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Episode 32: Aches and Pains: An Overview of Osteoarthritis Treatment

In our 32nd episode we review the therapeutic options for the treatment of osteoarthritis. We first deal with lifestyle interventions for osteoarthritis. We consider the pain pharmaceuticals like acetaminophen, topical or oral NSAIDs, and opiates as well as some of the other osteoarthritis therapies such as glucosamine or steroid injections. We also summarize a number of other interventions (cold compresses to surgical debridement).

Show Notes

1) Obesity and hip OA

Rheumatology 2002;41:1155-62

2) Exercise for OA of the knee

Cochrane Library

3) Aquatic exercise for knee and hip OA

Cochrane Library

4) Glucosamine for OA

Cochrane Library

5) Topical NSAIDs for OA

Longterm efficacy of topical nonsteroidal antiinflammatory drugs in knee OA

J Rheumatol 2006;33:1841-4

Topical diclofenac for OA of the knee

J Rheumatol 2004;31:2002-12

Meta-analysis of topical NSAIDs for OA

BMJ 2004;329:324

Meta-analysis of topical NSAIDs for OA

BMC Musculoskeletal Disorders 2004;5:28

Bandolier on topical NSAIDs

6) Oral NSAIDs including COX-2s for OA

BMJ 2004;329:1317

7) Oral NSAIDs vs Acetaminophen

A meta-analysis

Ann Rheum Dis 2004;63:901-7

A systematic review

J Rheumatol 2004;31:344-54

Versus diclofenac/misoprostol

Arthritis Rheum 2001;44:1587-98

8) Steroid injections for OA of the knee

BMJ 2004;328:869

Can Fam Physician 2004;50:241-8

Cochrane Library

9) Opioids for OA

Oxycodone

Arch Intern Med 2000;160:853-60

Codeine

J Rheumatol 2000;27:764-71

Morphine

J Pain Symptom Manage 2002;23:278-91

Tramadol

J Rheumatol 2007;34:543-55

10) Hyaluronic acid injections

Meta-analysis showing no effect

CMAJ 2005;172:1039-43

Cochrane review showing an effect

Cochrane Library

11) Surgical debridement

Cochrane review showing no benefit

Cochrane Library

12) Other

TENS

Cochrane review

Cochrane Library

Thermotherapy

Cochrane review

Cochrane Library

Ultrasound

Cochrane review

Cochrane Library

Balneotherapy for OA (Mineral Baths)

Cochrane review

Cochrane Library

Acupuncture

Meta-analysis

Rheumatology 2006;45:1331-7

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