{"id":7300,"date":"2022-04-13T23:55:31","date_gmt":"2022-04-14T05:55:31","guid":{"rendered":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/?page_id=7300"},"modified":"2022-09-15T12:28:01","modified_gmt":"2022-09-15T18:28:01","slug":"standard-7-adjunct-treatments","status":"publish","type":"page","link":"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-standards-toolkit-introduction\/standard-7-adjunct-treatments\/","title":{"rendered":"7. Adjunct Treatments"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#9ab9ad&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;||20px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>ADJUNCT TREATMENTS<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;22px&#8221; text_line_height=&#8221;1em&#8221; header_text_align=&#8221;center&#8221; header_text_color=&#8221;#FFFFFF&#8221; header_font_size=&#8221;38px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>STANDARD 7<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;20px&#8221; text_line_height=&#8221;1.9em&#8221; custom_padding=&#8221;||20px||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>If you\u2019re not able to try the Core Treatments, it\u2019s taking longer than expected to reach your goals, or you need more support to manage symptoms, you can ask about Adjunct Treatments. They include non-medicine and medicine options to improve your pain, movement, and ability to take part in your Core Treatments. Working with your team to develop your Adjunct Treatment plan will ensure that your priorities, values, and preferences are considered when choosing them.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; disabled_on=&#8221;on|off|off&#8221; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#9ab9ad&#8221; background_enable_image=&#8221;off&#8221; background_size=&#8221;contain&#8221; background_position=&#8221;center_left&#8221; custom_margin=&#8221;-12px||||false|false&#8221; custom_margin_tablet=&#8221;-12px||||false|false&#8221; custom_margin_phone=&#8221;0px||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; custom_padding=&#8221;||33px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_image src=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/line-01-e1650521660256.png&#8221; title_text=&#8221;line-01&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; width=&#8221;80%&#8221; max_width=&#8221;80%&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_fullwidth_image][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||0px||true|false&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; top_divider_color=&#8221;rgba(12,113,195,0.32)&#8221; top_divider_height=&#8221;27px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][lwp_divi_breadcrumbs _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/lwp_divi_breadcrumbs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#FFFFFF&#8221; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p class=\"overview\">OVERVIEW<\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul>\n<li><strong>Medicine will never make your OA pain go away. However, it usually helps reduce the pain\u202fabout 30 to 50%.\u200b<\/strong><\/li>\n<li><strong>Your OA\u202fSelf Management\u202fToolkit has some examples of non-medicine and medicine Adjunct\u202fTreatments\u202ffor you to talk to your clinician about.\u200b<\/strong><\/li>\n<li><strong>Opioids aren\u2019t recommended<\/strong>\u202fto treat OA pain as they have serious health and safety risks.\u200b<\/li>\n<li>Health Canada hasn\u2019t approved stem cell therapy for OA because there\u2019s not enough evidence to\u202fprove that it\u2019s safe.\u200b<\/li>\n<li>Cannabinoids aren\u2019t usually used for OA because there\u2019s not enough evidence to prove their\u202fsafety.<\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;18px&#8221; background_color=&#8221;#f2f2f2&#8243; custom_padding=&#8221;20px|20px|20px|20px|true|true&#8221; hover_enabled=&#8221;0&#8243; border_radii=&#8221;on|20px|20px|20px|20px&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<h3 style=\"text-align: left;\"><strong>KEY RESOURCES<\/strong><span style=\"font-size: medium;\"><span style=\"font-size: medium;\"><\/span><\/span><\/h3>\n<ul class=\"fix\" style=\"text-align: left; font-size: medium;\">\n<li><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/3_NEW-FORM-Care-Plan-Documentation-1.pdf\" target=\"_blank\" rel=\"noopener\">FORM to Document\/Modify a Care Plan for Conservative Management of OA\u200b<\/a><\/li>\n<li><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/191.full_.pdf\" target=\"_blank\" rel=\"noopener\">PEER OA Decision Aid<\/a><\/li>\n<li><a href=\"#\" class=\"learn-more ASLM\">Arthritis Society Learning Modules<\/a><\/li>\n<li><a href=\"https:\/\/myhealth.alberta.ca\/health\/pages\/conditions.aspx?Hwid=custom.ab_physio_cane_inst\">How to Use a Cane<\/a><\/li>\n<li><a href=\"https:\/\/myhealth.alberta.ca\/health\/pages\/conditions.aspx?Hwid=custom.ab_physio_walker_inst\">How to Use a Walker<\/a><\/li>\n<li><a href=\"https:\/\/myhealth.alberta.ca\/Alberta\/Pages\/Cannabinoids-and-Managing-Chronic-Pain-.aspx\">Managing Chronic Pain with Cannabinoids<\/a><\/li>\n<li><a href=\"https:\/\/myhealth.alberta.ca\/Alberta\/Pages\/stem-cell-treatment-for-osteoarthritis.aspx\">Stem Cell FAQ<\/a><\/li>\n<\/ul>\n<p style=\"margin-top: 20px;\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/resources-2\/\" style=\"text-align: left;\"><strong>View All Resources<\/strong><\/a><\/p>\n<p><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/references-for-standard-7-adjunct-treatments\/\" style=\"text-align: left;\"><strong>View References<\/strong><\/a>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(12,113,195,0.08)&#8221; background_image=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/shapes-bg-1.png&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p>Core Treatments are the basis of every care plan (<a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-4-core-treatment-1-education\/\">Standard 4<\/a>, <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-5-core-treatment-2-exercise-and-physical-activity\/\">Standard 5<\/a>, and <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-6-core-treatment-3-managing-weight\/\">Standard 6<\/a>). However, Adjunct Treatments can be considered if:<\/p>\n<ul>\n<li>You can\u2019t try the Core Treatments<\/li>\n<li>It\u2019s taking longer than it should to reach your goals<\/li>\n<li>You need more support to manage your symptoms<\/li>\n<\/ul>\n<p><strong>Adjunct Treatments are used to improve your ability to fully take part in your Core Treatments<\/strong>. The clinician can offer evidence-informed, <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW260448796 BCX0\"><span class=\"NormalTextRun SCXW260448796 BCX0\">non-medicine and medicine<\/span><\/span> treatments options to support your goals. If you\u2019re having a lot of pain, trouble doing the Core Treatments, and\/or your symptoms aren\u2019t being managed enough, talk to your clinician about Adjunct options. Muscle weakness, joint pain, and the fear of making symptoms worse can be barriers to doing the prescribed exercises and increasing your activity (<a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-5-core-treatment-2-exercise-and-physical-activity\/\">Standard 5<\/a>).<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600|||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;20px&#8221; global_colors_info=&#8221;{}&#8221;]Dealing with these physical and emotional barriers with Adjunct Treatments can support:[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul style=\"font-size: 18px; list-style: none; color: #000; padding-left: 0 !important;\">\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Strategies to help you manage pain<\/li>\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Improve the stability, strength, and mobility of your affected joint(s)<span class=\"tooltips\"><sup>5<\/sup><span class=\"tooltiptext\"><sup>5<\/sup>Yu SP, Hunter DJ. Managing osteoarthritis. Australian Prescriber. 2015;38(4):115-9.<\/span><\/span><\/li>\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Lifestyle changes<\/li>\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Your long-term commitment to exercise and physical activity<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<\/ul>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]Some of the treatments are in your <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/1b_OA-Self-Management-Toolkit-Treatment-Menu-1.pdf\" class=\"in-text\" target=\"_blank\" rel=\"noopener\">Toolkit Treatment Menu<\/a>. Talk with your clinical team about Adjunct treatments, as you\u2019ll have to pay for some of them yourself. Don\u2019t try an adjunct treatment without first speaking to your clinician.[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_image src=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/DataKnee_MAPtoMOTION.png&#8221; title_text=&#8221;DataKnee_MAPtoMOTION&#8221; align_tablet=&#8221;center&#8221; align_phone=&#8221;center&#8221; align_last_edited=&#8221;on|tablet&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; module_alignment=&#8221;center&#8221; min_height_tablet=&#8221;&#8221; min_height_phone=&#8221;&#8221; min_height_last_edited=&#8221;on|tablet&#8221; height_tablet=&#8221;300px&#8221; height_phone=&#8221;300px&#8221; height_last_edited=&#8221;on|tablet&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||||false|false&#8221; custom_padding=&#8221;||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_image src=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/image-20-03-01-scaled.jpg&#8221; title_text=&#8221;image-20-03-01&#8243; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||-129px|||&#8221; custom_padding=&#8221;||146px|||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(12,113,195,0.08)&#8221; background_image=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/2020\/11\/Background2.png&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Non-Medicine Options<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p>Non-<span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW188594036 BCX0\"><span class=\"NormalTextRun SCXW188594036 BCX0\">Medicine <\/span><\/span>options will help you address the physical and emotional barriers you face in your care journey. <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW188594036 BCX0\"><span class=\"NormalTextRun SCXW188594036 BCX0\">Medicine<\/span><\/span>\u00a0options may help you lower your pain to a level where you\u2019re more comfortable. Talk to your clinician about what you prefer, and which options best suit your needs.<\/p>\n<p><strong>Non-medicine Adjunct Treatments include:<\/strong><\/p>\n<ul>\n<li>Supports (walking and environmental)<span class=\"tooltips\"><sup>1,5<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<br \/><sup>5<\/sup>Yu SP, Hunter DJ. Managing osteoarthritis. Australian Prescriber. 2015;38(4):115-9.<\/span><\/span><\/li>\n<li>Cognitive behavioural therapy (CBT)<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<li>Self-management programs<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;1em&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Supports \u2013 Walking and Environmental<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><strong>Using walking supports can improve your stability, how well you move, lower the risk of falling, and reduce the amount of weight on your hip or knee joint. The table below has examples of supports.<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<th style=\"background-color: #fff2cc;\"><strong>Type <\/strong><\/th>\n<th style=\"background-color: #fff2cc;\"><strong>Facts and Benefits <\/strong><\/th>\n<th style=\"background-color: #fff2cc;\"><strong>Examples <\/strong><\/th>\n<\/tr>\n<tr>\n<td>Assistive Devices<\/td>\n<td>\n<ul>\n<li>Stabilizes the joint by reducing the load on the hip or knee joints<\/li>\n<li>Increases the size of your base of support to improve balance<\/li>\n<li>Moves some of the body weight to the arms<\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li>Canes<\/li>\n<li>Crutches<\/li>\n<li>Hiking poles\/walking sticks<\/li>\n<li>Walkers<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Braces<\/td>\n<td>\n<ul>\n<li>Worn under clothing<\/li>\n<li>Helps support the joint and improve alignment<\/li>\n<li>Redistributes forces on weight-bearing joints<\/li>\n<li>Decreases pain<\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li>Custom offloading brace<\/li>\n<li>Soft sleeve support<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Footwear and Orthotics<\/td>\n<td>\n<ul>\n<li>Decreases pain<\/li>\n<li>Improves overall movement (function)<\/li>\n<li>Improves alignment<\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li>Orthotics: commercial or custom made<\/li>\n<li>Footwear<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Environmental supports can conserve energy and give you options for safe movement. They include the assistive technologies and home adaptions shown below.<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<th style=\"background-color: #fff2cc;\"><strong>Type <\/strong><\/th>\n<th style=\"background-color: #fff2cc;\"><strong>What They Do <\/strong><\/th>\n<th style=\"background-color: #fff2cc;\"><strong>Examples <\/strong><\/th>\n<\/tr>\n<tr>\n<td>Items That Help You with Everyday Activities<\/td>\n<td>\n<ul>\n<li>Save your energy<\/li>\n<li>Reduce painful joint positions<\/li>\n<li>Help you carry out your everyday activities<\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li>Long shoehorn<\/li>\n<li>Long-handled reacher<\/li>\n<li>Sock aids<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Items That Can Help with Your Home Needs<\/td>\n<td>\n<ul>\n<li>Reduce painful joint position<\/li>\n<li>Increase the seat-to-floor height so there\u2019s less force on your joints<\/li>\n<li>Promote safety and help prevent falls<\/li>\n<\/ul>\n<\/td>\n<td>\n<ul>\n<li>Raised toilet seat<\/li>\n<li>Toilet armrests\/commodes<\/li>\n<li>Higher seat\/hip cushions<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Supports can address symptoms and make it easier for you to do your exercise and physical activities. If there are treatment options that would work for you, your primary clinician can refer you to supporting clinicians or medical supply stores that know about the walking supports commonly used by people with hip or knee osteoarthritis. You can also refer yourself to many clinicians who have supports expertise. Supports are usually affordable. However, there may be some funding support so check with your insurance provider or ask your primary clinician if they know about any funding supports.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(12,113,195,0.08)&#8221; background_image=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/shapes-bg-1.png&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;1em&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Cognitive Behavioural Therapy (CBT)<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600|||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;20px&#8221; global_colors_info=&#8221;{}&#8221;]Your osteoarthritis pain experience can be influenced by the physical changes of your osteoarthritis, your emotions, your behaviour, and even how you think<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span>. CBT may:[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul style=\"font-size: 18px; list-style: none; color: #000; padding-left: 0 !important;\">\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Support your mental health<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Help you learn ways to cope with the pain<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul style=\"font-size: 18px; list-style: none; color: #000; padding-left: 0 !important;\">\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Help you learn ways to manage your stress and anxiety<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<li style=\"background-color: #fff; padding: 15px; border-radius: 40px; margin-bottom: 30px;\">Help you change your behaviour<span class=\"tooltips\"><sup>1<\/sup><span class=\"tooltiptext\"><sup>1<\/sup>Bowden JL, Hunter DJ, Deveza LA, Duong V, Dziedzic KS, Allen KD, et al. Core and adjunctive interventions for osteoarthritis: Efficacy and models for implementation. Nature Reviews Rheumatology. 2020;16(8):434-47.<\/span><\/span><\/li>\n<\/ul>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]The clinician may offer advice for these or refer you to <a href=\"#\" class=\"learn-more referralclinicians\">clinicians<\/a> or other trained cognitive specialists that can support you. [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Self-Management Programs<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<p>Self-management programs offer resources and strategies that can help support you. These programs focus on:<\/p>\n<ul class=\"nest\">\n<li><em>Setting priorities and goals<\/em>: Identify and set the <a href=\"#\" class=\"learn-more smartgoals\">SMART goals<\/a> that are important to you<\/li>\n<li><em>Teaching you strategies to monitor your osteoarthritis<\/em> so that you recognize when it\u2019s time to ask for more support or <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW257127805 BCX0\"><span class=\"NormalTextRun SCXW257127805 BCX0\">help you keep working towards<\/span><\/span> your goals<\/li>\n<li><em>Teaching you problem-solving strategies<\/em>: To identify what may get in the way of you reaching your goals, and strategies for how to address them<\/li>\n<li><em>Teaching you strategies to cope with osteoarthritis<\/em>: Give you the tools and guidance to manage the emotional impacts of osteoarthritis for you and your family support systems<\/li>\n<li><em>Teaching you ways to manage your symptoms<\/em>\n<ul>\n<li>Hot and cold therapies: Heat or cold can help relieve joint discomfort. Note: Don\u2019t leave an ice pack on your skin for longer than 20 minutes at a time. The <a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/1_OA-Self-Management-Toolkit-2.pdf\" target=\"_blank\" rel=\"noopener\">Osteoarthritis Self-Management Toolkit<\/a> has more information about hot and cold therapies<\/li>\n<li>Selecting Your Activity: Building your understanding of your local structured exercise programs and physical activity options so you can choose new ones as you wish<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>When these programs are offered in a group setting, they also can help you meet others with osteoarthritis. Having the support of others on the osteoarthritis journey can improve how you manage your osteoarthritis.<\/p>\n<p><strong>All education resources and sessions will be combined with learning strategies to manage your osteoarthritis<\/strong> (<a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-4-core-treatment-1-education\/\">Standard 4<\/a>). The clinician will always work with you to review and modify your self-management strategies and as your symptoms change.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;rgba(12,113,195,0.08)&#8221; background_image=&#8221;https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/wp-content\/uploads\/2020\/11\/Background2.png&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; custom_padding_tablet=&#8221;||0px||false|false&#8221; custom_padding_phone=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Medicine Options<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>There are 3 types of medications:<\/p>\n<ul>\n<li>Non-prescription<\/li>\n<li>Prescription<\/li>\n<li>Joint injections<\/li>\n<\/ul>\n<p><strong>Remember that medicine will never make all your OA pain go away.<\/strong> However, it can help reduce the pain 30% to 50%. That change in pain can help you continue with your Core Treatments, which will then help your osteoarthritis symptoms even more.<\/p>\n<p>Medications can be recommended by a primary care physician and\/or with a pharmacist or nurse practitioner. Before recommending medication it\u2019s important that your clinician team assess:<\/p>\n<ul>\n<li>Your symptoms<\/li>\n<li>Your pain experience<\/li>\n<li>Other health issues you may have<\/li>\n<li>What other medicines you\u2019ve taken<\/li>\n<\/ul>\n<p>Complications, side effects, and possible ways the medication may work together are also considered. Your team will speak with other specialities as needed if there are questions about the medication you\u2019re taking because of another health issue. Joint injections are only done by trained clinicians.<\/p>\n<p>It\u2019s important to talk about ways or strategies for you to manage your symptoms at the same time as planning for a new or different medication. <strong>Medicine won\u2019t stop the pain.<\/strong> Some also have side effects, or your body builds up a tolerance to them, so combining medicine with other non-medicine treatments such as hot and cold therapies and the activities that you choose is the best strategy.<\/p>\n<p>Your clinician will speak with you about all the benefits, risks, side effects, and how to best take the medicine. Make sure to take the medicine as directed and tell your clinician right away if you think you\u2019re having side effects.<\/p>\n<p>It\u2019s also very important to tell your clinician if you have any changes in movement (function), pain, or other symptoms at all follow-up visits, so your medicine can be adjusted.<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_margin=&#8221;0px||||false|false&#8221; custom_padding=&#8221;0px||||false|false&#8221; top_divider_style=&#8221;arrow&#8221; top_divider_color=&#8221;#9ab9ad&#8221; top_divider_height=&#8221;20px&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text module_class=&#8221;heading&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;|600||on|||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;40px&#8221; header_2_font=&#8221;Source Sans Pro|600|||||||&#8221; header_2_text_align=&#8221;center&#8221; header_2_text_color=&#8221;#ffc212&#8243; header_2_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;70px||0px||false|false&#8221; custom_padding=&#8221;||0px||false|false&#8221; text_line_height_tablet=&#8221;&#8221; text_line_height_phone=&#8221;1em&#8221; text_line_height_last_edited=&#8221;on|phone&#8221; header_2_text_shadow_style=&#8221;preset1&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Other Therapies<\/p>\n<p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p>Other therapies include <a href=\"#\" class=\"learn-more jointinjections\"> joint injections<\/a>, which include steroids, hyaluronic acid (HA) preparations, platelet rich plasma (PRP), and stem cells. <a href=\"#\" class=\"learn-more stemcells\">Stem cell<\/a> therapy for osteoarthritis isn\u2019t allowed in Canada.<\/p>\n<p>There are a few <a href=\"#\" class=\"learn-more painmedication\">advanced options<\/a> to help manage pain including:<\/p>\n<ul>\n<li>Peripheral nerve block<\/li>\n<li>Opioids<\/li>\n<li>Referral for a joint surgery assessment (<a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-introduction\/standard-8-being-referred-for-joint-surgery\/\">Standard 8<\/a>)<\/li>\n<\/ul>\n<p><strong>Opioids aren\u2019t the first medication used to treat osteoarthritis pain<span class=\"tooltips\"><sup>8<\/sup><span class=\"tooltiptext\"><sup>8<\/sup>Ivers N, Dhalla IA, Allan GM. Opioids for osteoarthritis pain: Benefits and risks. Canadian Family Physician. 2012;58(12)<\/span><\/span><\/strong> because these drugs can have serious health and <a href=\"#\" class=\"learn-more painmedication\"> safety risks<\/a>.<\/p>\n<p><strong>Cannabinoids<\/strong> have created great interest in people with osteoarthritis. Cannabinoids are compounds found in the cannabis plant (marijuana is a well-known example). However, cannabinoids aren\u2019t usually recommended to treat osteoarthritis<span class=\"tooltips\"><sup>9<\/sup><span class=\"tooltiptext\"><sup>9<\/sup>Toward Optimized Practice (TOP). PEER simplified guideline: Medical Cannabinoids clinical practice guideline. 2018.<\/span><\/span>. Health Canada maintains that there\u2019s no scientific evidence that cannabinoids are safe and work for medical use. The topic Cannabinoids and Managing Chronic Pain from <a href=\"https:\/\/myhealth.alberta.ca\/Alberta\/Pages\/Cannabinoids-and-Managing-Chronic-Pain-.aspx\" target=\"_blank\" class=\"in-text\" rel=\"noopener\">MyHealth.Alberta.ca<\/a> answers many common questions about using cannabinoids.<\/p>\n<p>[\/et_pb_text][el_modal_popup modal_id=&#8221;jointinjections&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;jointinjections&#8221; modal_title=&#8221;Joint Injections&#8221; show_footer=&#8221;off&#8221; modal_header_custom_padding=&#8221;10px|10px|10px|10px|true|true&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; modal_title_text_font=&#8221;|600||||on|||&#8221; modal_title_text_font_size=&#8221;18px&#8221; modal_body_text_font_size=&#8221;16px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<p>Many studies are being done looking at joint injections as a treatment for OA. The study results don\u2019t tell us enough either way if joint injections should be a recommended treatment for OA. Because of this, the clinical guidelines can\u2019t recommend them as a treatment. However, some people have responded well to injections so can keep using them alongside their Cores. Different injections have different purposes, and for some people a combination of injections may be a good choice for them:<\/p>\n<ul>\n<li>Steroid (e.g., cortisone) is a strong anti-inflammatory medication. Steroids generally work quickly and last for 1 to 6 months.<\/li>\n<li>Hyaluronic acid (HA) is a compound found in normal, healthy joint fluid. An arthritic joint has less HA in it. HA injections work best when the arthritic joint isn\u2019t swollen. HA effects generally last 6 to 12 months.<\/li>\n<li>Platelet rich plasma (PRP) is a form of biologic injection that\u2019s becoming used more as therapeutic treatment option. A small amount of your blood is withdrawn in a test tube and then spun in a machine. The blood cells fall to the bottom and the clear yellow fluid (the plasma) floats to the top. The plasma is then injected into the joint. Health Canada hasn\u2019t approved PRP as a \u2018drug\u2019 treatment yet.<\/li>\n<\/ul>\n<p>Only some clinicians are trained to give injections. Steroid, HA, and PRP treatments are given by sterile injection into the knee. This simple procedure can be done in your clinician\u2019s office, or at a diagnostic imaging centre so the clinician can see the joint during the injection.<\/p>\n<p>Only some clinicians are trained to give injections. Steroid, HA, and PRP treatments are given by sterile injection into the knee. This simple procedure can be done in your clinician\u2019s office, or at a diagnostic imaging centre so the clinician can see the joint during the injection.<\/p>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;painmedication&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;painmedication&#8221; modal_title=&#8221;Advanced Pain Medication&#8221; show_footer=&#8221;off&#8221; modal_header_custom_padding=&#8221;10px|10px|10px|10px|true|true&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; modal_title_text_font=&#8221;|600||||on|||&#8221; modal_title_text_font_size=&#8221;18px&#8221; modal_body_text_font_size=&#8221;16px&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<\/p>\n<div class=\"modal-container\">\n<h5>Opioids<\/h5>\n<p><strong>Opioids aren\u2019t usually recommended to treat OA pain.<\/strong> Opioids can:<\/p>\n<ul>\n<li>affect your memory and concentration<\/li>\n<li>increase your risk of a fall<\/li>\n<li>increase your pain symptoms.<\/li>\n<\/ul>\n<p>Opioids can also increase your risk of:<\/p>\n<ul>\n<li>building a tolerance, which means you need a higher dose to get the same effect.<\/li>\n<li>becoming addicted<\/li>\n<li>accidentally overdosing, especially if used with other prescription medicine like sleeping pills, or alcohol, or if you have other health issues like sleep apnea.<\/li>\n<\/ul>\n<p>Before prescribing opioids, your clinician will assess all risks and your medical history carefully. If you do need advanced pain management, your clinicians will prescribe the lowest dose and for the shortest time. A strong opioid prescription plan includes:<\/p>\n<ul>\n<li>a talk about the benefits and risks of opioids<\/li>\n<li>a talk about how using opioids short-term is meant to support you <span data-contrast=\"auto\" xml:lang=\"EN-CA\" lang=\"EN-CA\" class=\"TextRun SCXW116854812 BCX0\"><span class=\"NormalTextRun SCXW116854812 BCX0\">during your core treatments<\/span><\/span><\/li>\n<li>instructions on when to use it, how to use it, and how long it\u2019s for<\/li>\n<li>a follow-up to ensure it\u2019s working and not causing side effects<\/li>\n<li>a naloxone kit with prescription (for some people).<\/li>\n<\/ul>\n<p>Expect your clinician to closely watch for changes in your mobility and movement, that you\u2019re taking the medication exactly as prescribed, and any side effects that may mean your medication needs to be adjusted.<\/p>\n<h5>Peripheral Nerve Blocks<\/h5>\n<p>This is like the \u2018freezing\u2019 used before a procedure, like stitching a wound or filling a cavity. In this case, the freezing is injected around a bundle of nerves. When the nerve is \u2018frozen\u2019, the brain doesn\u2019t get pain messages from the nerves. If freezing the nerve(s) gives enough pain relief, a longer lasting solution may be an option.<\/p>\n<p>If you lose sensation after a nerve block you may be at a higher risk for falls. In this case you may need a walking support after the treatment.<\/p>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;referralclinicians&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;referralclinicians&#8221; modal_title=&#8221;Referral Between Clinicians&#8221; show_footer=&#8221;off&#8221; modal_header_custom_padding=&#8221;10px|10px|10px|10px|true|true&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; modal_title_text_font=&#8221;|600||||on|||&#8221; modal_title_text_font_size=&#8221;18px&#8221; modal_body_text_font_size=&#8221;16px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<table>\n<tbody>\n<tr>\n<th style=\"background-color: #fff;\"><\/th>\n<th colspan=\"9\">Category of OA Treatments<\/th>\n<\/tr>\n<tr>\n<th>Discipline that may offer the treatment<\/th>\n<th>Education<\/th>\n<th>Exercise and Physical Activity<\/th>\n<th>Weight Management<\/th>\n<th>Supports (Walking and Environmental<\/th>\n<th>Cognitive Behavioural Therapy<\/th>\n<th>Self-Management Programs<\/th>\n<th>Non-prescription Pharma Treatments<\/th>\n<th>Prescription Pharma Treatments<\/th>\n<th>Joint Injections<\/th>\n<\/tr>\n<tr>\n<td>Family Physicians<\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X*<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<\/tr>\n<tr>\n<td>Nurse Practitioners<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<\/tr>\n<tr>\n<td>Physiotherapists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td>Restricted<\/td>\n<\/tr>\n<tr>\n<td>Occupational Therapists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X*<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Kinesiologists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Exercise Physiologists<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Sport and Exercise Medicine Physicians<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Radiologists<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Rheumatologists<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Physiatrists<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Chiropractors<\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Orthopaedic Surgeons<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Pharmacist<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Registered Dietitians<\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Counsellors<\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Psychiatrists<\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Psychologists\/Mental Health Therapists<\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td>X<\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Podiatrists<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<\/tr>\n<tr>\n<td>Pedorthists<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>X<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;smartgoals&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;smartgoals&#8221; modal_title=&#8221;Smart Goals&#8221; show_footer=&#8221;off&#8221; modal_header_custom_padding=&#8221;10px|10px|0px|10px|false|true&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; modal_title_text_font=&#8221;|600||||on|||&#8221; modal_title_text_font_size=&#8221;18px&#8221; modal_body_text_font_size=&#8221;16px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<table>\n<tbody>\n<tr>\n<td>S<\/td>\n<td><strong>Specific<\/strong><\/td>\n<td>The goal is specific to the OA treatment selected (e.g., going to the pool for aerobics).<\/td>\n<\/tr>\n<tr>\n<td>M<\/td>\n<td><strong>Measurable <\/strong><\/td>\n<td>How often you\u2019ll do the activity (e.g., going to the pool 2 days a week).<\/td>\n<\/tr>\n<tr>\n<td>A<\/td>\n<td><strong>Attainable <\/strong><\/td>\n<td>The goal is chosen in context of your life (e.g., going to the pool 2 days a week is an important but realistic change from what you\u2019re doing now and a there\u2019s a pool near you).<\/td>\n<\/tr>\n<tr>\n<td>R<\/td>\n<td><strong>Rewarding<\/strong><\/td>\n<td>The goal is meaningful to you. (e.g., going to the pool includes a chance to visit with a close friend and you\u2019ll be working on changes for your OA together).<\/td>\n<\/tr>\n<tr>\n<td>T<\/td>\n<td><strong>Timely<\/strong><\/td>\n<td>The goal has some due dates (e.g., pool visits start next week, and you and your primary clinician will review them in 4 weeks)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p style=\"padding-top: 20px;\">SMART goals take practice to write. They\u2019re the most successful when you and your clinician create them together.<\/p>\n<\/div>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;ASLM&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;ASLM&#8221; modal_title=&#8221;Arthritis Society Learning Modules&#8221; show_footer=&#8221;off&#8221; modal_header_custom_padding=&#8221;10px|10px|10px|10px|false|true&#8221; modal_body_custom_padding=&#8221;25px|20px||20px|false|true&#8221; modal_animation_style=&#8221;slide&#8221; modal_animation_direction=&#8221;left&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;0e4bb1fa-d312-42c0-b873-269eda7f61b5&#8243; modal_title_text_font_size=&#8221;18px&#8221; modal_body_text_font_size=&#8221;16px&#8221; modal_width_tablet=&#8221;100%&#8221; modal_width_phone=&#8221;100%&#8221; modal_width_last_edited=&#8221;on|desktop&#8221; border_color_all_trigger_element=&#8221;#005e85&#8243; border_color_all_modal=&#8221;#005e85&#8243; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/managing-chronic-pain\" target=\"_blank\" rel=\"noopener\">Managing Chronic Pain<\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/medical-cannabis-and-arthritis\" target=\"_blank\" rel=\"noopener\">Medical Cannabis and Arthritis<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/navigating-your-healthcare\" target=\"_blank\" rel=\"noopener\">Navigating Your Healthcare<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/overcoming-fatigue\" target=\"_blank\" rel=\"noopener\">Overcoming Fatigue<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/eating-well\" target=\"_blank\" rel=\"noopener\">Eating Well<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/daily-living\" target=\"_blank\" rel=\"noopener\">Daily Living<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/staying-active\" target=\"_blank\" rel=\"noopener\">Staying Active<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/mental-health-and-well-being\" target=\"_blank\" rel=\"noopener\">Mental Health and Well-being<br \/><\/a><\/li>\n<li><a href=\"https:\/\/arthritis.ca\/support-education\/online-learning\/arthritis-and-work\" target=\"_blank\" rel=\"noopener\">Arthritis and Work<br \/><\/a><\/li>\n<\/ul>\n<p>[\/el_modal_popup][el_modal_popup modal_id=&#8221;stemcells&#8221; trigger_element_type=&#8221;element_class&#8221; trigger_element_class=&#8221;stemcells&#8221; modal_title=&#8221;Stem Cells&#8221; show_footer=&#8221;off&#8221; _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;0e4bb1fa-d312-42c0-b873-269eda7f61b5&#8243; modal_title_text_font_size=&#8221;18px&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"modal-container\">\n<p>Stem cells are cells that can change into any tissue in the body. In theory, stem cells can be changed into cartilage to replace the lost or damaged cartilage in an arthritic joint. Health Canada is studying using stem cells as a treatment so it can\u2019t be used outside the study until more research is done into its safety.<\/p>\n<p>Read more about Stem Cell Treatment for Osteoarthritis (MyHealthAlberta).<\/p>\n<\/div>\n<p>[\/el_modal_popup][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.16&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<a class=\"et_pb_button et_pb_button_0 stickyMenu floating et_pb_bg_layout_light\" href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-standards-toolkit-introduction\/standard-8-being-referred-for-joint-surgery\/\" data-icon=\"5\"><span>VIEW NEXT<\/span><\/a>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.17.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"bookmark\">\n<div id=\"ribbon\"><span id=\"content\"><a href=\"https:\/\/toolkit.albertaboneandjoint.com\/osteoarthritis\/individual-standards-toolkit-introduction\/\">INDIVIDUAL<\/a><\/span><\/div>\n<\/div>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ADJUNCT TREATMENTSSTANDARD 7If you\u2019re not able to try the Core Treatments, it\u2019s taking longer than expected to reach your goals, or you need more support to manage symptoms, you can ask about Adjunct Treatments. They include non-medicine and medicine options to improve your pain, movement, and ability to take part in your Core Treatments. 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