By Fnu Seemant, MD

Patients with osteoarthritis, a degenerative joint disease, can find a team of health-care professionals to provide comprehensive osteoarthritis management at the Osteoarthritis Clinic in the Cayuga Wellness Center.

This painful joint disease often decreases patient’s ability to perform physical activity and puts them at risk for developing serious health conditions. Degeneration of cartilage at the ends of bones that form the joint along with changes in joint structures resulting in pain, swelling, and a diminished range of motion. While the disease can progress quickly and affect young people, the joint damage usually develops over many years. Unfortunately, there is no preventative medication available, but  there are variety of interventions and strategies  that patients can incorporate to slow its progression. Appropriate management at early stages allows most patients to reduce joint damage, maintain greater flexibility, and enjoy more active lifestyles.

The Osteoarthritis Clinic Cayuga Wellness Center, 310 Taughannock Blvd., Ithaca, includes physicians trained in musculoskeletal injuries who collaborate with orthopedic surgeons. Physical, occupational, and massage therapists, along with weight-loss and nutrition specialists, are also part of the team. Patient’s first visit to the clinic includes an on-site diagnostic work-up including X-rays, and sometimes ultrasound and lab work to determine which types of treatment can be most effective. While there is not yet a cure for osteoarthritis, several treatments can control pain, improve mobility, and reduce other health risks.

What causes osteoarthritis?

Research shows osteoarthritis is caused from tissue inflammation resulting from joint injury. Osteoarthritis can affect any joint, but it most often occurs in the knees, hands, and wrist. It can also affect the shoulder and spine.

Genetics plays a large role in osteoarthritis, and a heritable component is involved in up to 65 percent of those affected by the disease. However, being overweight is a major, but modifiable risk for developing osteoarthritis.

How is osteoarthritis diagnosed?

A medical history and physical examination are part of a patient’s evaluation. Diagnostic imaging help diagnose the disease and determine severity if disease. Blood tests and analysis of joint fluid are also used to rule out other causes of joint pain. The slow progression of the disease impedes early detection, and activity related joint pain and stiffness after inactivity or rest are often the first indicators a patient may have osteoarthritis.

How is osteoarthritis treated?

Treatment guidelines at the Cayuga Wellness Center’s Osteoarthritis Clinic are based on recommendations from the American College of Rheumatology, the Osteoarthritis Research Society International, and the European League Against Rheumatism.

The treatments aim to achieve improvement in joint function, pain control, maintaining healthy body weight, and achieving a healthy lifestyle. Comprehensive  care may involve several interventions that can be combined to fit a patient’s needs, lifestyle, and health.

Non-invasive care is often the first-line of treatment. It typically involves physical therapy, rehabilitation exercises, weight control, and joint protection. Staying active is most important. Physical or occupational therapy helps strengthen and maintain joint mobility; braces for knees or hands reduce pain and provide joint support. Medications such as acetaminophen and ibuprofen help relieve pain, and topical nonsteroidal analgesics can control hand and knee pain. Prescription medications are reserved for severe pain. TENS (Transcutaneous Electrical Nerve Stimulation), uses low voltage electric current to relieve pain, and acupuncture may be effective for some patients.

More severe symptoms can be treated with corticosteroid injections of the affected joint. Corticosteroid injection use ultrasound guidance to precisely deliver medication to the joint. The steroid can be used every three to four months to provide pain relief. Another type of injection is viscosupplementation, or joint lubricant injection. The injection is given weekly for a three- to five-week period. There is growing evidence for use of PRP ( platelet rich plasma) for arthritis is available at our Osteoarthritis Clinic. Genicular nerve block is another way to control pain which can be done in selective patients.

Severe cases of osteoarthritis involving the hip or knee that do not respond to other treatments, may need joint replacement surgery. The arthritis clinic’s orthopedic surgeons work with patients to review joint replacement surgery and manage post-surgical care with the clinic’s physical therapy and transition exercise programs.

Dr. Fnu Seemant is the Director of the Osteoarthritis Clinic at the  Cayuga Wellness Center. His specialty areas include treatment of acute and chronic musculoskeletal injuries, arthritis management, diagnostic ultrasound evaluation for soft tissue injuries, ultrasound-guided injections, and comprehensive concussion management. He is certified by the American Board of Family Medicine and holds certifications in geriatric medicine and sports medicine. To make an appointment at the Osteoarthritis Clinic, call (607) 252-3580.

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