BIOL 3051 Chapter Notes - Chapter 4.2: Cognitive Behavioral Therapy, Duloxetine, Osteoarthritis
20 Apr 2020
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Mild knee oa low levels of knee pain, well-preserved joint function & quality of life. Nonpharmacologic therapies alone or combo with topical therapies or analgesics on prn basis are likely to provide adequate control of symptom. Moderate/severe knee oa persistent pain, significantly impairs functionality, activity participation, & quality of life. Nonpharmacologic interventions are also first-line therapy plus treatment alternatives (nsaids), intra articular steroids, duloxetine, and possibly surgery. Non-pharmas: exercise, weight management, knee brace, walking device, cognitive behaviour therapy for pain coping. Pharms: nsaids duloxetine intraarticular glucocorticoids injection (short-term pain) orthoedic surgery. Knee oa with one or more joints involved prioritize therapies that address pain at individual level & not joint level. Patient with comorbidities (eg, cv, diabetes); therapies should be chosen to minimize adverse events while optimizing function and quality of life. Non-pharmacological therapies (1st line of therapy in oa): Non-pharms implemented for all. pharmacotherapy halt progression of disease, rather it helps manage symptoms.
