Osteoarthritis: a holistic approach

Abstract

-Osteoarthritis represents a massive and rapidly increasing burden on our society and the NHS. Current treatments are limited in efficacy and have significant toxicities. A conference was organised in conjunction with the British Society of Rheumatology with the aim of updating frontline clinicians and researchers on the size and causes of this problem, with a focus on modern management.

Prescribing Optimal Nutrition and Physical Activity as “First-Line” Interventions for Best Practice Management of Chronic Low-Grade Inflammation Associated with Osteoarthritis: Evidence Synthesis

“…Furthermore, the impact of low-grade inflammation can be more far reaching than physical complaints alone, in that even healthy older adults report poorer health commensurate with level of inflammatory markers [105]. Lastly, all indicators support that the approach to chronic progressive conditions such as osteoarthritis needs to be holistic and interprofessional [106]. Research is needed to capture the breadth of this evidence-informed practice approach.…”

“…Despite such guidelines, authorities in the field report a lack of efficacy of current treatments and associated adverse effects [6], with some proposing even greater attention to self-management [7]. Further, although low-grade inflammation underlies chronic osteoarthritis comparable to other conditions with significant lifestyle-related components often presenting concurrently with osteoarthritis, this inflammation has not been a focus of best practice guidelines, particularly of its nonpharmacologic management.…”

Recognizing and managing osteoarthritis

“…However, they can help rule out rheumatic disease that may be concurrent with OA. [3][4][5]8 Conservative management options include using cold/heat therapy, resting the joint for short periods of time to alleviate pain, avoiding joint overuse, supporting inflamed joints with orthotic devices, and exercise, both aerobic and isometric/ postural, to improve flexibility and strengthen muscles that support the affected joints. 4,5 Treatment strategies Because OA can't be cured, treatment focuses on alleviating signs and symptoms and slowing disease progression and includes physical rehabilitation, pharmacotherapy, and surgery.…”

“…When inflammation is present, OA may cause a slight elevation in white blood cell count and erythrocyte sedimentation rate. [3][4][5]8,9 Nonpharmacologic interventions for OA involve the application of heat or cold compresses. Management of both hip and knee OA requires a combination of physical activity and weight management.…”

“…Although it doesn't actually affect the inflammatory process, it may provide symptom relief for some patients. 3,4,8 Drug therapy Pharmacotherapy for OA focuses on relieving pain, reducing inflammation, and restoring function to the affected joint. Caution patients to wrap cold packs in a towel before applying them.…”