Early Warning Signs of Arthritis Infographic

Research has found that physicians who treat osteoarthritis patients are usually not using standard treatment guidelines which are based on the latest medical evidence.

The researchers noted medical practitioners were prescribing medications for inflammation and pain, or choosing surgical interventions instead of suggesting weight loss or exercise plans to patients with osteoarthritis.

A 2002 World Health Organization report estimated osteoarthritis to be the 4th leading cause of years lost because of disease worldwide. Osteoarthritis disability is rapidly becoming a significant public health issue with experts indicating that by 2020 the amount of people having osteoarthritis would have doubled as a result of increasing prevalence of obesity as well as the aging of the generation of “baby boomers”.

The researchers examined how standard clinical practice differs from evidence based recommendations for osteoarthritis management.

Existing clinical practice doesn’t reflect recommendations based on medical evidence. According to the researchers, therapeutic interventions are generally targeted at improving joint function and minimizing pain by making use of therapies that focus on symptoms, but don’t assist joint structure improvement or long term improvement of the disease. Often, doctors don’t suggest conventional non-pharmacologic management therapies leading to unnecessary diagnostic imaging and referrals to orthopedic surgeons.

Lots of people having osteoarthritis are obese or overweight. The study authors support medical evidence that recommends conventional non-pharmacologic management for patients with osteoarthritis. They also suggest that surgery be avoided whenever symptoms can be managed by other treatment methods. The standard indications for a surgical solution for the treatment of osteoarthritis are debilitating pain and significant limitation of functions like working, walking or sleeping. Previous research has however revealed that as much as 30% of some surgical procedures are unnecessary and recent recommendations suggest that routine arthroscopy for knee osteoarthritis management ought to be avoided.

The researchers also noted an excessive use of unnecessary diagnostic imaging rather than clinical diagnosis based on history and physical examination. According to current guidelines imaging ought to be reserved for instances when a diagnosis is not clear and radiography could eliminate other diseases which could produce similar symptoms. It’s estimated that there are 95 million CT, MRI and PET scans performed every year in the United States, and 20% to 50% of these scans were not necessary as the results didn’t help diagnose or treat the patient’s symptoms.

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References: DOI: 10.1002/acr.20278