How Chondrocalcinosis Is Treated

Chondrocalcinosis, also known as calcium pyrophosphate deposition (CPPD) and pseudogout, is a condition where calcium pyrophosphate crystals build up in the joints. It is a type of arthritis that causes inflammation, stiffness, tenderness, redness, and warmth of the joints. It usually affects one joint, but it may also affect several joints at once.

Symptoms of chondrocalcinosis can be similar to gout (a type of arthritis caused by uric acid crystals in the joints) or other kinds of arthritis. According to the College of Rheumatology, chondrocalcinosis affects around 3% of people in their 60s and 50% of people in their 90s.

When CPPD crystals form, they will deposit themselves in the cartilage (the cushion between the bones) and the synovial fluid (the lubricating fluid found in the joints). Crystal buildup can lead to sudden, painful attacks similar to what is seen and felt with gout.

A major difference is that gout is caused by uric acid crystals in the joints, as mentioned above, while a buildup of calcium pyrophosphate crystals causes chondrocalcinosis. Without diagnostic testing, chondrocalcinosis might be mistaken for gout.

There is no cure for chondrocalcinosis, but treatment can help relieve pain and symptoms and improve joint function. It is treated using various home remedies, lifestyle changes, over-the-counter (OTC) medicines, prescriptions, and complementary and alternative medicine therapies. Surgery is considered when other therapies haven’t helped.

Home Remedies and Lifestyle

Home remedies and lifestyle changes can help prevent chondrocalcinosis attacks and treat symptoms. Things that might help include resting and elevating the affected joint, icing a swollen and painful joint, or paying attention to your diet to reduce inflammation.

Rest and Elevation 

A painful joint is hard to use. Resting the joint for a day or two might help reduce inflammation, pain, and other symptoms. Elevating the affected joint is also helpful. If your knee has been affected by chondrocalcinosis, placing your foot on a footrest or lying down with your foot propped may reduce pain and other symptoms.

Cold Therapy

Cold compresses applied to an affected joint can help relieve pain and decrease swelling during a chondrocalcinosis flare-up. Any cold pack (i.e., an ice pack or bag of frozen peas) can numb the sore joint and reduce inflammation and pain.

Diet

Your diet can help manage inflammation associated with chondrocalcinosis. Try eliminating foods that promote inflammation. This includes added sugars, trans fats, red and processed meats, and omega-6 fatty acids (i.e., canola or corn oils, mayonnaise, etc.).

Instead, try eating more foods that contain omega-3 fatty acids, such as sardines, salmon, walnuts, and flaxseeds to help reduce or prevent inflammation. A plant-based diet loaded with antioxidant-rich fruits and vegetables can also help to ward off inflammation.

Over-the-Counter (OTC) Therapies

Healthcare providers usually recommend OTC nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesic pain relievers, like acetaminophen, to manage symptoms of chondrocalcinosis attacks.

OTC medicines are those you can buy without a prescription at a local or online retailer. Both NSAIDs and acetaminophen can have side effects and should only be used as directed by a healthcare provider.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are given in low doses to treat inflammation from chondrocalcinosis. These medications can help in treating acute flares associated with the condition. Left untreated, flares can last for long periods or become severe.

Two powerful NSAIDs, ibuprofen and naproxen, can usually reduce inflammation and pain pretty quickly. They help because they block cyclooxygenase (COX), an enzyme known for producing pro-inflammatory substances called prostaglandins. Low-dose OTC NSAIDs can help manage chondrocalcinosis flares.

Even so, despite their effectiveness, NSAIDs are known for their side effects and the potential for drug interaction. Therefore, it is a good idea to stop using an NSAID pain reliever as soon as the pain from the flare lessens. Long-term use of NSAIDs has been linked to kidney damage and peptic ulcers.

Ask your healthcare provider whether it is safe for you to use NSAIDs to manage chondrocalcinosis, at what dose, and for how long.

Tylenol (Acetaminophen)

Your healthcare provider might recommend an analgesic medication, such as Tylenol (acetaminophen), to manage pain related to chondrocalcinosis attacks. However, acetaminophen won’t help with inflammation and swelling.

Acetaminophen might be a better option over NSAIDs for people with high blood pressure or a history of stomach bleeding or ulcers. However, acetaminophen can cause liver damage and liver failure, especially if taken in high doses.

Talk to your practitioner before starting acetaminophen to determine if it is a safe option, especially if you have other conditions and take other medicines.

Prescriptions

When OTC pain relievers don’t help manage chondrocalcinosis, your healthcare provider might suggest prescription NSAIDs, corticosteroids, or a gout drug called Colcrys (colchicine).

Prescription NSAIDs

Prescription-strength NSAIDs, such as naproxen and indomethacin, can help manage pain and inflammation during chondrocalcinosis attacks.

Colcrys (Colchicine)

Colcrys (colchicine) is a gout medicine that can help to manage symptoms of chondrocalcinosis. If you have frequent attacks, your healthcare provider might prescribe Colcrys taken daily to prevent subsequent flares.

Corticosteroids

Corticosteroids are strong anti-inflammatories that are quite helpful in treating chondrocalcinosis and are a better option for people who can’t take NSAIDs.

Corticosteroids are often given as oral tablets. They can also be given intravenously (through an IV) or intra-articularly (as an injection into a joint). Oral corticosteroids are prescribed for severe attacks that affect more than one joint, but are usually tapered off after a short time. Injections can be helpful for acute attacks.

Other Prescription Drug Options

For some people, NSAIDs, corticosteroids, and colchicine don’t offer symptom or preventative relief from chondrocalcinosis. In these instances, your healthcare provider might prescribe disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and hydroxychloroquine:

• Methotrexate: No large randomized controlled trials support the use of methotrexate in CPPD, though smaller trials and case studies have shown promise.
• Hydroxychloroquine: Hydroxychloroquine can help reduce inflammation. It works by blocking the activity of certain inflammatory-producing substances.

Complementary and Alternative Medicine (CAM)

Prolotherapy, also known as regenerative injection therapy, is a complementary therapy used to treat joint and muscle pain. It involves repeated injections of an irritant solution (such as a sugar solution) into a part of an affected joint or a surrounding tendon or ligament.

The irritant is thought to trigger the growth of the connective tissue around the joint, eventually reducing pain. While the research is limited on the effectiveness of prolotherapy for treating chondrocalcinosis, some evidence suggests it might help with treating chondrocalcinosis of the knee.

Your healthcare provider is in the best position to answer your questions about prolotherapy and provide medical advice on whether this alternative therapy can help to manage your symptoms or prevent future attacks.

Procedures and Surgery

Additional options for treating chondrocalcinosis are joint aspiration and surgical intervention.

Joint Aspiration

Joint aspiration can help relieve pain and pressure from a joint affected by chondrocalcinosis. This is done by removing some of the fluid and crystals from the joint. After the fluid is removed, your healthcare provider will insert a numbing treatment and use a corticosteroid to help reduce inflammation.

Surgery

Chondrocalcinosis isn’t treated with surgery. However, if left untreated or if joint damage occurs, your healthcare provider might recommend surgery to repair or replace affected bones or joints.

A Word From Verywell

A chondrocalcinosis flare-up can last anywhere from a few days to several weeks. Most people can manage their symptoms at home, and your practitioner can offer treatments to help prevent future episodes. 

Make sure you talk to your healthcare provider about all the potential side effects and interactions of the medicines you use to treat chondrocalcinosis. Older adults, who are more likely to have this condition, are at an increased risk for severe side effects or interactions. Always inform your practitioner about changes to your health or the medications you take.