The osteoarthritis pain and tendinitis are first treated with analgesics and NSAIDs (nonsteroidal anti-inflammatory drugs). When medication no longer relieves them sufficiently, 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-inflammatories.
Orthoses to maintain the joint
Depending on the model, these devices can support the joint, immobilize it or correct a deviation. The most prescribed are the flexible orthoses for the knee, because they reduce pain and give a sense of security. Less often offered for the other joints, they are very useful for the fingers.
“They seem to bring a real benefit, since 40% of people using a hand orthosis are still wearing it 5 years later”, emphasizes Dr. Laurent Grange, rheumatologist at the University Hospital of Grenoble.
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 flare-ups”says Professor Francis Berenbaum, rheumatologist at Saint Antoine Hospital in Paris.
Performed by the doctor, the injection decreases the pain within hours or even 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 that is not enough, to carry out a second one a few weeks later, without exceeding three per joint.
Apart from inflammatory flare-ups, injections of hyaluronic acid are also offered in knee osteoarthritis. The idea is to bring this component of joint fluid to the osteoarthritic joint that lacks it. Some patients say they take less painkillers afterwards. Problem: the cost of the treatment is quite high (250 euros per injection) and it is no longer supported while injections were previously reimbursed at 60%.
The prosthesis, considered as a last resort
“We offer a prosthesis when all the medical treatments have been tried and the quality of life remains very impaired. We never place a prosthesis on simple radiographic signs. It is really the functional state that guides the decision”insists Dr. Grange.
The most frequently placed prosthesis is that of the hip, but knee, shoulder, ankle, wrist… can also be replaced. As long as you don’t do it too soon, because the prostheses eventually wear out. “Their lifespan is 15 to 20 years. This is why we try to delay the fitting of the first prosthesis until 60 years old”emphasizes Professor Berenbaum.
A replacement is not impossible, but it is difficult to do it more than once. The installation of a prosthesis in people who are too young, therefore risks leaving them very handicapped and without a solution years later. You shouldn’t wait too long either, because the surgery will give less good results 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 understanding why” notes Professor Berenbaum.
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