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Treatment of osteoarthritis

At the Chiromedic Center, we believe that patient with osteoarthritis approach should be a team approach and a systematic and gradual approach. We aim to control pain and inflammation, maximize function, improve quality of life and prevent progression of the condition.
Dr. Francis Fontaine M.D. Dip. Méd. Sport. CCMF (MSE)
Dr. Francis Fontaine M.D. Dip. Méd. Sport. CCMF (MSE)Médecin généraliste, médecine sportive
Dr. Francis Fontaine M.D. Dip. Méd. Sport. CCMF (MSE)
Dr. Francis Fontaine M.D. Dip. Méd. Sport. CCMF (MSE)Médecin généraliste, médecine sportive
- Dirigeant du Centre Chiromédic
- Diplomé de l’Académie Canadienne de Médecine du Sport et de l'exercice (CASEM)
- Certification de compétence additionnelle en médecine du sport et de l'exercices par le Collège de Médecins de Familles du Canada
- Membre de l’Association québécoise des médecins du sport
- Titulaire d’un doctorat en médecine de l’Université de Montréal
- Titulaire d’un doctorat en chiropratique de l’Université du Québec à Trois-Rivières
- Médecin de l'équipe nationale de Ski Acrobatique du Canada (incluant aux Jeux Olympiques de PyeongChang 2018)
- Consultant pour le Cirque du Soleil
- Médecin dans l'équipe médicale des Jeux Olympiques de Vancouver 2010
- Directeur Médical du Groupe Yvon Michel (GYM)
- Membre de la Society for Tennis Medicine and Science (STMS)

Dre Alexandra Bwenge M.D. Méd. Sport. CCMF (MSE)
Dre Alexandra Bwenge M.D. Méd. Sport. CCMF (MSE)Médecin généraliste, médecine sportive
Dre Alexandra Bwenge M.D. Méd. Sport. CCMF (MSE)
Dre Alexandra Bwenge M.D. Méd. Sport. CCMF (MSE)Médecin généraliste, médecine sportive
- Diplômée en médecine du sport de l'Académie canadienne de médecine du sport et de l'exercice (CASEM)
- Certification de compétence additionnelle en médecine du sport et de l'exercice par le Collège des Médecins de Familles du Canada
- Impliquée avec des équipes et athlètes nationaux

Dre Marianne Chabot, M.D. Dip. Méd. Sport
Dre Marianne Chabot, M.D. Dip. Méd. SportMédecin généraliste, médecine sportive
Dre Marianne Chabot, M.D. Dip. Méd. Sport
Dre Marianne Chabot, M.D. Dip. Méd. SportMédecin généraliste, médecine sportive
- Titulaire d'un doctorat en médecine de l'Université de Sherbrooke
- Diplômée en médecine du sport de l'Académie canadienne du sport et de l'exercice (CASEM)
- Impliquée avec les athlètes nationaux
- Formations en échographie musculosquelettique

The first step will be to evaluate the cause of your pain.

Pain secondary to osteoarthritis can be easily confused with pain caused by soft tissue damage (bursitis) or a biomechanical cause.

The second step will be to evaluate natural or non-pharmacological approaches.

There is obviously weight loss, relative rest, physical care, exercises, orthotics, diet and prevention. In patients with excess weight, even modest weight loss can produce a significant improvement in joint pain and a gain in function.
    
For patients suffering from temporary over-use, rest for a short time, typically 12 to 24 hours can provide relief. Resting for more than 72 hours can lead to muscle atrophy and loss of function.
    
The physical care of your physiotherapy or chiropractic professional improves function and relieves pain by increasing flexibility and strengthening your musculature. Professional supervision will motivate you to continue your exercises while making sure your technique is safe. They will also be able to give your counselors low-impact exercises, warm-up and proper stretching, and orthotics if needed.

If these interventions are not enough, consider the next step:

Interventional or pharmacological approach

At this level, there is an approach with oral medication or an injection approach.

Acetaminophen is the first line at this stage, but anti-inflammatory drugs (by mouth or topical application) and analgesics can also be considered more potent. It will be important to discuss with your doctor the pros and cons of each according to your personal condition.

The injection approach relies mainly on the injection of cortisone, viscosupplementation or platelet-rich plasma.

At the chiromedic center, all the injections are done under ultrasound guidance to ensure the accuracy, efficiency and safety of the injection.

Intraarticular cortisone injection

Cortisone is a potent anti-inflammatory drug, injected directly into the pain site, which comes into action quickly and can relieve several months. Do not exceed 3 cortisone injections per site per year.

Here are the joints we can treat: shoulder, elbow, wrist, finger, hip, knee, ankle and toe.

 

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Viscosupplementation injection : (Durolane, Cingal, Synvisc, etc…)

Viscosupplementation consists of intra-articular injection of hyaluronic acid. This product is similar to the synovial fluid that naturally lubricates our joints. As we age, our normal joint fluid becomes depleted and loses its elasticity and lubricity. The injection of viscosupplementation aims to restore a damping power and lubricate the joint. A well-lubricated joint will be less painful and should deteriorate less quickly. In addition to protecting cartilage, studies report relief up to a year.

Viscosupplementation is possible in the following joints: Knee, hip, shoulder, ankle, elbow, finger and toe.

Platelet-rich plasma injection

Although the PRP was initialy used to treat tendon injuries, multiple studies since 2010 support the use of PRP for osteoarthritis, particularly for the knee and hip. There are several types of PRP preparation and we now have a better understanding of the type of PRP that is indicated for osteoarthritis, a platelet-rich plasma that is low in leukocytes. A December 2018 publication even suggests that the PRP would now be the first choice for treatment of osteoarthritis by injection.

Stem cell injection

A very promising option for the treatment of osteoarthritis is the injection of mesenchymal stem cells. There are currently 2 ways to produce them, either following a puncture of bone marrow in the pelvis or during an aspiration of adipose tissue in the buttock or the abdomen. New, less invasive techniques are being developed to produce stem cells. Many research are under way and the results are promising but currently it is the last resort solution prior to surgery due to its experimental nature.

Book an appointment now

If pain persists and you need help, our multidisciplinary team will be able to get you back on track quickly.