Acute osteoarthritis flare-up: preventing chondrolysis

Edito of 06/01/2013

An acute painful episode of osteoarthritis requires relative rest of the joint and prescribing an anti-inflammatory treatment. Indeed, it is during these inflammatory flare-ups that alterations occur to the cartilage, leading to its degradation.

The evolution of osteoarthritis is unpredictable. Usually, within the framework of a chronic painful condition, acute flare-ups occur corresponding to joint inflammation and relatively fast degradation of the cartilage.

The osteoarthritic patient needs to know the tell-tale signs of an acute flare-up: being awakened by pain during the night, joint stiffness in the morning lasting an unusually long time (over 15 minutes) and swelling around the joint, easily recognisable at the knee. He or she needs to be aware that these manifestations are a warning sign that requires seeking medical advice as soon as possible.

To avoid too rapid destruction of the cartilage (eventually confirmed by an X-ray sometime after the flare-up), the appropriate measures need to be taken as quickly as possible.

The first measure is to put the joint relatively at rest. While physical exercise is one of the key non-pharmacological measures in the treatment of osteoarthritis, resting the painful joint is essential during an acute episode. This does not mean that all physical exercise should be discontinued. There are means of mobilisation and walking without using the painful joint.

An anti-inflammatory treatment is the second measure. A short course of non-steroidal anti-inflammatory drugs is prescribed, taking into account the potential side effects (gastric and cardiovascular). An intra-articular corticosteroid injection may be considered in easily accessible joints, especially after evacuation of the fluid.

 

Arthrolink Editorial Committee