Tag: Knee Osteoarthritis

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Knee Osteoarthritis

Building an Exercise Habit

The seed of every habit is a single, tiny decision but as that decision is repeated, a habit sprouts and grows stronger.

“All big things come from small beginnings. The seed of every habit is a single, tiny decision but as that decision is repeated, a habit sprouts and grows stronger. Roots entrench themselves and branches grow. The task of breaking a bad habit is like uprooting a powerful oak within us. And the task of building a good habit is like cultivating a delicate flower one day at a time.”

James Clear, Atomic Habits

In order to get in better shape and meet any necessary weight loss goals, it’s all about developing new habits. And, as the above quote from the New York Times Best Selling book Atomic Habits states, it’s all done, one day at a time.

If you are new to working out, a good start is to set goals that you will be able to meet without a ton of effort and motivation ( which is something that needs to be developed over time).

One of the easiest ways to start exercising is to take your exercise goals and break them into small exercise segments that you are likely to do. Then you can build up a longer exercise plan over time.

Author James Clear writes about this concept in Atomic Habits. Clear writes that it’s important to split your exercise plan into easily obtainable chunks because when something is easy, we’re more likely to do it. And, by doing the exercise daily, no matter how little at a time, we will begin to build new habits.

So what does breaking a workout into segments look like?

It could look different depending on what it is you ultimately want to achieve. For example, if you want to start walking on the treadmill regularly, rather than plan to walk for 30 minutes a day, five days a week- change it to “I’m going to walk on the treadmill for 5 minutes.”

Then you can build from there.

Maybe the next day you will walk on the treadmill for 2 sets of 5 minutes, with a little break in between. Then 3 sets of 5 minutes, 4 sets of 5 minutes, until you reach your 30-minute goal.

If you need to, you can even make your daily goal smaller.

Whatever it is, just make the goal something that you will actually do.

You might be thinking, ” Why should I develop an exercise plan, especially when I’m dealing with the symptoms of knee osteoarthritis?”

That’s a great question, and to better answer it, you may want to check out studies like this one.

Studies have shown that people who regularly participate in land-based exercises such as walking, rate their knee pain to be 10 to 15% less than people who do not exercise. Even more, it has been discovered that those who exercised regularly need less pain medication, and in many cases, none at all.

In our next article, we will take a look at some of the exercises that can benefit your knee health. And, we will offer some suggestions as to how it can be developed into an exercise habit. A habit that will benefit your body, your mind, and of course, your knees.

 

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Knee Osteoarthritis

Exercise and Maintaining a Healthy Weight

One of the most common goals of the new year is to exercise more and lose weight. This is a great goal, especially when it comes to dealing with the symptoms of knee osteoarthritis, as exercise and maintaining a healthy weight, can both decrease knee pain and increase knee mobility.

Those of us that already go to a gym, might notice an influx of people working out in January, as new years resolution-based memberships skyrocket.

We also might notice that this increase in people tapers off considerably as the weeks go by.

Why is this?

We know that by exercising and maintaining a healthy weight, we can experience significant health benefits such as improved circulation, increased feelings of wellness and well-being, and reduced knee and joint pain. Regular exercise can also dramatically reduce our risk for all sorts of other health problems.

So knowing all of this, why is it that so many well-intentioned people fail to achieve their exercise and weight loss goals?

According to James Clear, the author of the New York Times bestselling book Atomic Habits, one reason for this could be that they set unrealistic standards for themselves.

Clears writes that many well-intentioned workout regimens are just too hard to maintain day to day and week to week. Therefore, he writes that the better choice is to set small goals to make little changes that build over time.

And how does one make these little changes?

By building new habits.

So what is a habit?

According to James Clear, “Habits are the small decisions you make and the actions you perform every day.”

He goes on to say that “Your life today is essentially the sum of your habits. How in shape or out of shape you are? A result of your habits. How happy or unhappy you are? A result of your habits. How successful or unsuccessful you are? A result of your habits.”

So the key to changing these habits is by introducing some new ones.

In order to build a new habit, such as regular exercise, Clear’s recommendations are:

Start with an incredibly small habit.

The author states that one of the best ways to start building a new habit is to choose something that doesn’t take a lot of motivation to do.

For example, instead of saying “I’m going to do 50 sit-ups every day.” Try starting with five.

Increase your habit in very small ways.

In Atomic Habits, Clear writes that it’s important to start small at a new task or activity, and then gradually improve.

He recommends that we aim to increase a new habit by merely one percent every day.

As a result of doing this, Clear has found that motivation and willpower are given time to grow, therefore making it easier to practice the new habit.

In our next article, we will continue looking at research-based recommendations for building an exercise habit in order to decrease knee pain, and increase function.

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Knee Osteoarthritis

Inflammation: Destroyer or Healer?

Inflammation is a normal part of the body’s defense system against infection, however, it can also be damaging.

What comes to mind when you hear the word “inflammation”?

A sore throat, lower back pain, joint pain, knee pain?

If you think of any of these, and countless others, you are right.
All of them are influenced by inflammation.

Though inflammation is a normal part of the human body’s defense system and can be beneficial when there is injury or infection, it can be damaging when it occurs in healthy tissue.

Inflammation can be especially harmful if it becomes chronic and lasts for too long.

In fact, chronic inflammation may persist for months or even years. And, in the case of inflammation in the knees by way of osteoarthritis, this inflammation can have a negative impact on not only your overall health but your quality of life as well.

For many years, knee osteoarthritis has been viewed as primarily a degenerative disease, one that is more often than not chalked up to the “wear and tear,” of aging and time.

However, over the past few decades, numerous studies have indicated that inflammation may play a more important role in the progression and severity of knee osteoarthritis.

According to a recent article called “Inflammatory Activity in Symptomatic Knee Osteoarthritis,” published in Arthritis & Rheumatology, inflammation can be triggered by factors like biomechanical stress.

Biomechanical stress is considered to be the internal and external forces that exert stress on the human body, which in this case, is the knees.

Examples of this type of stress on the knees include standing in one place for extended periods of time, reduced circulation and muscle fatigue, exposure to cold temperatures, contact stress or pressure, physical exertion, repetition, heavy lifting, and weight-related joint stress.

In the article, the authors stated that based on the findings of numerous research studies, biochemical stress has been proven to stimulate the release of early-stage inflammatory cytokines which in turn induces the activation of signaling pathways.

So what does that all mean?

It means, that as a result of biomechanical stress, more inflammatory molecules are generated. And, as a result, the anatomical and physiological functions of the joint are altered, and the incidence of knee osteoarthritis is greatly increased.

Though inflammation is one of the main contributing factors in the development and progression of knee osteoarthritis, it also must be said that while it can lead to tissue damage, it is also central to the repair process.

Current research is now seeking to understand the drivers and the regulation of knee inflammation.

The body’s natural wound-healing response manifests itself in the osteoarthritic joint, which has led to an increasing interest in how the immune response may influence disease progression.

Researchers are interested in determining if the body attempts to deploy the wound-healing cascade during osteoarthritis and could the disease be driven by a partial or even stalled repair process.

The bottom line is that inflammation most certainly plays a role when it comes to knee osteoarthritis, however exactly what that role is, remains to be studied further.

Research studies are being conducted at this time, to try and understand the cells and signals in both wound healing inflammation and the immune processes involved, in order to better understand the progression of osteoarthritis in the knees.

The hope is that by understanding these processes, potential therapeutic targets could be revealed in order to slow the rate of disease progression or enhance the inherent repair mechanisms.

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Knee Osteoarthritis

Knee Pain, Even at Rest?

The pain of knee osteoarthritis can be felt not only during movement such as walking, but also during rest.

The pain of osteoarthritis in the knees can be felt when standing up, walking, or doing any other movement. Which makes sense.

However, did you know that many people with knee osteoarthritis experience pain even when they are at rest?

In order to decrease this pain, many turn to over-the-counter NSAIDs, prescription medications, knee injections, and physical therapy. Then if none of those work, the next step is usually knee replacement surgery, however, this is changing as more and more people are opting to treat their condition with Genicular Artery Embolization.

Genicular artery embolization is a procedure that can treat knee osteoarthritis by blocking the blood flow to the inflamed areas of the knee that are causing decreased mobility and pain.

The outpatient procedure is performed by way of a tiny catheter which is inserted into the blood vessels and then guided by a highly skilled interventional radiologist, to the artery that supplies blood to the areas of knee pain.

The interventional radiologist then releases microscopic spheres into the specific blood vessel (genicular artery) to block this flow.

As a result of this blockage, inflammation is greatly decreased and so is knee pain.

Unlike knee replacement surgery which requires recovery time in the hospital, patients who undergo GAE treatment can go home the same day.

In most cases, pain relief begins to occur within two weeks, as the inflammation in the knee joint is reduced, thereby relieving the knee pain associated with osteoarthritis.

In fact, according to a study published in The Journal of Vascular and Interventional Radiology, knee pain has been shown again and again to be significantly reduced as a result of genicular artery embolization- particularly for those dealing with moderate-to-severe knee pain.

This particular study found that its participants showed continued improvement in their knee osteoarthritis symptoms at one-month, three-months, and at their six-month checkups. Not only did their symptoms improve, but the MRI scans taken at this point of recovery, proved it.

The Journal of Vascular and Interventional Radiology also published the results of a study that followed ten patients through their GAE journey, pre and post-procedure.

At the one-year mark, the participants reported:

Median pain: 15.4% improvement
Knee/leg function: 21.3% improvement
Quality of life: 100% improvement

This study also conducted follow-up tests with the participants that included a six-minute walk and a 30-second chair sitting/standing test. As a result of the GAE procedure scores for these tests improved by 26% and 43% respectively.

Add to that, the fact that in both studies no adverse reactions were reported, and you have yourself an excellent option for treating knee osteoarthritis.

To learn more about GAE, and to see if this procedure could benefit you and relieve your osteoarthritis knee pain, please call and set up a consultation today.

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Knee Osteoarthritis

Inflammation or Osteoarthritis?

Knee osteoarthritis can develop into a debilitating condition with a marked impact on a person’s overall health and quality of life.

When left untreated, knee osteoarthritis can develop into a debilitating condition with a marked impact on a person’s overall health and quality of life.

For many years the gold standard for treating knee osteoarthritis has been a total knee arthroplasty, also known as a knee replacement surgery.

Though this surgery has a well-established track record with a positive outcome, it is not without its complications.

First of all, a knee replacement, which is a major surgery that involves replacing either the damaged part of or the entire joint with a prosthesis— has a long long recovery period. And, it’s not necessarily a good fit for everyone.

According to an article published in the Journal of Arthroplasty called “Why are total knee arthroplasties failing today—has anything changed after 10 years,” a fair number of patients with knee osteoarthritis are not good candidates for knee replacement surgery.

The study found that certain comorbidities, such as diabetes, obesity, coronary artery disease, malnutrition, renal disease, cirrhosis, and immunosuppression, are associated with increased medical and surgical complications when a knee replacement surgery is performed.

Studies have also found that the patient’s age is another factor to consider, due to the possibility that a knee replacement surgery performed on a young person, could increase their risk of aseptic loosening, and lead to several revision surgeries in the future.

Studies have also found that elderly patients are not always the best candidates for knee surgery, given the occurrence of age-related co-morbidities, and their increased risk of fractures.

Though knee osteoarthritis used to be considered a normal “wear-and-tear” disease brought on by years of stress on the knee and meniscal degeneration that comes with age, recent data has suggested it’s not that simple.

In fact, according to recent data published in The Journal of Rheumatology, entitled “Osteoarthritis, angiogenesis, and inflammation,” it is now understood that inflammation plays a role in not only the pain from knee osteoarthritis but also the progression of the disease itself.

So if inflammation is not only causing pain but driving the progression of knee osteoarthritis, can anything be done to stop it?

Fortunately, yes.

There is a treatment that can help alleviate these symptoms and potentially prevent further structural progression. That treatment is called Genicular Artery Embolization.

Genicular Artery Embolization is a minimally invasive outpatient procedure, in which the arteries that supply blood to the synovial lining of the knee are selectively catheterized.

Once the arteries are reached, tiny particles are injected through the catheter into these arteries where they reduce the blood supply, and in turn, reduce inflammation. The procedure typically takes one to two hours, and the patient can return home the same day.

Many people are experiencing the benefits of Genicular Artery Embolization, which can result in both immediate and long-term pain relief for patients with osteoarthritis.

GAE is an excellent choice for people who are not good candidates for knee replacement surgery due to certain comorbidities. It’s also a great choice for people who would like to postpone surgery, or who are too young for a knee replacement operation.

To learn more about Genicular Artery Embolization, and to find out if the procedure can benefit you, please call us today to set up your initial consultation.

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Knee Osteoarthritis

The High Cost of Knee Replacement Surgery

Of all of the different types of arthritis, osteoarthritis is the most common, affecting over 30 million adults in the United States alone.

Of all of the different types of arthritis, osteoarthritis is the most common, affecting over 30 million adults in the United States alone.

And knee osteoarthritis, which used to be considered just a normal wear and tear associated with aging, affects more than just the elderly.

In fact, according to a study called The Framingham Osteoarthritis Study, published in Arthritis Rheumatology, symptomatic knee osteoarthritis affects at least 4.3% of men and 8.1% of women of all ages.

So it’s not just the wear and tear of age and time.

That being said, symptomatic knee osteoarthritis does predominantly affect individuals over the age of 65, with roughly half of the people experiencing a life-limiting physical disability as a result.

According to estimates from the Framingham Osteoarthritis Study, the number of individuals over the age of 65 is projected to rise to 78 million by 2035 from 49.2 million in 2016. This means the prevalence of knee osteoarthritis will potentially skyrocket as well.

In fact, according to an article published by the United States Bone and Joint Initiative, entitled “The Burden of Musculoskeletal Diseases in the United States“ the number of Americans receiving a total knee arthroplasty (also known as knee replacement surgery) was over 4.7 million individuals in 2010 with the overall trend being of increasing prevalence over time.

The rising number of individuals both young and old suffering from knee osteoarthritis pain is not only a hindrance to the quality of life for millions of people, but it is also expensive.

According to the aforementioned article by the United State Bone and Joint Initiative, the annual total hospitalization charges for knee replacement surgery nearly quadrupled from $8.1 billion in 1998 to $38.5 billion in 2011!

Furthermore, from that, they also estimated that the average lifetime direct medical cost for treatment for individuals diagnosed with knee osteoarthritis is estimated to be $12,400 or 10% of all estimated direct medical expenses for those individuals.

Most of these costs are attributed to knee replacement surgeries which on average cost around $20,293, and for patients that require revision surgery, the additional costs on top of the initial surgery cost, average $29,388.

Fortunately, medical advancements have been made in the treatment of knee osteoarthritis, which can effectively lower these costs. One of the key advancements is a treatment procedure for knee osteoarthritis called Genicular Artery Embolization.

In our next article, we will take a look at this effective and more affordable outpatient procedure.

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Knee Osteoarthritis

Side Effects and Risks of Corticosteroid Injections

Corticosteroid and hyaluronic acid injections can help to relieve osteoarthritis knee pain, however, it is temporary.

Corticosteroid or hyaluronic acid injections can help to relieve knee pain, however, it is temporary.

Not only is the relief temporary but there is ample evidence to support that exercise can be just as effective, and so can a simple injection with plain old saline solution (which is often used as the placebo in clinical trials).

Again and again, exercise, in order to treat knee osteoarthritis pain, is recommended over knee injections. One reason is that knee injections come with many more risks than exercise.

One of the biggest risks of knee injections is infections of the knee joint. This is especially true of corticosteroids.

If there are germs on the needle that is used for corticosteroid injections, an infection can happen.

Though joint infections are rare, they do happen. And when they do, they can cause serious problems. Therefore it is critical that these knee injections and performed by experienced doctors that follow hygiene standards such as properly disinfecting the skin before the injection.

The risk of infection is slightly higher with corticosteroid injections than with hyaluronic acid, because of the effect that steroids can have on the immune response of the joint.

In fact, repeated steroid injections over a long period of time can weaken the joint cartilage as well, furthering this risk.

Other possible side effects of steroid knee injections include pain and swelling at the injection site. This is especially true in the days after treatment when the muscles and ligaments may be slightly weakened.

There is also the risk that, for those getting treated with multiple steroid injections, the skin at the injection sight can become permanently discolored.

Some of the other potential side effects of steroid knee injections are:

–  osteoporosis of nearby bone tissue

–  osteonecrosis, which is the death of bone tissue

–  a temporary flare of pain and inflammation in the joint

–  joint infection

–  nerve damage

–  thinning or lightening of the skin and soft tissue around the injection site

–  allergic reaction

–  elevated blood sugar levels in some people with diabetes

 

There is also evidence to suggest that cortisone injections come with not only the risk of infection post-injection but that when administered in the time period before knee surgery, these injections can lead to a much greater post-surgical infection risk.

Even when corticosteroids are effective, according to a research study published by an independent group of scientists from the Cochrane Collaboration, these injections might reduce osteoarthritis symptoms for several weeks in roughly 10 out of 100 people.

 

The Bottom Line: Though there was a time when corticosteroid injections were considered to be some sort of miracle cure for knee pain, in more recent years, research has shown that this isn’t entirely true.

In fact, several studies have found that corticosteroid knee injections provided no significant pain relief after two years. And, some studies have even shown that cortisone can make the situation worse by thinning out the meniscus, causing more bone on bone in the knee.

In our next article, we will take a look at the effectiveness of hyaluronic acid injections, as well as the potential side effects and risks.

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Knee Osteoarthritis

Hyaluronic Acid Injection for Osteoarthritis

A type of knee injection that is used to temporarily reduce knee pain,  is a Hyaluronic Acid Injection, also known as viscosupplementation.

Another type of knee injection that is used to temporarily reduce knee pain, is a Hyaluronic Acid Injection, also known as viscosupplementation.

Hyaluronic acid is a gel-like substance that occurs naturally in the body as part of the synovial lining that coats the joints. Hyaluronic acid is also present in other areas of the body such as the skin and eyes, where it helps retain moisture and keep these areas lubricated.

When it comes to relieving osteoarthritis knee pain, hyaluronic acid can be injected into the knee to help provide cushioning and lubrication.

The injection of this lubricating fluid into the knee joint can sometimes result in temporary lubrication that may help to decrease knee pain and inflammation, as well as improve knee function.

However, unfortunately, just like with corticosteroid knee injections, the relief experienced as a result of hyaluronic acid injections is temporary.

That being said, though hyaluronic injections are temporary solutions, and will not cure knee conditions, they can be effective at relieving knee pain, in some cases, for up to six months.

The process of getting a hyaluronic knee injection is done through what is known as an intra-articular injection. This injection is usually administered by a nurse or trained healthcare professional, who should first check to make sure that this type of injection is suitable for you.

Typically hyaluronic knee injections are between one and five injections, usually a week apart depending on the brand of hyaluronic acid your healthcare professional uses.

The recovery period, post-injection typically involves avoiding jogging, high-impact sports, or being overly active for at least a few days following the injections. It is also recommended to avoid carrying heavy items or standing for long periods post injections.

For some, hyaluronic injections can provide immediate relief. While for others, it can take several weeks for the inflammation and pain to subside.

In fact, several clinical studies have investigated the effectiveness of hyaluronic acid injections in treating knee osteoarthritis. And one of their findings was that the average time it takes to experience pain relief is around 4 weeks post-injection.

Studies have also found that the duration of relief periods can vary from 2 months to up to 6 months. With the most effective period, on average, being between weeks 5 and 13.

It’s important to note that not all studies conducted to test the effectiveness of hyaluronic acid injections in treating knee osteoarthritis have reported positive results. For this reason, some doctors may not recommend this treatment. Research also shows that these injections may not work in overweight people due to the narrowing of joint space in the knee.

More recently, other types of injections are emerging, though they are still in the experimental stage, and are not FDA-approved at this time. These include using platelet-rich plasma or stem cells to help relieve pain and potentially encourage the healing of damaged soft tissues. Some people have found that these injections can provide long-term relief and help them to remain active, but they may not be suitable for all.

The bottom line when it comes to hyaluronic knee injections is that they do not treat osteoarthritis or the knees themselves. However, they can provide temporary relief.

This temporary relief can be best put to use by using it as a time to begin physical therapy and exercises to help strengthen the muscles that support the knee. It’s also a potential treatment to help relieve the pain in the weeks leading up to surgery or genicular artery embolization, which will provide long-term pain relief.

In our next article, we will take a look at some of the side effects and risks associated with corticosteroid and hyaluronic acid injections. As well as dive deeper into what the research says about these temporary solutions to osteoarthritis knee pain.

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Knee Osteoarthritis

Knee Injections: Do They Work?

Knee osteoarthritis is painful and can cause a decrease in mobility, and it puts limits on what you can do. Can knee injections help?

Knee osteoarthritis is painful and can cause a decrease in mobility that puts limits on what you can do. Therefore many people turn to knee injections to help relieve this pain.

So what are knee injections? And do they work?

When physical therapy and pain medication taken by mouth fail to relieve the aching pain caused by osteoarthritis of the knee, sometimes doctors will recommend an injection of medicine directly into the arthritic joint. These injections of medicine can reduce inflammation and relieve pain.

The most common type of knee injections are corticosteroid injections and hyaluronic acid injections. Let’s take a look at what these medicines are and how they work, starting with corticosteroid injections.

Corticosteroids are synthetic drugs that closely resemble cortisol- which is a hormone that is naturally produced by the adrenal glands and regulated by the pituitary gland inside the brain.

Cortisol is essential for life, as it helps to maintain blood pressure, immune function, and the body’s anti-inflammatory processes.

Cortisol can also:

–  help the body manage stress

–  convert protein into glucose to boost flagging blood sugar levels

–  work in tandem with the hormone insulin to maintain constant

–  blood sugar levels

–  reduce inflammation

–  contribute to the maintenance of constant blood pressure

–  contribute to the workings of the immune system.

Corticosteroid is a synthetic cortisol that is also used to help relieve knee pain by treating inflammation that is responsible for swelling and pain. Once injected into the knee, corticosteroids work quickly to temporarily relieve knee osteoarthritis pain.

The temporary pain relief from a corticosteroid injection can be helpful if a person with knee pain needs to engage in physical therapy, attend to an important life event, or postpone knee replacement surgery or genicular artery embolization to a later, more convenient time.

That being said, the key word here is temporary.

Though these injections can be helpful, they do not treat the knee condition itself, but rather provide short-term, temporary relief. Relief, that over time, will wear off completely.

It’s also important to note that just like any medication-related treatment, corticosteroid injections do not work for everyone. And, even when they are effective, the results may vary.

Some studies show that on average, just 40% of patients feel better after receiving cortisone shots for knee osteoarthritis.

In one study, one month after undergoing treatment, people who received cortisone injections were asked to report and rank their improvements on a 10-point scale, with 1 being the least improvement and 10 being the most improvement.

The average score that the participants ranked their improvement in symptoms was a 5 out of 10.

So yes, the injection helped, but only slightly.

The Bottom Line: Corticosteroid injections can be helpful for short-term knee pain relief leading up to a long-term solution treatment such as surgery or genicular artery embolization. However, these injections are not without their own set of side effects and risks.

In our next article, we will take a look at the use and efficacy of hyaluronic acid injections. As well as dive deeper into what the research says about these temporary solutions to osteoarthritis knee pain.

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Knee Osteoarthritis

Prescription Painkillers for Knee Pain

The first line of medication treatment to reduce knee pain is usually NSAIDs, however, sometimes opioids are used. But are they worth their risk?

The first line of medication treatment to reduce knee pain is usually NSAIDs, however, sometimes opioids are used. But are they worth their risk?

As we covered in previous articles, NSAIDs stand for Nonsteroidal anti-inflammatory drugs and are used to treat inflammation, pain, and swelling. These medicines can be bought at the drugstore, grocery store, and even at one of your local gas stations.

They are common, they are everywhere, and they are helpful.

However, though NSAIDs are effective, they can be problematic when taken for long periods of time or at high doses. Higher doses and time spent taking these medications can increase the risk of gastrointestinal bleeding, and ulcers, and even lend themselves to cardiovascular problems. NSAIDs can also cause fluid retention and kidney problems.

For people with knee osteoarthritis who can not achieve adequate pain relief from over-the-counter medicines, or can not take them for other reasons, sometimes the prescription drug tramadol is used.

Tramadol, which is sold under the brand names Ultram®, Ultracet, and Ultram® ER (extended-release), among others, is an opioid pain medicine that is sometimes used to treat moderate to moderately severe pain. Belonging to a class of opiate analgesics, tramadol is a narcotic that works by changing the way the brain and the nervous system respond to pain.

When it comes to relieving acute pain, prescription painkillers are sometimes used because they can relieve acute pain very effectively. The most common of these are morphine, codeine, and oxycodone, among several others- and they are primarily used in emergency and intensive care situations to induce anesthesia or reduce severe pain.

Though prescription painkillers like tramadol are sometimes used to treat osteoarthritis knee pain, recent studies have shown evidence that they don’t necessarily work better than NSAIDs do. Not only that but opioids like tramadol have been shown to lose their effectiveness with time.

Recently, The Cochrane Review shared the results of some extensive research regarding the benefits and harms of tramadol for treating osteoarthritis. They examined 22 studies involving 3871 people taking tramadol and 2625 people in a comparator group.

What they found overall, was that compared with a placebo, the evidence showed that taking tramadol for up to three months had no important benefit on pain or function. They also found that many people in the tramadol group experienced side effects that led them to stop taking it, such as nausea, vomiting, dizziness, constipation, tiredness, and headache.

Other studies have found that tramadol can be effective at relieving osteoarthritis pain in elderly sufferers, but, only when it is combined with acetaminophen ( Tylenol).

This makes one wonder if it’s the tramadol or the Tylenol that’s making the difference. In fact, a recent meta-analysis comparing NSAIDs and opioids for relief of knee osteoarthritis pain in over 5,500 patients found that on average, oral NSAIDs, less potent oral opioids (such as tramadol), and more potent oral opioids (such as oxycodone) all had similar efficacy and each reduced pain by about 30 percent.

There are also some studies that present evidence to support the claim that using opioids, such as tramadol to relieve osteoarthritis pain can actually make the condition worse. The problem is believed to be caused by the fact that opioids alter the perception of pain, but they do not do anything to help improve the symptoms of osteoarthritis.

Unlike NSAIDs, Tramadol doesn’t reduce inflammation and swelling, and it comes with its own set of side effects, ranging from nausea, vomiting, and dizziness, to addiction and even death.

Fortunately, most people do not need to take opioids for knee osteoarthritis, and most doctors will err on the side of caution when it comes to prescribing them. Though opioids, like tramadol, can be helpful in the short-term treatment of severe pain, in order to bridge the gap until a knee surgery or procedure can be performed- other than that, most find they are better off using NSAIDs for pain relief.

For those that wish to avoid taking medications as much as possible or who wish to focus on treating knee osteoarthritis directly, there are many other options. Not only can physical therapy and diet and lifestyle changes make a difference, but so can an invasive surgery such as a knee replacement, or a non-invasive procedure called Genticular Artery Embolization, which we specialize in here at MidAtlantic Vascular and Interventional.

The Bottom Line: Sometimes due to an inability to take NSAIDs due to gastrointestinal problems, cardiovascular risks, and kidney problems, a prescription opioid such as tramadol could be prescribed. However, even in these cases, the risks and potential problems that can come from using opioids may outweigh the benefits.