Amendola A, Zimmerman MB, et al. Effects of transcutaneous electrical nerve stimulation on pain, pain sensitivity, and function in people with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2012;92(7):898-910.
Atamaz FC, Durmaz B, Baydar M, Demircioglu OY, Iyiyapici A, Kuran B, et al. Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study. Arch Phys Med Rehabil. 2012;93(5):748-56.
Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013;21(9):1145-53.
Sofat N, Ejindu V, Kiely P. What makes osteoarthritis painful? The evidence for local and central pain processing. Rheumatology (Oxford). 2011;50(12):2157-65.
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