Acetaminophen still first line of defense against osteoarthritis

When testing for osteoarthritis in the knee, be sure to take a standing radiograph, said David E.J. Bazzo, MD, Associate Professor of Family Medicine at the University of California, San Diego, School of Medicine.

Too often physicians order a lying-down knee radiograph, which doesn't make clear the amount of joint space diminishing in size, he said.

About 25% of all Americans suffer from osteoarthritis, the most common type of arthritis in the country, and that figure jumps to 80% among people age 70 and older.

The goal of treating osteoarthritis is to reduce patients' pain, preserve the function of their joint, and reduce the progression of the condition.

OTC acetaminophen is the first line of defense against osteoarthritis. It sounds simple, Dr Bazzo said, but it really works as long as the patient maintains regularly scheduled doses of 3 grams per day. If the patient has no history of liver problems, it's possible for them to take 4 grams per day.

If the pain doesn't subside after 4, 6, or 8 weeks of acetaminophen, NSAIDs can be prescribed. However, these carry a greater risk of GI complications.

For patients with intermittent osteoarthritis who don't respond to conservative treatments, physicians should consider opioids.

Injections of corticosteroids are very effective, Dr Bazzo said, but he advised not to inject a patient in the same joint more than 3 times per year, at least 1 month apart.

Canes, walkers, and braces help prevent bone breaks, notably hips.

Exercise and stretching build up muscle strength that can ease pressure on joints.