Osteoarthritis Patient Education

Doctors Who Treat Osteoarthritis

Initial consultation for diagnosis and treatment of osteoarthritis will most likely be initiated with a healthcare provider that is currently responsible for patient care. Following doctors are listed below in this patient education guide.

• General Practitioner – Takes care of the overall health of the patient and often act as a liaison between the patient, family and other specialists. They are generally well familiar with the patient, having followed both patient and his/her family over a period of time.
• Internist – Specializes in the organ systems of adults.
• Gynecologist – Deals with female genital health and associated conditions.
• Geriatrician – Focuses on health and disease of the elderly patient.

After a preliminary diagnosis has been made, a referral will be made to a specialist who will confirm the diagnosis and concentrate on improving the quality of life, including relief from pain and enhanced range of motion for the joint affected. Specialists include:

Rheumatologist - Doctor who focuses on diseases of the bones, joints, tendons and muscles. Conditions they treat include:

• Arthritis
• Gout
• Osteoporosis
• Tendonitis
• Bursitis

Orthopedist - Physician who focus on the health of the musculoskeletal system, including joint problems and replacements.

Physiatrist - Concentrates on rehabilitation therapy and physical medicine to restore the functions of the patient. They assess and treat those suffering from:

• Pain
• Disabilities
• Lack of function

Physical Therapist - Formulates personalized exercise protocols to strengthen muscles around the joints to increase movement range and diminish pain.

Occupational Therapist - Helps the patient formulate new techniques to perform daily activities so that there is less joint stress.

Holistic Practitioner - Views the body overall, considering physical, mental, and spiritual components. Herbs and nutritional supplements are considered in addition to meditation, cleansing, diet and exercise protocols.

Acupuncturist - Relieves pain and enhances healing through the ancient traditional Chinese medicine using special needles inserted and manipulated in various body energy zones.

 

How to Prepare for Your Osteoarthritis Doctor Visit

There are several things that you should consider bringing to your doctor’s office to maximize the benefit of the consultation and the time allotted for your doctor visit. Read the list below in this patient education guide for more information.

• Bring a list to the doctor’s office of symptoms. There are several entries you should note regarding your symptoms such as:
  • How long you have had them?
  • What makes your osteoarthritis symptoms better or worse (activity or medicines)?
  • Is there a pattern to them?
  • Did any injury occur?
  • Do your osteoarthritis symptoms affect your range of motion or prevent you from doing any particular activity?
• Bring a list of medications. Note your dosage.
• Take along a list of questions that you have prepared prior to the visit.
• On the day of the exam, wear loose-fitting clothes.

 

Questions to Ask Your Doctor About Osteoarthritis

From your initial diagnosis throughout your treatment and care, you will have questions about your osteoarthritis.

This patient education guide lists questions to discuss with your doctor so you can make informed decisions about your condition.

Questions About My Diagnosis

• Can osteoarthritis be cured?
• Will my joint problem progress and get worse? How severe is my osteoporosis?
• What medical conditions are associated with this condition?
• Could it be that I have a different joint condition and why is it osteoarthritis?
• What symptoms should necessitate a call to the physician?
• Is this a natural aging process?

Questions About My Treatment

• Can I just use Tylenol or nonprescription pain medications? Do I need to take additional medications?
• Why did you choose this treatment? What are the side effects?
• Should I take stomach medications to prevent ulcers with my new treatment?
• Would weight loss help to treat my joint problem?
• Are there herbs or natural supplements that could treat my joint problem?

Questions About My Lifestyle & Family

• Does osteoarthritis run in families? Can my family prevent getting osteoarthritis?
• What types of exercise do you recommend to improve my condition?
• Are there foods that I should avoid (that would make the condition worse)?
• Is there a special diet that would improve my condition?
• Will I still be able to drive or work?
• Are there devices that can help me function?
• Are there special classes that I can take or support groups that I can join?

 

Common Tests or Labs to Diagnose Osteoarthritis

There are several tests that your physician may order to distinguish between the various arthritis forms to be certain of an osteoarthritis diagnosis. Listed in this patient education guide are the most common tests used to identify osteoarthritis in a patient.

Test	Why Test?	What Happens?	Normal Result
Joint Fluid Analysis	Rules out gout, infection or injury	A needle is used to collect fluid from the affected jointA local anesthetic is used to numb the area beforehand.	Joint fluid should appear clear, not cloudy or abnormally thick.Blood should also not be present
X-Ray	Assesses joint spaces	The joint is placed near the X-Ray machine and a picture is taken of the areaThe patient is asked to keep still for the few seconds it takes for each image.	Narrowing indicates cartilage break downBone spurs may be seen
Magnetic Resonance Imaging (MRI)	Detailed body image of the affected joint	A patient lies on a table that slides inside a large machine. Dye may be injected by syringe into your veins to help make clearer images.	Visualizes detailed images of bone, cartilage and soft tissues around joints
Blood Test	Blood tests differentiate the type of arthritis	Blood is drawn with a syringe from the arm, typically.	Test results will be normal when the diagnosis is osteoarthritis, but are abnormal for other types of arthritis, such as rheumatoid or LupusRheumatoid Factor Anti-CCP (level of antibodies binding to citruline modified proteins ESR (erythrocyte sedimentation rate) indicates inflammation ANA screens for Lupus CRP (C-reactive protein), indicates amount of inflammation

 

Common Medications and Treatments for Osteoarthritis

While there is no cure for osteoarthritis, there are treatment regimens that relieve pain and improve joint motion so that participation in daily activities is possible.

 

Natural Treatments

Physical therapists and occupational therapists devise exercise plans and devise new methods for completing daily tasks in a way that decreases stress on joints and relieves the associated pain.

Medical devices are available to give joint support, alleviating pressure or joint immobilization.

There are hospital facilities as well as the Arthritis Foundation that offer pain classes for those diagnosed with chronic joint pain. Instruction offers tips and guidance for alleviating joint pain and coping with its daily grind.

An acupuncturist may relieve pain by the insertion and manipulation of specialized needles. Herbal Therapy includes:

• Ginger
• Glucosamine and chondroitin
• Avocado-soybean unsaponifiables

Tai chi and Yoga have also been shown to help alleviate osteoarthritic pain by stretching the muscles around the effected joints and reducing stress.

 

Medications

The following chart details medications used for relief of osteoarthritis. You should always discuss drug risks and possible side effects with your physician.

Drug	How it Works
Ibuprofen (over the counter pain medicine)	Decreases inflammation  Decreases pain
Naproxen (over the counter pain medicine)	Decreases inflammationDecreases pain
Acetaminophen	Decreases pain
Tramadol (by prescription)	Central acting analgesic pain relief
Narcotics	Relieves strong pain
Corticosteroid injections	Relieves joint pain
Hyaluronic acid injections	Cushions the knee joint to relieve pain

 

Surgeries

In some cases, surgery may be warranted to solve joint damage and/or relieve pain. The three most common surgical options include:

• Joint Replacement - Damaged joint surfaces are replaced with prostheses (plastic and metal replacement devices). This provides a return to an active, painless life. Duration of benefit depends on types of activity and stress placed on them.
• Osteotomy - Surgical incision across the adjacent bone to realign them, diminishing stress to the affected joint thereby relieving pain.
• Arthrodesis - Bone fusion to an affected joint to relieve pain and improve stability. Weight bearing is improved, even though flexibility is compromised. This is an alternate for those unable to have joint replacement.