Non-surgical treatment for osteoarthritis is often the first line of therapy. Osteoarthritis is a chronic joint disorder that primarily affects the most load-bearing joints: the knees, hips, hands, and spine. It leads to pain and swelling, which can result in disability over time. The complex interplay of risk factors—age, gender, and lifestyle—has been increasing the incidence of the disorder.
Various non-surgical options that integrate medications with physical therapies are available. However, they have a limited impact on the progression of the disorder into advanced stages, where surgery remains the last option. Scientists are adopting different approaches to formulate a more effective treatment. At present, Stem Cell Therapy for Osteoarthritis is their key focus. It is a non-surgical alternative, but does it work? This blog explores the non-surgical treatments for osteoarthritis and analyzes stem cell treatment for osteoarthritis.
What is Osteoarthritis?
Osteoarthritis is a disorder of joints that begins with the breakdown of the cartilage. Cartilage is the tissue above bones in a joint. It enables smooth movement of bones over each other without any friction. Factors such as high mechanical load, trauma, or age can result in an injury to cartilage. It results in the degradation of the bone matrix, activating repair mechanisms in response. However, inefficiency of these mechanisms causes outgrowths and bone thickening (Fig 1). With repeated injury, the damage extends to nearby tissues encompassing bones, ligaments, and tendons. The tissue deterioration also activates inflammatory pathways that aggravate the condition.
Figure 1. Illustration of healthy and osteoarthritis joints. Cartilage degradation leads to abnormal bone remodeling (bony spurs) and inflammation in synovium (synovitis). (Image Courtesy: PMID: 37511413)
Non-Surgical Treatment for Osteoarthritis
The treatment approach for osteoarthritis aims to reduce pain and further tissue damage. Doctors often recommend a comprehensive treatment plan incorporating different pharmacological (drugs) or non-pharmacological approaches.
Non-Pharmacological Therapy
- Exercise: It is critical for the management of osteoarthritis. It focuses on decreasing the load on joints and increasing muscle strength around them. Exercises like aerobics, strength training, swimming, stretching, etc., aid in shedding weight and stretching muscles. Exercise should be chosen cautiously to avoid adding stress to joints.
- Mechanical Interventions: These employ knee braces, taping, foot orthoses, etc., to reduce joint strain. These interventions supplement physical therapy and could modestly relieve pain. Up to a certain degree, they can be beneficial in correcting joint misalignment.
- Electrotherapy: Applying electrical impulses, particularly to knee osteoarthritis, can improve muscle strength, increase blood circulation, decrease pain, and induce tissue repair.
- Diathermy: It transfers heat to the underlying tissue, elevating blood flow, diminishing muscle stiffness, and alleviating pain, leading to tissue repair.
- Radiofrequency: This procedure delivers heat to a targeted location to damage nearby nerve cells. It therefore disrupts the transmission of pain signals, lowering pain and enhancing movement.
- Diet: Nutrition plays a vital role in therapy. Therefore, it is advised to increase the uptake of foods that support bone health while decreasing inflammation or obesity-causing foods.
Pharmacological Therapy
- Drugs: The common drugs for osteoarthritis are non-steroidal anti-inflammatory drugs (NSAIDs) that alleviate inflammation and pain. These include Cox inhibitors such as ibuprofen, aspirin, rofecoxib, celecoxib, etc. They are available in topical and oral formulations. Although oral formulations are comparatively more effective but also associated with gastrointestinal complications.
- Injectables: In case of poor response to oral or topical medications, corticosteroids are injected into the tissue. These anti-inflammatory molecules, such as methylprednisone and triamcinolone, relieve pain and improve joint mobility. Corticosteroids can be administered into the cartilage (intra-articular route) or into other tissues like genicular nerves (genicular nerve block), medial collateral ligament (MCL), etc.
Injections of hyaluronic acid, a component of cartilage and synovial fluid, have also been employed. This can increase the synthesis of HA naturally. However, due to its controversial efficacy, it is advised only if other treatments are not working.
Why Regenerative Medicine for Osteoarthritis?
Despite the many options available, there is no cure for osteoarthritis. The current treatments only:
- Provide relief from symptoms such as pain and swelling
- Improve joint movement up to a certain degree
- Slows the progression, but cannot halt it
Additionally, these treatments require continuous use for persistent results. Due to the absence of tissue repair, the damage often advances to a later stage. At this stage, patients rely on surgical treatment, including damage repair (arthroscopy), bone alignment (osteotomy), or hip/knee joint replacement.
Therefore, research has concentrated on regenerative medicine. It comprises diverse avenues such as platelet-rich plasma (PRP) and prolotherapy that enhance tissue healing. However, Osteoarthritis Stem Cell Treatment has shown the maximum benefits.
Stem Cell Therapy for Osteoarthritis
Stem cells act on the mechanisms behind osteoarthritis. Mesenchymal stem cells (MSCs) have been utilized the most among different stem cell types. They act in the following manner:
- Tissue Regeneration: cartilage damage implies loss of cartilage cells. MSCs replenish their population by the Akt and ERK pathways while inducing repair via long non-coding RNAs.
- Anti-inflammation: MSCs curb inflammation by producing IL6 and TGFβ. They also regulate the COX2-PGE2 pathway for pain relief.
- Alter Immune Response: Inflammation recruits immune cells to the injury site, causing more harm. MSCs suppress the development and activation of immune cells and shift their response towards the reparative process.
Does Stem Cell Treatment for Osteoarthritis Work?
All of the pathways listed above represent years of research in animal models to establish the potential of osteoarthritis stem cell treatment. However, it does not ensure a similar impact on humans. Therefore, scientists have conducted clinical studies on humans to evaluate the potency of stem cell treatment, leading to the following results.
- Injection of MSCs improved the WOMAC (measures pain, stiffness, and function) and VAS (measures pain) scores half a year after treatment. The patients experienced improvement in walking and climbing. Even five years after the treatment, patients sustained the improvements.
- Similarly, two years after MSC injections, patients continued experiencing less pain, enhanced function, and better WOMAC scores.
These trials also demonstrated that MSC administration did not result in the risk of tumors or any other severe disease. Several such clinical trials have ascertained the effectiveness of stem cell therapy.
It is a non-surgical alternative that offers long-lasting results, surpassing the current modalities. With the optimization of the treatment protocol, it will soon be accessible through hospitals as a standard treatment.
Conclusion
Osteoarthritis treatment involves a holistic approach combining medications and physical therapies with lifestyle modifications. However, they can only manage the symptoms without restoring the function. Regenerative medicine for osteoarthritis, mainly stem cell therapy, overcomes the drawbacks of current treatments. The favorable outcomes of clinical trials verify that the therapy is indeed effective. The retention of the outcomes of the treatment for more extended periods is an advantage over other therapies. Advancells empower the rise of Stem Cell Treatment for Osteoarthritis by delivering premium-quality, ethically sourced stem cells.
FAQ’s
Q- Can osteoarthritis be prevented?
Osteoarthritis occurs due to various risk factors. It cannot always be prevented, but the risk can be lowered with healthy lifestyle habits such as maintaining a healthy weight, exercising, avoiding injuries, and choosing supportive footwear.
Q- What distinguishes rheumatoid arthritis from osteoarthritis?
Osteoarthritis results from cartilage breakdown, while rheumatoid arthritis occurs due to the immune system attack on the joints.
Q- Does walking help people with osteoarthritis?
Yes, people with Non-Surgical Osteoarthritis benefit from walking. It strengthens muscles, lessens stiffness, and preserves joint flexibility. Supportive footwear is advised, though, and excessive exertion should be avoided.
Q- Is stem cell therapy effective for osteoarthritis?
Research on animals and humans has supported the positive effects of stem cells on the disorder. Patients have experienced reduced pain and enhanced function for long periods of time, indicating that stem cell therapy is effective.
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