In terms of what we can do for osteoarthritis and what is osteoarthritis – which is a term we hear a lot on television, we see in printed advertisements from companies that are selling anti-inflammatory medicines, whether its aspirin or whether its ibuprofen or some other form of an anti-inflammatory. It's very widespread, lots of people have osteoarthritis, most people have osteoarthritis. Osteoarthritis means inflammation of a bone joint and the reaction of the body to that inflammation. And actually in some cases, there is a significant percentage of people who do not have pain from their osteoarthritis that can develop over a long period of time. There is inflammation, but it’s really so clinical and people aren't debilitated by it although it may bother them from time to time, but their joints continue to deteriorate as a result of this chronic inflammation. They'll enlarge the tissues around the joint or the joint capsules will thicken up and sometimes partially calcify. And at any point in time, with or without any additional trauma or what seems like minimal trauma – a hard sneeze, a cough, bending over to pick up an empty Coke can off the floor – you feel something snap or move and all of a sudden you have pain. And that’s just like a knee that you've been dealing with for years and years that suddenly just gets worse; you’re just standing there and you move to twist and all of a sudden your knee gets worse, you’re limping on it for days or weeks or it even swells up because you have caused additional damage inside the joint which is now kicked you over from a minor problem to a more significant one.
Anti-inflammatories will many times work for that knee for a period of time, whether you take them by mouth or maybe you take them by injection at the doctor’s office or whether they actually inject them into the joint. And that's true for the joints in your back too. You can treat it by mouth; you can treat it by injections in the muscles at the doctor’s office, or injections into the joint with anti-inflammatory medications. The anti-inflammatory medicines are pure and simple just decrease, chemically interfere with and decrease the inflammatory response, which means that swelling subsides, which means that tissue will loosen up and move more normally, but it doesn't correct the fact that you have osteoarthritis and degenerative changes in those joints. A lot of patients, a lot of people go through phases with their osteoarthritis it's a little uncomfortable occasionally, it becomes more uncomfortable more frequently, maybe some episodes of severe that lasts for minutes, hours, a day or two and then they're back. They don't have trouble for weeks or months or they can get into situations, a small percentage, where they have literally the most amount of pain and those are the situations where we have to get much more aggressive with thoughts of surgical intervention and fixating those joints or cutting those joints out, etcetera.