First-line Treatment for Osteoarthritis Is Alpha and Omega
21 Apr 2020
Over ten years ago, Sweden implemented a method of first-line treatment for osteoarthritis. A method based on information, exercise, and weight control – proven to reduce pain, decrease patients willingness for total joint replacements, and help patients stop taking analgesic medication. But what is first-line treatment for osteoarthritis, and how does it work?
In this article, you will find out more about what first-line treatment means, what the benefits are, and how you can implement it into your organization – and thus, be able to treat more patients and reduce MSK spending.
What Is First-Line Treatment for Osteoarthritis?
Osteoarthritis (OA) is caused by incorrect or excessive strain on the joints, which can have different causes: genetic as well as lifestyle-related. Treating OA simply comes down to reducing the negative impact on the affected joint.
According to worldwide guidelines, customized, regular exercise supervised by a physical therapist is the first-line treatment of osteoarthritis.
OA treatment occurs in several stages:
Step 1: According to international science, guidelines, and information from international organizations (such as OARSI), OA treatment should primarily consist of specific, individualized exercise and education – where the first one mentioned helps to reduce the negative strain on the joint. In some cases, weight control may also be relevant if the strain on the joint is excessive.
Step 2: The next stage of OA treatment is pain relief and physical aids. This includes mild painkillers, but also larger interventions such as cortisone injections. Aids in the form of canes or knee protection can also reduce the pain and make everyday activities easier.
Step 3: In cases where the methods mentioned above have been tried for a long period of time, without satisfactory results, surgery may be necessary. But what is important to remember, is that total joint replacement is a treatment that often comes with side effects, high costs, and varying end-results.
Therefore, surgery should be the last option considered for OA patients, meaning that every OA patient should have tried both individualized and supervised exercise and pharmacological pain relief before surgery. The patient should also try to exercise based on their ability, both before and after the surgery, to get the best results possible.
All OA patients: Education, exercise, and weight control Some OA patients: Pharmalogical pain relief, aids, and passive treatment given by a therapist Few OA patients: Surgery
The three fundamental pillars of first-line treatment:
Specific, individualized exercise Exercise has a positive effect on the relationship between degradation and the construction of the cartilage’s building blocks in the joint, and it will stimulate the cartilage to repair itself. As the exercise gives effect, the muscles around the joint grow. This, in turn, allows the affected joint to receive more strain without taking any damage. In addition, exercise makes it easier to load the joints correctly – which reduces the risk of OA developing further.
Therefore, physical activity and specific exercise reduces the pain and increases the physical function of patients with OA. The exercises should, in some way or another, be led by an occupational therapist or physical therapist.
Information and education Besides specific, individualized exercises – information and education are fundamental pillars within first-line treatment for OA. Offering patients proper education about their condition as well as health in general, will help them stay motivated and understand, handle, and treat their OA.
Weight control Being overweight can affect patients with OA negatively. This is especially prevalent in patients with OA in the supporting joints, such as in hip and knee. Thus, weight control and weight loss may be considered as a part of first-line treatment for OA.
The Benefits of First-Line Treatment for Healthcare Providers
First-line treatment is not only beneficial for the patients – it comes with major advantages for health plans, health systems, and employers as well. First-line treatment holds the potential to reduce the number of total joint replacements needed: meaning money, and lives, saved. First-line treatment also saves resources in healthcare, by making sure that every patient gets the best available treatment – directly – without expensive detours. Furthermore, the number of sick-leaves and early retirements can be expected to decrease.
How Is First-Line Treatment for Osteoarthritis Offered?
In Sweden, there is something called “OA schools” (self-management programs). These schools – including information, exercise, and weight control, preferably led by an occupational therapist or physical therapist – are a part of the healthcare system, are offered as a treatment to patients with osteoarthritis, and are available both face-to-face and online.
The Digital Version of First-Line Treatment for Osteoarthritis
To be able to make these programs (“OA schools”) more accessible for the population – and to help health plans, health systems, and employers reduce their MSK spend – Joint Academy has developed a digital OA clinic. Joint Academy connects patients with physical therapists to deliver first-line treatment for chronic joint pain – online. The treatment is completely aligned with the face-to-face treatment mentioned above.
According to international guidelines, OA treatment should primarily consist of first-line treatment, including specific, individualized exercise and education. By initially offering this kind of treatment to all OA patients, healthcare providers will be able to treat more patients, save more lives, and reduce MSK spend.