Preventing worsening arthritis

Q: I having been having knee pain over the last few months that my doctor tells me is due to osteoarthritis.  I take ibuprofen which helps the pain. But I wondered what other options are available that help improve the pain and prevent worsening?

A: Osteoarthritis (OA) is a common cause of joint problems in which the joint cushion, or cartilage, wears down, resulting in pain and decreased function.  We do not currently have ways to reverse the damage of the joint, so the management of OA involves relieving pain and improving mobility.  The good news is that some minor lifestyle changes can make a big difference. These include weight loss, heat/cold application to the joint, assistance devices for walking (like a cane), and consistent aerobic exercise and muscle strengthening.  Weight loss not only relieves the excess stress on the joint, but can slow the progression of cartilage loss.  Importantly, though many people with OA say that their joints hurt after exercise, a consistent strengthening and exercise regimen can actually significantly improve pain and functionality (AAOS Knee-OA guidelines, 5/2013).  This can be developed with the help of a trained physical therapist.  As far as other conservative management techniques, the American Academy of Orthopedic Surgery recommends against glucosamine, hylauronic acid, chondroitin and shoe wedges citing limited evidence.