Brief Answer:
Initial management is always Conservative.

Detailed Answer:
Hi, thanks for writing to XXXXXXX

From your brief description, I understand that you are concerned with arthritic knee joints.

You have not mentioned about your age and also the duration of your symtoms.

Anyway, the general management guidelines for Osteoarthritis of knee joint are as follows -

* ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling.
* USING CANES: Assistive devices can make it easier to go about your day without stressing your painful joint. A cane may take weight off your knee or hip as you walk. Carry the cane in the hand opposite the leg that hurts.
* LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints. Weight reduction for obese patients, wearing shock-absorbing shoes, avoiding activities like climbing stairs and using a walking stick are worthwhile.
* ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. If this fails to control pain, a non-steroidal anti-inflammatory drug may be better.
* PHYSICAL THERAPY : The mainstay of treatment in the early case is physical therapy, which should be directed at maintaining joint mobility and improving muscle strength.
Exercise can strengthen your muscles, which can help keep your joints more stable, and the stronger muscles help to absorb energy and protect the joint surface.
* OVER THE COUNTER PAIN CREAMS : Local massaging with creams and gels may provide temporary relief from osteoarthritis pain. Some creams numb the pain by creating a hot or cool sensation. Other creams contain medications, such as aspirin-like compounds, that are absorbed into your skin.
Pain creams work best on joints that are close to the surface of your skin, such as your knees.
* GLUCOSAMINE & CHONDROITIN SULFATE : Daily intake of Glucosamine & chondroitin supplements over a period of 3-4 months will help in reducing the arthritic pains and thereby decreases the necessity to take daily analgesic medications. Research suggests that vitamins C and D may help protect you against the progression of osteoarthritis.
* VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years.

If all the above measures fail to provide significant pain relief, you may need a total knee replacement surgery depending upon your age.

Hope I have addressed your query. Happy to help further

Regards

---

Brief Answer:
Conservative treatment is the mainstay.

Detailed Answer:
Hi, Nice to hear from you.

Even the management of osteoarthritis of back & Degenerative disc disease is conservative initially, which is as follows -

- Avoid lifting heavy weights as it imparts more strain on your back
- Avoid excessive forward bending activities as it will worsen the disc protrusion, if you want to bend forwards, you have to keep your hips and knees in some flexion.
- Use a lumbosacral back support to stabilize your spinal muscles
- Intermittent pelvic traction might be helpful to cause a regression of the protruded discs
- Maintain optimum body weight,if you are obese
- Physiotherapy is needed to strengthen your back muscles. Physiotherapy has to be done only after the acute pain has subsided.
- Use analgesics like advil or aleve and muscle relaxants as needed. Vitamin B12 supplements may be helpful.
- Lumbar facet joint blocks will help in alleviating the pain arising due to arthritic changes in the facet joints.
- If your fail to improve with the above measures, an Epidural steroid injection may provide good symptom relief for a few months.

For Chronic back pain with no improvement with conventional measures, RADIO FREQUENCY ABLATION may be an option to try and see if it works.

Radiofrequency ablation ( RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area.

RFA can be used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.

The degree of pain relief varies, depending on the cause and location of the pain. Pain relief from RFA can last from six to 12 months and in some cases, relief can last for years. More than 70% of patients treated with RFA experience pain relief.

Hope I have justified your query. Good day

---