Managing osteoarthritis: the treatment options.

NSAIDs have been a mainstay of treatment for patients with osteoarthritis (OA), but toxicity may be a problem and cyclooxygenase-2 inhibitors may increase cardiovascular risk. Current OA treatments combine several approaches to alleviate symptoms. Patient education and physical and occupational therapy are valuable components. Support appliances help stabilize joints and improve function. Weight loss is recommended in patients who have a high body mass index. Studies of complementary and alternative medicine therapies are inconclusive. Surgery may be indicated. Acetaminophen is considered first-line pharmacologic therapy for mild to moderate OA. Opioid analgesics are useful in patients with moderate to moderately severe pain. Intra-articular corticosteroids can relieve pain and reduce effusions. Topical NSAIDs and capsaicin may reduce OA-related pain. [ABSTRACT FROM AUTHOR]