How can osteoarthritis be treated and relieved?

There is no definitive cure for osteoarthritis, but several approaches can help to manage symptoms and improve quality of life:

Non-pharmacological treatments

• Lifestyle modifications: Measures such as maintaining good lifestyle habits, maintaining a healthy weight or reducing body weight (if necessary) through a balanced diet and regular exercise help to improve self-management and have a preventive and stabilising effect during the rehabilitation phase. In addition, avoiding high-impact activities and adopting ergonomic practices can prevent symptoms from worsening^(27,28,33). 
• Orthopaedic devices: Orthoses, splints and other devices can help relieve pressure on joints and improve mobility⁽²⁶⁾. Many Thuasne products are available to help you manage this condition. 
• Complementary therapies: Some people find relief through complementary therapies such as acupuncture, massage or yoga⁽²⁴⁾.
• Physiotherapy: Physiotherapy plays a crucial role in the treatment of osteoarthritis, using a variety of techniques such as hot compression, aquatic therapy, electromagnetic therapy and short-wave ultrasound. These methods improve blood circulation, reduce inflammation and relieve pain, thus helping to alleviate symptoms. A physiotherapist can design a personalised exercise programme tailored to the specific needs of each patient, maximising the therapeutic benefits^(25,33).
• Physical exercise: Exercise therapy offers advantages such as ease of implementation, effective pain relief and improved joint function, and is recommended by various guidelines as a first-line treatment method for osteoarthritis. Aerobic exercise is the most commonly used and can reduce pain and improve physical function. Strength training is the most effective form of exercise therapy for muscle weakness⁽³³⁾.

Pharmacological treatments

• Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs exert anti-inflammatory effects by reducing the synthesis of prostaglandins, natural substances in our body that increase pain and inflammation. They are used as a first-line treatment for osteoarthritis. Because of certain potential side effects and an increased risk of cardiovascular disease, it is important to take several factors into account and to use these drugs judiciously⁽⁴⁸⁾.
• Intra-articular injection of glucocorticoids and hyaluronic acid: Intra-articular injection of glucocorticoids can curb abnormal proliferation of connective tissue, reduce synovitis, significantly reduce joint pain and improve joint function. Hyaluronic acid reduces joint pain, increases joint mobility, reduces synovitis and promotes chondrocyte anabolism in osteoarthritis patients. Glucocorticoids and hyaluronic acid effectively relieve joint pain and swelling, but should not be used repeatedly because of the harmful effects of injections on cartilage, such as erosion of the cartilage by the syringe needle⁽³³⁾.
• Antioxidants: Antioxidants such as superoxide dismutase, vitamins C, D and E can offer protective effects for cartilage by blocking oxygen free radical pathways. This is particularly beneficial in osteoarthritis patients as it reduces inflammation and oxidative stress, helping to preserve the integrity of the cartilage⁽³³⁾. 

Surgical treatment

Surgical treatment is recommended for patients with advanced osteoarthritis who do not respond well after conservative treatment, and whose condition adversely affects their daily lives. Current methods of surgical treatment of osteoarthritis include arthroscopy, osteotomy and arthroplasty (prosthesis): 

• Arthroscopy: For patients with mild to moderate osteoarthritis, arthroscopy is a better option as it offers the advantages of a smaller wound and rapid recovery. It involves inserting an instrument called an arthroscope (a thin tube fitted with a camera and a light) through a small incision to view the inside of the joint directly on a screen. The main aims of arthroscopy are diagnosis and treatment. Diagnosis aims to identify abnormalities such as cartilage, ligament or meniscus lesions. Treatment involves repairing or removing damaged tissue, removing fragments of bone or cartilage, and treating inflammation. 
  Arthroplasty (artificial joint replacement with a total or partial prosthesis): This is a surgical procedure designed to replace a damaged joint with a prosthesis (total or partial). Artificial joint replacement is the terminal treatment for osteoarthritis and may be considered for patients with severe osteoarthritis for whom conservative treatments (drugs, physiotherapy) are no longer sufficient to relieve pain or restore mobility.
• Osteotomy: This involves cutting and realigning a bone to correct a deformity or redistribute the loads exerted on a joint. This technique can be used to treat osteoarthritis, which can cause uneven wear and tear on the joints. 
  Cartilage grafting: Cartilage grafting is a procedure designed to treat localised cartilage defects in joints. The process involves harvesting healthy cartilage from a non-weight-bearing area of the joint and then implanting the harvested cartilage into the damaged area. This targeted approach allows specific cartilage defects to be repaired without the need for complete joint replacement. It is typically used for younger, active patients with focal cartilage damage who are looking to preserve their joint and avoid more invasive procedures such as joint replacement⁽³⁹⁾. 
• Debridement: Debridement is a surgical procedure that removes damaged tissue, bone fragments or other debris from a joint. This procedure is frequently performed arthroscopically to clean the joint, thereby relieving pain and improving joint function by removing harmful debris or inflamed tissue. However, it does not address the underlying problem of joint degeneration, which often makes it a temporary solution. Debridement is generally performed in the early to moderate stages of osteoarthritis, when joint function is still relatively preserved but damaged tissue is causing pain or mechanical symptoms⁽⁴⁰⁾. 
• Arthrodesis: Arthrodesis is a surgical procedure that involves fusing two bones in a joint to eliminate movement and reduce pain in a degenerated or damaged joint. This procedure is generally performed when conservative treatments have failed and joint replacement (arthroplasty) is not feasible. Unlike arthroplasty, which replaces the entire joint with an artificial prosthesis, arthrodesis reduces the mobility of the joint by permanently joining the bones. For this reason, it is generally considered an option of last resort⁽⁴¹⁾.