Inflammatory osteoarthritis treatment

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Most painful conditions, including osteoarthritis, involve some degree of inflammation.

Inflammation is a complex immune response the body makes to injury, infection, or other damage. It includes the "recruitment" of various chemical mediators in the body to combat the injury or infection.

Medications that reduce the inflammatory response are often used for osteoarthritis treatment. But in many individuals, medications that reduce pain without affecting inflammation can be just as effective as the anti-inflammatory medications. This suggests that inflammation may not be the sole cause of pain for patients with osteoarthritis.

Some of the medications used to treat osteoarthritis include:

• Analgesics
• Non-steroidal anti-inflammatory drugs
• Intra-articular steroids
• Hyaluronic acid.

In addition, there is evidence that the use of autologous stem cells can also be effective for treating osteoarthritis through both the cartilage growth effects as well as the immune modulating effects.

In the past it was believed that the process was predominately a degenerative one. However, more recently, there is increased belief that the immune system is playing an active role in progression of the disease through T cell and immune complex mechanisms.

This has opened the therapeutic options to include disease modifying drugs rather than symptomatic therapies alone.

We have resorted to using disease-modifying anti-rheumatic drugs in patients with refractory inflammatory erosive osteoarthritis with good results. This suggests that perhaps the immune response in inflammatory osteoarthritis may not be that much different than what we see in rheumatoid disease.

An example of the new approach to this problem is this paper…

Successful treatment of inflammatory knee osteoarthritis with tumour necrosis factor blockade

M Grunke and H Schulze-Koops

Department of Internal Medicine 3, University of Erlangen-Nuremberg, Krankenhausstrasse 12, 91054 Erlangen, Germany

(Annals of the Rheumatic Diseases 2006;65:555-556; doi:10.1136/ard.2006.053272)

This points out the fact that inflammatory forms of osteoarthritis may need to be treated more aggressively. It appears that this disease may behave like low grade rheumatoid arthritis.

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