Osteoarthritis of the knee: Choosing the right pain medicine

hey sorry I'm a bit late today oh no problem I only just got here anyway I noticed maybe your Annie's giving you trouble good and how hey you see me doctor yet yeah actually the reason why I'm late I saw this morning so what'd she say oh she said this osteo arthritis osteoarthritis would that the same thing is just plain arthritis well I'm really not sure [Music] osteoarthritis is a condition that affects a person's joints often the knees there are several types of arthritis and they have different causes and treatments osteoarthritis is one time it's the most common type of arthritis and it's mostly caused by wear and tear on a joint so it's more common as we age and more likely to affect joints we've overused or injured in the past osteoarthritis can affect any joint hips shoulders wrists and even the joints in the hands and fingers but in this program we're going to talk about osteoarthritis of the knee the inside of a healthy knee looks like this it's padded with cartilage which is a rubbery tissue that provides a cushioning effect and it also contains a small amount of fluid when the cartilage wears away the bones are rubbing together without that cushion and can cause the joint to become inflamed which results in pain and stiffness a person who has osteoarthritis of the knee finds it harder to move because of the pain the knee may even be swollen and tender to the touch some patients say their pain and stiffness are more noticeable after exercise or movement sometimes a knee can also hurt and feel a little stiff in the morning getting better when you start moving around these symptoms or what you experience tend to get worse over time at first it might go away when you rest as time goes on it might still be there even at rest or it may even wake you up at night your doctor can tell if you have osteoarthritis by discussing your symptoms with you examining your joints and looking at an x-ray of your knee osteoarthritis tends to run in families other people at risk for getting osteoarthritis are those who have old knee injuries or who have done sports or work that overuse their knees and people who are overweight carrying around extra pounds causes greater wear and tear which damages the joints particularly the knees your risk of developing osteoarthritis increases as you age osteoarthritis doesn't usually get better on its own no treatment can cure osteoarthritis but the recommendations and drugs we'll talk about in this program can relieve or reduce the pain and help you move around better so what else did the doc say man what kind of treatment to that well she's going to talk me through all that when I go in to see her on Friday I wonder if maybe that surgery they do would help you know the one that you threw that little scope I don't know and there's this other thing I heard about where they give you injections in your knees you know maybe that would help I'll ask about this oh I don't know might be worth asking and what my mom has some kind of arthritis she takes different pills for hers and she uses creams I'm not sure what all she uses it I know she uses something she gets from a health food store I'm not sure how much good it does her yes a lot of questions so I guess you have to you know read up talk to the doc maybe make a list [Music] if you were diagnosed with osteoarthritis your doctor will discuss three major areas of treatment with you they are activity and exercise weight control and pain relief let's look closer at each one starting with your activity your doctor will want you to get regular exercise especially doing things that strengthen the muscles that support your knee swimming water aerobics or gentle exercise and warm water are particularly good for osteoarthritis as they don't put undue stress on joints walking is also excellent exercise for this if you feel that pain keeps you from being able to exercise your doctor may recommend physical therapy physical therapists can teach you exercises that aren't painful but will help with strength and flexibility so you can move more comfortably if you don't have access or can't afford a physical therapist you can ask your doctor to teach you some exercises for your knees it's important that you do them daily and you have to remember that it may take a few weeks before you see improvement in your knees a second thing your doctor will discuss is whether you're overweight the extra weight we carry puts a great deal of stress on our knees every pound you lose can result in thousands of pounds of less stress on your knees over time so if you're carrying extra weight your doctor will recommend ways for you to lose some of it and finally your doctor will discuss pain relief with you whether you need medication and what kind is best for you in the next segment of the program we'll be looking at different options you might consider over-the-counter pills and creams and prescription drugs as you'll see for each of them there are benefits but also risks to consider but before we continue let's talk about treatments you may have heard about that your doctor probably won't recommend for your hostile arthritis you may have heard of arthroscopic surgery where the surgeon operates on your knee joint through a small opening in the skin although there are many knee conditions that are helped by this kind of surgery osteoarthritis is not one of them another treatment you might have heard of is one where these injections or shots are filled with joint lubricant a gel-like substance injected right into the knee these shots aren't the same as cortisone shots that are sometimes used when your joints get swollen the lubricant treatments are usually given over several weeks however this treatment has not been found to be effective for osteoarthritis of the knee studies found that people receiving these shots didn't get much pain relief or improvement in movement and the shots do have the risk of complications such as infection swelling and pain so your doctor is not likely to suggest joint lubricant injections these lubricant shots are different from the cortisone shots that are directly applied to the joint many people do feel an improvement after a cortisone shot another treatment that you may hear your doctor talk about is glucosamine and chondroitin these are two substances that are sometimes sold as nutritional supplements instead of as drugs or medications because they are not sold as drugs they might not be checked for their quality so the dose and quality is different between each brand and sometimes bottles of the same brand are different there have been some studies looking at whether glucosamine and chondroitin are beneficial for hasti or arthritis of the knee in general most studies have shown that they were not very helpful keep in mind also that even though they are not labeled or classified as drugs they can still have side effects or cause problems taking them to review the main treatment approaches for osteoarthritis will be exercised with possible physical therapy weight loss if it's needed and pain relievers next we're going to look at the kinds of pain relievers you and your doctor will consider my knee pain from that osteoarthritis got so bad it was interfering with my whole life I was feeling down and isolated from my friends and family because I couldn't take part in too many activities we used to do together I knew I needed to do something about it and make a decision as soon as possible but I just wasn't sure which treatment was best for me I could barely get out of bed in the mornings I would have to lie in bed for a while Wayne until my joint stiffness was bearable enough to be able to get up and start my day my knee also heard as I tried to walk it was caused me to be late for work and I don't think my boss was too happy about that that osteoarthritis was taken over my life now I knew I didn't want to get the surgery on my knee I think they call it arthroscopic surgery because first of all I couldn't take time off from work and also because I couldn't afford it but the real reason is because I've actually frightened the idea of surgery even though the surgery is supposed to be done through just a small cut my friend said that I should use glucosamine and chondroitin because they said it helped them reduce their pain well it really didn't work for me another friend of mine said that I should try joint lubricant shots these are shots given to the knee with a gel like material I was given a few shots over a few weeks I felt a little better but not that much though my doctor said the treatments work differently for every person and that these shots may help some people but many others don't feel any improvement I think that when people use one type of treatment and it doesn't work they should talk to their doctor about moving on to another hey happy Monday yeah not so much I just got that manual with the new rules and regs yeah me too there's a couple in there I want to ask you about but first fill me in on the knee I take it surgery and knee injections aren't the ticket nope nothing what's wrong with this me kind of lose a few pounds get some exercise she wants me to get some physical therapy hmm so what'd you say about the pain well that's gonna be the biggest question what kind of medicine I can take for it I don't they just tell you which one is best huh turns out they're quite a few things that can go into the decision for any one person different side effects for one oh yeah yeah I guess you have to decide what you're willing to put up with yeah I guess then that's whether you just use an over-the-counter one or need a prescription I guess that affects the cost - so you gave me a bunch of stuff to read and she gave me one to start off with just to see how it's working so I'll go back in two weeks with another list of questions probably yeah that's how you get it right yeah so what you think is going to happen in Don's apartment not at the manager [Music] we've seen that exercise possibly with physical therapy and weight control are two very important components of treating osteoarthritis of the knee but most patients will also need some kind of medicine for pain relief as well either on a regular basis or just occasionally there are several kinds of medicines that may be recommended by your doctor for pain relief and there are differences between them you'll want to know about they differ in the kinds of benefits they offer the side effects they have and some may pose more risks for some people than others they also differ in how much they cost you can find information about individual drugs and their costs in this booklet now let's look at each of the categories of pain relievers and a little more depth we'll start with the simplest and safest many people get pain relief from capsaicin skin cream like za streaks or Thera gram with few or no side effects or risks capsaicin creams don't reduce inflammation or swelling but can give some pain relief if you need more relief than what a skin cream provides one of the most commonly recommended medicines that you can buy over-the-counter and take it orally or by mouth is acetaminophen which you may know by its brand name tylenol the benefits of tylenol are that it provides most people with pain relief and most people can take tylenol without problems or side effects however tylenol may not be enough for some patients and they may need to try other treatments one of the best alternatives is to use non-steroidal anti-inflammatory drugs or NSAIDs these are drugs that as the name indicates are not steroids but do act to reduce inflammation you may be familiar with insides like ibuprofen which you might know by brand names like Advil or motrin or naproxen which you might know by its brand name believed aspirin is also an NSAID NSAIDs are effective at relieving pain and they also reduce inflammation and swelling however these medications have more risks than tylenol one of the most serious is that they can be hard on the stomach and can cause stomach bleeding in some people the people at most risk for stomach bleeding are those who take high doses of these pills or use them for a long time people who have had stomach bleeds before people who are older especially those over age 75 and people who are taking blood thinner drugs like coumadin or aspirin to prevent blood clots stomach bleeds can be very serious and even life-threatening so people in these risk groups should be very careful about taking NSAIDs and only do so under a doctor's supervision if you have ever had an ulcer in your stomach and especially if you have had bleeding from it you should not take NSAIDs including aspirin be sure your doctor knows if you have had stomach bleeding all of the drugs we've mentioned so far can be bought over the counter without a doctor's prescription many of these medicines ibuprofen or naproxen for example can also be prescribed in higher doses by your doctor another prescription and said is called a cox-2 inhibitor it's brand name is celebrex prescription NSAIDs celebrex and prescription-strength ibuprofen are very effective at relieving pain and swelling they may also have the same risk of stomach irritation as other NSAIDs and in addition they appear to slightly increase the risk of heart attacks so they may not be suitable for you if you have other heart risk factors such as smoking or high cholesterol or high blood pressure if you want to lower these risks it's best to use naproxen or a leaf or Tylenol take low doses less often and supplement with other pain relief like the skin creams that go over your joints one of the most powerful treatments for inflammation is steroids like cortisone but their effect is only temporary and it is dangerous to use steroids too often especially if they are taken by mouth because of this cortisone pills are usually not recommended for osteoarthritis because these medicines have the potential for side effects and some potentially serious risks you should be sure to ask your doctor about any drug you take so you can be aware of any unwanted reactions and report them to your doctor don't forget that weight control and exercise or physical therapy can reduce the amount of pain medication you might need doctor I have some questions about my medication good good let's talk about it well I probably is but first I wanted to ask you none of the medicines we've discussed gets rid of osteoarthritis but many have been shown to help with pain and inflammation and allow people to resume their activities we've seen that there are a number of things to consider when choosing a pain relief treatment for osteoarthritis with your doctor you and your doctor need to choose more carefully if you're on certain medications like blood thinners if you've ever had stomach bleeding if you have ever had a heart attack or are at risk for one if you smoke are overweight have high blood pressure risks of heart attack are also higher as we age you also have to be careful if you have kidney problems because NSAIDs can make them worse the goal is to choose a pain reliever helps you feel better and be more active without having too many problems some pain relievers work right away and others have to be taken regularly to see any therapeutic effect your doctor needs to see you regularly in order to monitor how you are doing and to make sure your medications are not causing any harm to you so it's important to keep up with all of your clinic and doctors appointments a few weeks ago I was at the gym with my workout buddy Mike who also has osteoarthritis in his knee and he just wasn't working out as hard as he used to I asked him if you've gotten enough sleep the night before he told me that he's been feeling pretty tired and weak lately I asked him if he had gotten the flu or something and he told me he didn't know why he had no energy I told him that he should probably see his doctor because it just didn't seem normal to me it turns out that might want to see one of those stomach doctors I think they're called gastroenterologist and the doc told him that he had an ulcer in his stomach it was probably caused by him taking those non-steroidal anti-inflammatory drugs also known as incense for his knee pain the doc told him that he was losing blood through the ulcer and that was why he was feeling so weak he asked him to stop taking the NSAIDs immediately the doctor said that some people on top of feeling weak see blood in their stools they might even notice of black and sticky tall like substance the doc told Mike that when people see this in their stools they need to call their doctors right away because it can be an emergency he also said that if you're taking these anti-inflammatory medicines and you start having heartburn or stomachache you should let your doctor know before more serious problems happen so catch the game on Saturday how's that my kids little league game I got the good parts on the radio though you mean the bad parts oh yeah we got stomped Rob it's more like it yeah definitely you know I saw that last play on TV later yeah bad call worst so looks like you're getting around bet at Eve days treatment working pretty much I guys see my back mole off in two just to make sure yeah that's a good idea I told my mom some of what you told me I think she needs to see her doc you know she takes a lot of medicine for hers and she's getting older so my sister made an appointment for we're gonna go with or talk to the doc see if we can't sort out something better at least make sure she's doing okay that's the right thing to do yeah exercise works best for me I thought that exercise would be bad for my needs since the cartilage is worn away I was completely wrong staying active helps to decrease the pain and gives you more energy throughout your day every morning I wake up and take my dog for a walk around my neighborhood on Tuesday and Thursday evenings I go to water aerobics class at the Community Recreation Area there is no way that I can run would jump around but I love the water aerobic exercises because it doesn't hurt my knees and it makes my legs feel stronger it is actually quite relaxing and suits my arthritis pain since I started exercising I also started to eat healthier I have lost a few pounds by changing my diet and by starting my new exercise plan I can really see that just by losing a few pounds I have a lot less pain a friend told me that when you walk the force on your knees is two to five times the total weight of your body so losing only a little weight will take a lot of pressure off the knee joint and it may even slow the progression of osteoarthritis [Music] you

Channel: MD Anderson Cancer Center

Views: 185,120

Keywords: osteoarthritis, knee pain, osteoarthritis treatment, pain medicine, MD Anderson, Integrative medicine

Id: kuNOkijTh1E

Length: 21min 29sec (1289 seconds)

Published: Thu Jun 08 2017