What is osteoarthritis?
Osteoarthritis refers to the progressive wear of joint cartilage, which can be associated with pain, stiffness and reduced mobility. The knee, hip, hand and shoulder joints are particularly often affected. In Austria, several hundred thousand people are estimated to suffer from osteoarthritis-related complaints – with an increasing trend at older ages.
The good news: not every case of osteoarthritis needs to be treated surgically. A well-considered osteoarthritis pain management plan on a conservative basis can often reduce symptoms noticeably over a long period and help maintain quality of life.
Goals of conservative treatment
Conservative therapy for osteoarthritis pursues several aims:
- relief of pain
- preservation or improvement of joint function
- slowing the course of the disease
- reduction of inflammatory flare-ups
- improving quality of life in everyday situations
As a rule, several components are combined, since no single approach addresses all aspects simultaneously. The choice depends on the stage of the disease, the joint affected, accompanying conditions and individual needs.
Basic measures: lifestyle and exercise
Exercise and physiotherapy
Regular, joint-friendly exercise is one of the most important pillars in the management of joint pain. Suitable activities include:
- swimming and aqua aerobics
- cycling on level ground
- Nordic walking
- targeted strength training under guidance
Physiotherapy can help to build up muscle, compensate for incorrect loading and maintain mobility.
Weight management
Excess weight particularly increases the load on the knee and hip joints. Even a moderate reduction in weight can contribute to noticeable relief.
Ergonomics and aids
Orthopaedic insoles, supports, walking sticks or cushioned heels can relieve joint strain. Adjustments to the workplace or home environment may also be useful.
Drug therapy
Pain-relieving and anti-inflammatory medications
For short-term relief of acute symptoms, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac are often used. They have pain-relieving and anti-inflammatory effects, but due to possible side effects (stomach, kidneys, cardiovascular system) they should only be taken on medical advice and usually for a limited period.
Paracetamol may be an alternative for mild pain, although its effectiveness in osteoarthritis is limited.
Topical applications
Pain-relieving gels or creams containing NSAIDs or capsaicin are applied directly to the affected joint. They generally have fewer systemic side effects and are particularly suitable for joints close to the surface, such as the knee or fingers.
SYSADOAs – slow-acting substances
Substances such as glucosamine, chondroitin sulphate or hyaluronic acid (oral) are grouped under the term "symptomatic slow-acting drugs in osteoarthritis". The evidence is inconsistent; some patients may experience relief.
Interventional procedures
When basic measures and oral medications do not provide sufficient help, targeted injections into or around the joint can be a useful addition.
Corticosteroid injections
Glucocorticoids are injected directly into the joint and can significantly reduce acute inflammation and severe pain in the short term. Due to possible side effects on cartilage, they are usually only used on a limited number of occasions.
Hyaluronic acid injections
Hyaluronic acid is a natural component of joint fluid. Injection into the joint is intended to improve lubrication and support shock absorption. This treatment may particularly contribute to relief in mild to moderate osteoarthritis.
Platelet-rich plasma (PRP)
In the PRP procedure, the patient's own blood is processed and the resulting platelet-rich plasma is injected into the affected joint. The growth factors it contains are intended to stimulate repair processes. Current studies suggest positive effects, but a conclusive evaluation is still pending.
Radiosynoviorthesis and further procedures
For chronic inflammatory conditions, more advanced procedures such as radiosynoviorthesis may be considered in specialised centres. The indication is decided on an individual basis.
Complementary and physical therapies
In addition to the classical components, there is a range of supplementary measures that can support treatment success:
- Heat and cold applications: heat relaxes the muscles, while cold can have a soothing effect during acute inflammation.
- Electrotherapy (e.g. TENS): may contribute to pain reduction.
- Manual therapy and osteopathy: to improve mobility and relieve surrounding structures.
- Acupuncture: individual studies indicate possible benefit, particularly in knee osteoarthritis.
- Nutrition: an anti-inflammatory diet with plenty of vegetables, omega-3 fatty acids and few highly processed foods can have a supportive effect.
What you can do yourself
Active patient participation is considered an essential factor for treatment success. Helpful approaches include:
- regular, measured exercise
- avoiding prolonged protective postures
- a balanced diet
- adequate fluid intake
- stress management and sufficient sleep
- avoiding nicotine
A pain diary can also be useful for better identifying triggers and effective measures.
When medical evaluation is advisable
A medical consultation should take place if:
- pain persists or increases over several weeks
- mobility is markedly restricted
- pain occurs at rest during the night
- joints are swollen, reddened or feel warm
- everyday life is noticeably impaired
Thorough diagnostics – consisting of a medical history, clinical examination and, if necessary, imaging – form the basis for individually tailored treatment.
Conclusion
Conservative treatment of osteoarthritis is varied and should be applied in a stepwise, individually adapted manner. A combination of exercise, targeted drug therapy, interventional procedures and complementary measures can relieve pain and improve quality of life. In many cases, surgery is not strictly necessary or can at least be postponed.
This article does not replace medical advice.