Summarize the following:
Make an appointment with your family doctor to confirm if you have arthritis in your knees. Your doctor will likely take x-rays and blood tests to confirm a diagnosis of OA, RA or other types of arthritis, such as gout. If the arthritis is causing lots of pain and stiffness, over-the-counter medications may not be strong enough to lessen the symptoms. In such cases, your doctor will likely prescribe stronger anti-inflammatories.  COX-2 inhibitors (celecoxib, meloxicam) are strong types of NSAIDs that may cause fewer stomach problems. They are commonly prescribed for OA of the knee. Disease-modifying anti-rheumatic drugs (DMARDs) are commonly used to deal with the pain and slow the progression of RA by reducing an overactive immune system. DMARDs include methotrexate, sulfasalazine, hydroxychloroquine, etanercept, and adalimumab. Classic signs of arthritis on x-ray are: loss of joint space due to thinning cartilage and bone spurs that stick out from the femur or tibia bones. An injection of corticosteroid medication (cortisone) into a knee joint can quickly reduce inflammation and pain, and allow normal movement of the joint pretty quickly. Corticosteroids are hormones that display powerful anti-inflammatory properties and are made by the body's adrenal glands. They are injected by an orthopedic surgeon under anesthesia. The most commonly used preparations are prednisolone, dexamethasone, and triamcinolone. The effects of the medications are short-term — lasting from weeks to months typically.  The number of cortisone injections you can get each year is limited because it can worsen knee joint damage over time. Potential complications of corticosteroid knee injections include local infection, excessive bleeding, tendon weakening, local muscle atrophy and nerve irritation/damage. Steroid injections can be relatively expensive if your insurance doesn't cover it. Using low-energy light waves (called infrared) is known to be able to speed up wound healing, decrease pain and decrease inflammation in a variety of joints, including the knees. Use of infrared radiation (via a hand-held device or within a special sauna) is thought to penetrate deep into the body and improve circulation because it creates heat and dilates (opens up) blood vessels. Furthermore, there are virtually no negative side effects of infrared therapy.  In most cases, significant knee pain reduction occurs within hours after the first infrared treatment, which lasts between 15 and 30 minutes per session. Pain reduction ranges from 40% to 100% better after treatment and is often long lasting — weeks or even months.  Health professionals most likely to use infrared therapy on joints include some chiropractors, osteopaths, physiotherapists and massage therapists. Acupuncture therapy involves sticking thin needles into specific energy points within your skin/muscle in efforts to decrease pain and inflammation and to potentially stimulate healing. Acupuncture is gaining popularity as an arthritis therapy and some studies indicate that it can relieve pain and improve function in people with OA of the knee. Acupuncture is relatively painless and has an excellent safety record — the only risks are local bruising and infection. It seems to be worth a try if your budget allows for it, as it isn't covered under most health insurance plans.  Acupuncture is based on the principles of traditional Chinese medicine and alleviates pain and inflammation by releasing the hormone serotonin and other substances called endorphins. Acupuncture is much more mainstream now and practiced by a variety of health professionals including some medical doctors, chiropractors, naturopaths, physiotherapists and massage therapists — whoever you choose should be certified by NCCAOM. If conservative home-based remedies and non-invasive treatments from your doctor aren't effective at reducing the symptoms of your knee arthritis, then surgery may have to be considered. Surgery should only be done in severe cases of arthritis where the knee joint is severely damaged and all other modes of treatment have failed. There are many types of surgical replacements, ranging from minor arthroscopic surgery to complete knee replacement surgery. Surgery is more common for advanced OA and not as common for inflammatory types of arthritis, unless the cause is clearly understood or the entire knee joint is destroyed.  Arthroscopic involves inserting a small cutting instrument with a camera attached into the knee to clean up pieces of torn cartilage. Recovery time is quick — a week or two, depending on the extent of the damage. Cartilage grafting involves adding healthy cartilage to a damaged knee meniscus. This procedure is usually considered only for younger patients with smaller areas of damaged cartilage. A synovectomy involves removing the knee joint lining that's been inflamed and damaged by RA. An osteotomy involves reshaping or sanding down the leg bones that form the knee joint — the tibia and/or the femur. An arthroplasty is a total or partial knee replacement. The damaged cartilage and bone is removed and replaced by an artificial knee joint made of metal and plastic. This surgery is the most invasive and takes the longest amount of time to recover from.
Get stronger prescription medications from your doctor. Ask your doctor about steroid injections. Consider infrared therapy. Try acupuncture treatments. Consider surgery as a last resort.