Most commonly, patients have a more diffuse form of joint surface damage. Symptoms can almost always be reduced without surgery. The most important initial treatment for lower extremity arthritis is weight control since a joint will experience 4-5 times the load of a person’s weight when walking. Certain foods can reduce inflammation, such as nuts and dark green vegetables. Fried foods and foods with white flour and refined sugars increase inflammation and should be avoided. We have also found glucosamine and chondroitin supplements to be helpful in some patients. Low impact exercise can increase flexibility and improve strength. Anti-inflammatory medicines such as ibuprofen or naproxen can relieve pain but should be used for short periods only, especially in patients with any gastrointestinal problems, high blood pressure or a cardiac history as it can make these conditions worse. Cortisone injection into a joint can be effective in reducing pain and inflammation but should not be used frequently because, in the long run, they can make the arthritis worse.
Recently, visco supplementation shots have been introduced for knee arthritis. These are believed to improve the cushioning effect of joint fluid. We have found them effective in many patients with mild to moderate osteoarthritis.