Although keyhole surgery and joint replacement surgery for both hips and knees is highly successful if one can avoid or prevent the need for surgery this is the ideal. In general for osteoarthritis I recommend the following actions:
1. Weight Loss
Every extra pound that you have on you as extra weight translates to an extra five to six pounds of weight going through the hips and knees during walking. Weight loss can often make a dramatic difference.
2. Stop Smoking
Smoking can reduce the blood supply and therefore aggravate any underlying pathology.
3. Regular Exercise
Exercise in fact is good for joints as it improves the lubrication and blood supply of the joint. The best way to progress arthritis is to remain or become a coach potato. However, I do not recommend high impact exercise such as running, jogging or step aerobics. The impact of these activities is too much and can further damage an already damaged joint surface. Walking, cycling, swimming, aerobics and yoga are all excellent forms of activity. If walking long distances then I recommend using European walking poles. They can reduce the load to the hips and knees by up to 65%.
4. Use of trainers with a gel or air insole
This type of footwear can reduce the load transmitted from the ground to the hips and knees by 15%. It will feel more comfortable walking and one can walk a greater distance. Remember to change your trainers regularly. If you use them regularly they need to be changed every six months or 500 miles. If you wear trainers daily I recommend having two pairs and alternating them. This is because the cushioning in a trainer can take up to 24 hours to reform and therefore if you use the same pair of trainers each day the resisting effect is reduced.
Paracetamol can often be very effective and is one of the safest drugs with minimal side effects. The maximum dosage is 2 tablets 4 times a day and this is often something to start with. Anti-inflammatories such as ibuprofen can be useful. Some patients cannot take them and there are side effects. They should always be taken with food, stopped if indigestion develops and not taken by people with gastric ulcers, asthma or kidney problems.
Evidence for the effectiveness of glucosamine is mixed. Studies show it either has no effect or has a small effect. The positive studies suggest that it may slow down the progression of arthritis and the effect can be as good as taking painkillers. Studies that do show benefits recommend at least 1500 mg of glucosamine a day. As with any medication one should always read the label for contra-indications and side effects from your GP.
7. Cod Liver and Omega 3 Oil
Although this is often used by people with cardiac disease or trying to prevent cardiac disease there is some evidence that it can be beneficial in painful joints. It may reduce the inflammation around joints in commonly used supplements.
8. Read the Book “Heal your Hips”
This is a very good book written by an American author that tells you all about hip problems, strategies for improving the symptoms and preventing the necessity for surgery.
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