Osteoarthritis. Aggravating factors and therapeutic measures.

Clinical criteria for diagnosis of osteoarthritis are not yet formally established; at present, diagnosis is usually made through physical and radiologic examination and evaluation of synovial fluid. Severe trauma and possibly repeated microtrauma, excessive activity, inactivity, and obesity are believed to aggravate symptoms. Treatment objectives are to reduce pain and improve, or at least preserve, function. Antiinflammatory agents provide relief for many patients, although gastrointestinal reactions may accompany their use. Antispasmodics may be helpful for pain caused by muscle spasm, and intraarticular injections of depocorticosteroids are useful for inflammation. Agents that provide analgesia are an appropriate part of the therapeutic program. Patients should be taught to protect weakened joints through use of orthotics, strengthening exercises, and proper body movement and posture. A supportive physician who encourages a healthy life-style and positive outlook will see better physical as well as emotional results with these patients.