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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Severe Arthritis Be Treated?

Hi, I have a question regarding my grandmother. She is 74 years old, she is 5’3”, and she weighs 160/170 pounds. She has stints in her heart, that require her to be on blood thinners. She has severe arthritis, and she cannot stand for more than 5 minutes at a time. I am desperate to get her to lose weight, and would like to know what all my options were regarding this. Thank you.
posted on Mon, 23 Apr 2018
Twitter Sun, 27 May 2018 Answered on
Twitter Tue, 29 May 2018 Last reviewed on
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Internal Medicine Specialist,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
It seems your grandmother is suffering from Osteoarthritis.
Acetaminophen, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), and
Cyclooxygenase-2 (COX-2) Inhibitors can be used for pain relief. Acetaminophen (paracetamol) is the initial analgesic of choice for patients with OA in knees, hips, or hands. For some patients, it is adequate to control symptoms, in which case more toxic drugs such as NSAIDs can be avoided. Gel or topical solution of NSAIDs can be applied .Topical NSAIDs are slightly less efficacious than oral agents, but have far fewer GI and systemic side effects.

When medical therapies have failed and the patient has
an unacceptable reduction in their quality of life and ongoing pain and disability, then at least for knee and hip OA, total joint arthro-plasty is indicated.
For patients with symptomatic knee or hip OA who have not had an adequate response to the medical treatments and are either unwilling to undergo or are not candidates for total joint arthroplasty, opioid analgesics (Tramadol) have shown modest efficacy and can be tried.
Regards,
Dr. T.K. Biswas M.D.
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How Can Severe Arthritis Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It seems your grandmother is suffering from Osteoarthritis. Acetaminophen, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), and Cyclooxygenase-2 (COX-2) Inhibitors can be used for pain relief. Acetaminophen (paracetamol) is the initial analgesic of choice for patients with OA in knees, hips, or hands. For some patients, it is adequate to control symptoms, in which case more toxic drugs such as NSAIDs can be avoided. Gel or topical solution of NSAIDs can be applied .Topical NSAIDs are slightly less efficacious than oral agents, but have far fewer GI and systemic side effects. When medical therapies have failed and the patient has an unacceptable reduction in their quality of life and ongoing pain and disability, then at least for knee and hip OA, total joint arthro-plasty is indicated. For patients with symptomatic knee or hip OA who have not had an adequate response to the medical treatments and are either unwilling to undergo or are not candidates for total joint arthroplasty, opioid analgesics (Tramadol) have shown modest efficacy and can be tried. Regards, Dr. T.K. Biswas M.D.