Arthritis treatment: conservative and operative methods

physiotherapy exercises for osteoarthritis

Osteoarthritis is a painful change and deformation of the joints. It occurs when the articular cartilage is irreparably damaged. With conservative treatment or surgery, the symptoms of joint wear and tear can be significantly reduced.

Overview of the disease

  • The following joints are most commonly affected: knees, hips, shoulders, spine, fingers and toes, ankles;
  • The main signs: pain on exertion, pain at the beginning of exercise (at the beginning of physical activity), reduced mobility, deformation of the joints, phases of aggravation: swelling, redness, persistent pain;
  • Diagnostics: physical examination, x-rays, computed tomography (CT) or magnetic resonance imaging (MRI);
  • Treatment: exercise, heat or cold treatments, pain relievers, intra-articular injections (hyaluronic acid, chondroitin sulfate), in later stages - joint replacement (surgery);
  • Caution: Many osteoarthritis does not require long treatment, but physiotherapy and prevention of exacerbations should be carried out adequately and, if necessary, the pain syndrome should be stopped.

Treatment methods for osteoarthritis

How to treat osteoarthritis of the fingers

What helps with osteoarthritis or osteoarthritis? For most patients, this is the main question. Answer: There is still no osteoarthritis treatment that can repair damaged cartilage.

Treating osteoarthritis can only relieve symptoms of the condition. The treatment is also intended to prevent prolonged wear and tear on the joints.

Because over time, the disease also leaves traces on worn joints and damages joint capsules, bones and muscles.

Treatment for osteoarthritis includes conservative and surgical procedures. The attending physician selects the most suitable method for each patient. Among other things, it evaluates which joints are affected, how severe the general wear and tear is and how severe the symptoms are.

Conservative treatment

Conservative osteoarthritis treatments are designed to relieve pain, combat inflammation, and improve muscle strength and coordination. Physiotherapeutic procedures, which are carried out both during an exacerbation and in phases of "calm" symptoms, play a major role.

Physiotherapy treatment

physiotherapeutic treatment of osteoarthritis

Various forms of physical therapy can relieve symptoms of osteoarthritis. These include:

  • Physical therapy;
  • Manual therapy;
  • Thermotherapy (not in the acute stage);
  • Cryotherapy (in the acute stage);
  • Exercise joint-friendly sports such as Nordic walking, swimming and cycling;
  • Water therapy and baths;
  • Electrotherapy;
  • Ultrasound therapy;
  • Orthopedic devices.

To treat chronic osteoarthritis pain, you can use heat from heat treatments, packs, baths, or infrared light. On the other hand, severe swelling and discomfort are relieved by cold treatments or compresses.

Physiotherapy is also helpful for osteoarthritis as it strengthens the muscles. A massage is also recommended: it relieves tension and improves blood circulation.

Joint movement during exercise

Regular exercise keeps your joints flexible. Therefore, people with osteoarthritis should integrate sport and exercise into their everyday life. Swimming is a good example. It trains the joints without putting too much strain on them. For the same reason, it is advisable to hike and cycle on the plain.

Exercise can not only prevent osteoarthritis, it can also slow it down and relieve symptoms.

Less suitable for osteoarthritis are sports with abrupt, heavy joint loads, extreme movement or a high risk of injury. These include, for example, tennis, ice skating, soccer, handball, karate and boxing.

Joint fixation

Joint fixation in osteoarthritis

Bandages, elastic bandages, soft soles and crutches make the joints easier to function. Orthoses help in the same way. These are special support devices for joints. They prevent painful movements. However, orthoses are not very flexible and only need to be worn briefly to avoid stiffening of the joint.

If the person is overweight, try to lose weight. This puts less strain on the joints. Regular exercise and a healthy diet will help you lose weight.

Medicines used to treat pain and inflammation

Painful joints in osteoarthritis can be rubbed with pain relieving ointments, creams or gels from the pharmacy.

Local anesthetics are used to relieve pain: they are injected into the joint or around the affected area.

Osteoarthritis (or osteoarthritis) is usually a non-inflammatory process. However, the inflammatory process often joins the tissue affected by the osteoarthritis. Then they speak of osteoarthritis or activation of arthritis.

A doctor will often prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) for treatment. Sometimes glucocorticoids are also injected into the joint to reduce inflammation.

Some patients with osteoarthritis receive injections of hyaluronic acid or chondroitin sulfate into the joint. These are glycosaminoglycans and natural components of the synovial fluid. By injecting hyaluronic acid directly into the affected joint, its mobility is restored.


Surgery can fix problems in osteoarthritis patients and stabilize the joints. It also relieves pain and prevents inflammation. In some cases, the damaged cartilage is replaced during the operation. Osteoarthritis patients can move better after the operation.

Joint irrigation and treatment

operative treatment of osteoarthritis

In osteoarthritis, the affected joint is sometimes washed with saline solution. This happens most often, for example, with the knee joint.

Rinsing the bursa removes damaged cartilage and tissue fibers as well as other particles floating in the synovial fluid. The procedure is also intended to alleviate any inflammation in the joint.

Reorganization means complex treatment of the joint capsule. The rough surfaces of the cartilage in the joint are removed with instruments. It also removes areas or tissues that can hinder joint mobility. Acute pain disappears at least temporarily with the treatment.

The joint treatment is carried out as part of an arthroscopy. Surgical instruments are inserted into the joint through very small incisions.

Stimulation of cartilage growth

Arthroscopy involves making small injections of the remaining surface of the cartilage for therapeutic purposes. This should stimulate cartilage cells to form replacement tissue. However, this new cartilage tissue has a different structure than the original cartilage and does not fully meet the requirements of the joint.

In some cases, cells can be transplanted into the damaged joint during several years of illness.


The corrective osteotomy repositions the joint bones for a more even distribution of the load on the joint surfaces: some of the pressure is transferred from the osteoarthritis zone to healthy areas of cartilage and bone. In most cases, this type of osteoarthritis treatment also involves improving the function of the joint capsule and the ligaments to restore joint mobility.

Joint replacement

Arthrosis endoprosthesis

If no other osteoarthritis treatment can alleviate the pain, a joint replacement is possible. This means that the damaged joint (or parts of it) is replaced with an artificial one. Basically, the operation is performed for osteoarthritis of the knee or hip joints.

Complex exchanges are the last option

Strictly speaking, worn joint tissue and joint surfaces are surgically removed and replaced with metal, plastic and ceramic prostheses (alloarthroplasty). There are prostheses that only replace parts of the joint and there are those that replace the entire joint. They are either attached to the bone surface or with screws. With this osteoarthritis treatment method, it is possible to correct the position of the joint if necessary.

Every prosthesis can wear out over time. When this happens depends on various factors: age, gender, osteoarthritis disease, infections, type of joint and type of prosthesis.

A lightweight prosthesis needs to be replaced more often. Regular x-rays can detect wear and tear on the prosthesis in good time.


Arthrodesis can help relieve the pain of osteoarthritis. This is a strengthening of the affected joint: it is more stable, but also less mobile. Therefore, arthrodesis is usually only carried out on joints where reduced mobility does not interfere with the patient's everyday life. These include the joints of the fingers and toes, as well as small joints in the wrist.


In this form of osteoarthritis treatment, the damaged joint bodies are removed and surgically reconstructed without a prosthesis. However, resection endoprosthetics are rarely used today.

This option can be considered for osteoarthritis of the thumb (rhizarthrosis), especially if conservative treatment of osteoarthritis has not been successful. One of the affected metacarpal bones is removed and replaced with the body's own tendon tissue. Often the tendons of the long muscle of the thumb or flexor tendons are used. This form of therapy for rhizarthrosis is not considered a standard method.

Resection endoprosthetics are also performed in the case of osteoarthritis of the big toe or osteoarthritis between the collarbone and the humerus.

Alternative treatment for osteoarthritis

Homeopathic remedies for osteoarthritis

What helps with osteoarthritis besides conventional medical procedures? Many patients are interested in this question. They want to support treatment with "natural", simple methods. Although many alternative methods have not been scientifically proven to be effective, they provide good relief from osteoarthritis in some patients. Homeopathy, herbal medicine, magnetic therapy, and acupuncture are commonly used to relieve symptoms ofRelieve arthritis.

Salts and Homeopathy

In many cases, osteoarthritis patients rely on these two alternatives: salts and homeopathic granules to relieve osteoarthritis symptoms. In addition, salt baths and compresses are also supposed to prevent osteoarthritis. Proponents say that both treatments have no side effects and are therefore suitable for self-medication.

Experts recommend using minerals in combination with an ointment or cream gel. Homeopathic remedies for osteoarthritis should be discussed with an experienced therapist.

Plant substances

The treatment of osteoarthritis has also been based on medicinal plants for centuries. These include African devil's claw, nettle, comfrey, willow, dandelion, cayenne pepper, and rose hip. However, osteoarthritis symptoms will improve if you use herbs for a long period of time. Your doctor or pharmacist will advise you on the exact use and dosage.

Magnetic Therapy

Treatment of osteoarthritis with magnetic field therapy is intended to relieve pain, restore joints and improve the patient's quality of life. The magnetic field is generated either by a natural magnetic stone or by an electric coil.

Medical studies have shown that magnetic field therapy can be particularly helpful for osteoarthritis of the knee. But patients with chronic complaints in several joints (polyarthritis) should also benefit. No side effects were observed with this alternative treatment for osteoarthritis.

X-ray therapy

X-ray treatment for osteoarthritis is said to reduce inflammation and improve blood circulation. The irradiation should take place at regular intervals and only very low doses of radiation are used.

X-rays are used, for example, in the treatment of rhizarthrosis and in the treatment of Heberden's osteoarthritis.


Stimulation of certain points on the skin with acupuncture in order to normalize disturbed processes in the body again. Usually the course of treatment requires several sessions.

The use of acupuncture for osteoarthritis is not widely accepted. However, some patients report that acupuncture can actually help relieve arthritis pain. Acupuncture can relieve chronic pain, especially with combined wear and tear on the knee structures.

Osteoarthritis and Diet

The link between arthritis and diet is often debated: Can poor diet contribute to osteoarthritis? Should you change your diet if you have osteoarthritis?

In general, some foods cannot be said to cause osteoarthritis. However, the type of diet can actually influence its course: the decisive factor is how much we eat and how our meals are prepared.

Less calories

As a result of the weight gain, the joints are more stressed and wear out faster. Therefore, obese people are at higher risk of developing osteoarthritis.

If osteoarthritis is already present, obesity, especially in the knee joint, contributes to the combined wear and tear.

Obesity has a huge impact on the joints. An excess of kilograms is particularly critical at a young age.

Therefore, if the person is prone to obesity, the diet should be adjusted by counting calories in osteoarthritis. A healthy body weight relieves the joints, can relieve symptoms of illnesses and slow down the progression of changes.

Less animal fat

useful products in the treatment of osteoarthritis

Proper nutrition for osteoarthritis means reducing the intake of meat and other animal products. Reason: If joints are damaged, inflammation develops more easily with osteoarthritis. Several metabolic products mediate these inflammatory reactions in the body and are made from arachidonic acid (an omega-6 fatty acid). These are mainly animal products.

Therefore, in osteoarthritis, the diet should limit the use of arachidonic acid. Instead, you should eat foods with more omega-3 fatty acids, as these inhibit inflammatory reactions. Omega-3 fatty acids are found, for example, in rapeseed and linseed oil and in fatty fish such as herring, mackerel and salmon.

Therefore, the following guidelines for proper arthritis diet apply:

  • Reduce your consumption of meat and eggs;
  • Fish in the feed twice a week (e. g. salmon, mackerel, herring);
  • Use vegetable oils such as rapeseed oil, linseed oil, sunflower oil, or olive oil;
  • Eat lots of fruits and vegetables;
  • Whole grains and legumes are preferred;
  • Drink at least 1. 5 liters of water or unsweetened tea daily;
  • Calcium from low-fat dairy products to strengthen bones
  • Avoid caffeine, alcohol, and nicotine.

Such an osteoarthritis diet cannot replace other therapeutic measures, but it can complement them sensibly. This means that the diet does not cure the osteoarthritis, but has a positive effect on the patient's condition.

Keep moving!

Gymnastics for osteoarthritis

Despite the potential pain, "immobility" is not a good idea when treating osteoarthritis - it actually speeds up the process of destruction.

Only when the joint is working and when the joint surfaces move is a lubricant, the so-called synovial fluid, formed, which reduces friction in the joint and supplies the cartilage with nutrients.

Ideal movements that do not stress the joint too much: swimming, cycling, Nordic walking and gymnastics.