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骨关节炎-Osteoarthritis
来源:医学全在线 更新:2008/9/1 字体:

 

Medicines and food supplements used to treat osteoarthritis

Paracetamol
Paracetamol is the common medicine used to treat OA. It often works well to ease pain. It is best to take it regularly to keep pain away, rather than 'now and again' when pain flares up. A normal adult dose is two 500 mg tablets, four times a day. It usually has no side-effects, and you can take paracetamol long-term without it losing its effect.

Anti-inflammatory painkillers
These medicines are not used as often as paracetamol as there is a risk of serious side-effects, particularly in older people who take them regularly. However, one of these medicines is an option if paracetamol does not help. Some people take an anti-inflammatory painkiller for short spells, perhaps for a week or two when symptoms flare-up. They then return to paracetamol when symptoms are not too bad. There are many different brands of anti-inflammatory painkillers. If one does not suit, another may be fine.

Side-effects occur in some people who take anti-inflammatory painkillers:

Some types of anti-inflammatory painkillers come as topical preparations that you rub on affected joints. Compared to tablets, the rub-on preparations may not work as well. However, the amount of the drug that gets into the bloodstream is much less, and there is less risk of side-effects.

Codeine
Codeine is sometimes combined with paracetamol for added pain relief. Constipation is a common side-effect from codeine. To help prevent constipation, have lots to drink and eat a high fibre diet.

An injection of steroid medicine
An injection directly into a joint is an option if the joint becomes badly inflamed.

Hyaluronic acid
Regular injections of hyaluronic acid directly into a joint is a relatively new treatment. The exact way it may help is not clear. It may help with 'lubrication' and 'shock absorption' in a damaged joint. It may also stimulate cells which make cartilage. Further research is needed to clarify the role of this treatment. Currently it is sometimes used when symptoms are severe, particularly in the knee.

Glucosamine and chondroitin
These have become popular treatments. They are classed as a food supplements and not as medicines. You can buy them at health food shops and pharmacies. Glucosamine and chondroitin are chemicals that are part of the make-up of normal cartilage. They may have a role in making and maintaining cartilage. The theory is that taking these supplements may help to improve and repair damaged cartilage.

Research studies have found that some people with OA of the knee have modest pain relief when they take glucosamine every day. However, if does not help everyone. It is also not clear whether it has any effect in slowing the progression of the disease. Therefore, they may be worth a try, but further research is needed to clarify the role of glucosamine and chondroitin in treating OA.

Avocado/soybean unsaponifiables
Some research trials have studied a product called 'avocado/soybean unsaponifiables'. This is an extract derived from one-third avocado oil and two-thirds soybean oil. The results of the trials showed that some people with OA who took this product had less pain and required less amount of usual painkillers. It is not clear how it works. It is thought that one or more of the chemicals in this mixture may have some kind of protective effect on joints. Some manufacturers are starting to make capsules containing this mixture to buy as a food supplement. Further research is needed to clarify the role of this product.

Surgery for osteoarthritis

Most people with OA do not have it badly enough to need surgery. However, OA of a joint may become quite severe in some cases. Some joints can be replaced with artificial joints. Hip and knee replacement surgery has become a standard treatment for severe OA of these joints. Some other joints can also be replaced.

Joint replacement surgery has a high success rate. However, like any operation, joint replacement surgery is not without risk.

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