Common treatment for knee osteoarthritis could make it worse, studies show CNN

CNN
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A common treatment for some arthritis pain may actually make it worse, according to two new studies.

“Knee osteoarthritis is one of the most chronic, degenerative and progressive conditions, with an estimated incidence of 800,000 patients each year in the United States alone,” said lead author of one of the studies, Dr. Upasana Bharadwaj.

Osteoarthritis is a common form of arthritis in which the cartilage in a joint breaks down over time and the bones around it change, getting worse over time, according to the US Centers for Disease Control and Prevention. United.

At least 10% of patients in the study used injections to manage pain, added Bharadwaj, a postdoctoral researcher in the department of radiology at the University of California San Francisco School of Medicine. Two of these pain management injectables are corticosteroids, the more common of the two, and hyaluronic acid.

The studies, which were presented at the annual meeting of the Radiological Society of North America, used X-ray or MRI images to track the progression of osteoarthritis in patients’ knees. Some of these patients received no treatment and others received injections of corticosteroids or hyaluronic acid, according to the studies.

Both papers showed a statistically significant increase in the progression of degenerative knee cartilage changes over two years in people who received corticosteroid injections compared to those who received hyaluronic acid or no injection, according to the authors of the study.

However, just because the images look worse doesn’t mean people feel more pain, said Azad Darbandi, lead author of the other study.

“You can see that the knee looks bad on an X-ray, but the patient may not have more serious symptoms,” added Darbandi, a researcher and medical student at the University’s Chicago Medical School. of Medicine and Science Rosalind Franklin.

The studies highlight a debate in the osteoarthritis scientific community about the role of changes in the structure of the joint. Currently, pain is the leading recognized symptom, said Jason Kim, vice president of osteoarthritis research at the Arthritis Foundation. Kim did not participate in either study.

The takeaway from the studies is that corticosteroids should be administered with caution for pain associated with osteoarthritis.

Hyaluronic acid injections may be a promising option for managing pain, but they’re less used because there’s less research and most patients have to pay out of pocket, Darbandi said.

“Perhaps hyaluronic acid injections need further investigation for pain management,” he said.

Corticosteroids are a quick way to relieve pain and control inflammation, but might not be a good option for long-term treatment, Kim said. Repeated injections can put patients at risk for other problems, such as infections, because corticosteroids suppress your immune system, he said.

And some people may not see significant benefits from steroid or hyaluronic acid injections, Kim added.

For a long-term strategy, Kim recommended building a team of trusted healthcare providers, including your primary care physician, orthopedic specialist, physical therapist, nutritionist, and rheumatologist.

Managing weight and body mass index, or BMI, could be helpful to improve metabolic effects and reduce overall inflammation, Kim said. It’s also important to try to exercise and be physically active, he said, adding that walking has been shown to improve arthritis.