The osteoarthritis pain and tendonitis are first treated with analgesics and NSAIDs (nonsteroidal anti-inflammatory drugs). When the drugs no longer provide enough relief, the doctor may suggest corticosteroid injections. They can also be indicated in the event of side effects (digestive disorders) or contraindications, which are quite common with conventional anti-inflammatory drugs.
Orthotics to maintain the joint
Depending on the model, these devices can support the joint, immobilize it or correct a deviation. The most prescribed are flexible knee orthoses, because they reduce pain and give a feeling of security. Less often offered for other joints, they are very useful for the fingers.
“They seem to bring a real benefit, since 40% of people using a hand orthosis still wear it 5 years later”, underlines Dr Laurent Grange, rheumatologist at Grenoble University Hospital.
Infiltration in the event of a crisis
“All the joints can benefit from infiltrations with good results when they are carried out at the time of inflammatory outbreaks”, specifies Pr Francis Berenbaum, rheumatologist at Saint Antoine hospital in Paris.
Performed by the doctor, the injection decreases the pain in a few hours or even a few days. Its effect lasts, depending on the case, from a few days to one or two months. After a first session, it is possible, if this is not enough, to perform a second session a few weeks later, without exceeding three per joint.
Apart from inflammatory outbreaks, hyaluronic acid injections are also offered in osteoarthritis of the knee. The idea is to bring this component of joint fluid to the OA joint that is lacking. Some patients say they take less painkillers afterwards. Problem: the cost of the treatment is quite high (250 euros for the injection) and it is no longer supported whereas injections were previously reimbursed at 60%.
The prosthesis, considered as a last resort
“We offer a prosthesis when all medical treatments have been tried and the quality of life remains very poor. We never place a prosthesis on simple radiographic signs. It is really the functional state that guides the decision”, insists Dr Grange.
The most common prosthesis is that of the hip, but knee, shoulder, ankle, wrist … can also be replaced. As long as you don’t do it too early, because the prostheses will eventually wear out. “Their lifespan is 15 to 20 years. This is why we try to delay the installation of the first prosthesis until 60 years”, underlines Professor Berenbaum.
A replacement is not impossible, but it is difficult to do it more than once. Placing a prosthesis in people who are too young may therefore leave them very handicapped and without solution years later. You should also not wait too long, as surgery will work less well if the bones, muscles and ligaments are damaged.
But for some joints, the prosthesis will not solve everything. “After the installation of a knee prosthesis, 15% of people operated on continue to have pain, without us understanding why” , notes Professor Berenbaum.
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