Knee Osteoarthritis: Conservative treatment options

Dear Ask The Doctor: What other meds. and injections are available for osteoarthritis of the knees in advanced stages? Have already had Synvisc, cortison, and Euflexxa. Can't have N-Saids. Will not have surgery. Can you help?

Dear Phyllis: All those medications that you mentioned are pretty much what are available for knee osteoarthritis regarding of conservative treatment, the other treatment alternative is surgery. Some lifestyle changes may delay or limit osteoarthritis symptoms: weight loss:  studies suggested that, for women, weight loss may reduce the risk for osteoarthritis in the knee. Exercise: Regular exercise may help to strengthen the muscles and potentially stimulate cartilage growth. Avoid high-impact sports. The following types of exercise are recommended: range of motion, strengthening, and aerobic. Diet: Antioxidant vitamins C and E may provide some protection. Vitamin D and calcium are recommended for strong bones. The recommended daily dose of calcium is 1000-1200 mg. The current guideline for vitamin D is 400 IU per day. Avoid more than 1200 IU of vitamin D per day. Heat: Hot soaks and warm wax (paraffin) application may relieve pain. Assistive devices are used to improve function of moveable parts of the body or to support, align, prevent, or correct deformities. Splints or braces help with joint alignment and weight redistribution. Other examples include walkers, crutches or canes, and orthopedic footwear. Over the counter  medications (OTC) : Acethaminophen (Tylenol) is the first drug recommended for osteoarthritis. In the view that you do not tolerate the NSAIDs, you may try  some OTC preparations including chondroitin  and glucosamine sulfate, which are natural substances found in the joint fluid. Chondroitin is thought to promote an increase in the making of the building blocks of cartilage (collagen and proteoglycans) as well as having an anti-inflammatory effect. Glucosamine may also stimulate production of the building blocks of cartilage as well as being an anti-inflammation agent. Glucosamine was found to increase blood sugar in animal studies, so people with diabetes should consult their doctor first. Recent studies showed that glucosamine might slow progression of osteoarthritis in the knee.