|Treatment depends upon the specific diagnosis and the underlying cause of joint pain or inflammation. Analgesic and anti-inflammatory oral medications are used in early and in late stage arthropathy. In some diseases (e.g., rheumatoid arthritis), potent anti-inflammatory medications may be used to reduce the destructive inflammatory process, and immunosuppressive drugs, disease modifying antirheumatic drugs (DMARDS), or biologic therapies may be used to slow the progression of the disease. In other diseases such as osteoarthritis, medication may control symptoms but does not change the progression of the disease. Short-term immobilization using a resting splint or special immobilizing boot may help decrease the speed of joint destruction in a peripheral joint. Arthropathy may be treated with physical and/or occupational therapy to instruct the individual in stretching and strengthening exercises, as well as in joint protection strategies. Antibiotics may be required to treat arthropathy secondary to underlying infectious arthritis.|
Painful spinal joints can be selectively injected with a local anesthetic and an anti-inflammatory corticosteroid to reduce back pain. Similarly, joints in the upper and lower limbs may be injected with an anti-inflammatory corticosteroid or with hyaluronic acid derivatives to improve joint lubrication. The pain relief from injections is temporary. If effective, the injections can be repeated.
Surgery may be required in cases of severe arthropathy. In the spine, hypertrophic facet arthropathy may require partial facetectomy, decompressive laminectomy, or spinal fusion if spinal nerves are being compressed by new bone formation. Spinal fusion may also be necessary if spinal instability is present. If a joint is unstable, arthrodesis may be necessary using stabilizing hardware (internal fixation) or bone grafting to stabilize the joint and reduce pain. Total joint replacement may be necessary (e.g., total knee or hip replacement) if joint surfaces have been destroyed.
Source: Medical Disability Advisor
|ACOEM's Practice Guidelines, the gold standard in effective medical treatment of occupational injuries and illnesses, are provided in this section to complement the disability duration guidelines.*|
|* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before assuming an equivalence.|
Source: ACOEM Practice Guidelines