The key to managing osteoarthritis is to use multimodality. Multimodality is best for two reasons: 1) by using multiple methods to reduce inflammation and pain we achieve better pain relief in our patients
and 2) by using various methods together we can use less of each individual one. This last reason is important when we start thinking of strong drugs.
Glucosamine, chondroitin, MSM, etc
these are cartilage precursors and building blocks. They help repair the cartilage as well as reduce inflammation. This is a holistic method to help improve pain relief and reduce the progression of osteoarthritis. Two notes: 60 minutes did a segment last year that the average amount of glucosamine and chondroitin in over the counter tablets was 15% of what was on the label. So if you think you are getting 1000mg, you are probably only getting 150mg!!!! A good company is DMV products, they make a great chewable called Synovi G3 with all three: glucosamine, chondroitin and MSM along with antioxidants and omega 3s. Also you can ask your herbalist or veterinarian for a product that they really trust. Also please do NOT use shark cartilage two reasons: 1) it does not work as well in studies and 2) it is bad for the sharks! The average age of the shark taken in a fishing boat is 2 years younger than its sexual maturity for this reason much of the shark sources are from illegal fisheries that are going to endanger the sharks. Sorry, I got
Specifically EPA when taken in high enough levels, EPA stays in the joint and after two weeks of sufficient levels, the joints stop releasing various inflammatory mediators. This helps 1) reduce inflammation and pain and 2) reduce the progression of the osteoarthritis. Additionally the other forms of omega 3s help the rest of the body and germane to this topic they help naturally improve kidney blood flow which if we remember from above, is important when we are using high levels of a Cox1 interacting drug such as rimadyl or deramaxx.
NSAIDs reduce inflammation and pain as we previously discussed.
Tramadol. This medication helps with the pain as it is an opioid but does NOT help with the inflammation nor affect the progression of osteoarthritis. Think of tramadol as a big happy band-aid. Makes things feel and look better but does not address anything underlying. For this reason I add this on last and only in conjunction with the above medications/holistic remedies.
Other options. Antioxidants can be very helpful in all forms of inflammation. Maintaining proper weight is very important. Exercise low impact exercise such as swimming. Physical therapy and massage can be helpful. Magnet therapy and K Lasers therapy have proven themselves very helpful. Fentanyl patches and morphine can also be used for pain. And the list goes on
Again, multimodality is the key.
It is like having many friends the support becomes synergistic.
I hope this helps.