The American College of Rheumatology and Arthritis Foundation have put out new practice guidelines on how to manage osteoarthritis (OA).

Arthritis affects over 300 million people worldwide.  The most common joints affected are knees, hips, and hands.

Treatment suggestions

Nonpharmacologic:

1. Exercise
2. Tai chi
3. Lose weight!  …even a 5% weight loss helps.
4. Tibio-femoral knee braces may help decrease knee pain and increase walking speed.
5. Acupunture and heat or cold interventions may help

Pharmacologic:

1. NSAIDs (ibuprofen and naproxen) oral or topical (cream)  provide temporary improvement
2. Corticosteroid injections into the joints help knee and hip OA.

What has been shown to not help?  Transcutaneous electrical nerve stimulation (TENS units) does not improve knee OA.  Bisphosphonates, methotrexate, and hydroxychloroquine do not improve pain or function. Platelet-rich plasma, stem cells, and hyaluronic acid have failed to demonstrate clinical benefit in trials.