Medication Use

Pain Killers (Analgesic Medications)

Paracetamol (acetaminophen) somewhat alleviates the pain of mild to moderate osteoarthritis. There is strong scientific evidence confirming this. Additionally, Paracetamol has been proven to be more effective in combination with tramadol or another weak opioid than as monotherapy [1]. Some studies have found approximately 20% of low grade OA patients taking tramadol, stop taking their medication due to insufficient relief [1].

There is strong scientific evidence that Tramadol is as effective as weak opioids for musculoskeletal pain. However, the adverse events of Tramadol are to the same extent as opioids [1].

Current analgesic medications have shown limited effectiveness for long-term osteoarthritis. The adverse events associated with analgesics often prohibit long term use for patients [2].

Medication is unlikely to be a complete solution for people with Osteoarthritis, and even when pain relief is achieved, nonmedical interventions, such as physiotherapy, occupational therapy, orthotics, or psychological treatment, might be needed to restore normal function and well-being [2].

Opioids

Studies have shown opioids reduce severe osteoarthritis pain by approximately 24% [1]. Weak opioids reduce mild to moderate osteoarthritis and low back pain by approximately 40% and they are as effective as NSAIDs for osteoarthritis pain [1].

Opioids can cause unpleasant adverse effects. Majority of the common side effects can include constipation, fatigue, dizziness, nausea and vomiting for over 50% of patients utilising these medications [1]. Opioids such as Carbamazepine and Gabapentin (Neurontin) have shown the ability to help with neuropathic pain as well as arthritic pain [1].

NSAIDs (Anti Inflammatory Medications)

NSAID’s, fully known as “nonsteroidal anti-inflammatory drugs”, have been studied in depth. Previous literature shows, they are able to reduce the pain of osteoarthritis by at least 30% [1]. Combining NSAIDs with other analgesics and/or opioids (as guided by your doctor) have shown complement pain reduction [1]. NSAIDs can have similar adverse events as analgesics and opioids have previously shown, however they can also increase the risk of cardiovascular events [1].

Topical Analgesics Creams (heat creams and anti-inflammatory creams)

Topical analgesic creams are often used for a variety of conditions involving acute or chronic pain. Most common use is around sprains and muscle aches [3]. They have presented some effect in helping with early stages of osteoarthritis pain involving the hand or knee joints, as well as minor neuropathic pain [3].

Studies observing persistent 6 to 12 week use of topical analgesic creams in the application of chronic osteoarthritis in the hands and knees confirm limited effect [3].

Anti-depressants

Unfortunately, depression is common among patients suffering from long-term osteoarthritis. Studies have observed over 2000 patients and approximately 30% of these patients were identified to have potential depression [9]. As general health declined for these patients, the impact of depression had become worse.

Amongst all of the patients who were deemed to have potential depression, only 50% of them received treatments to improve their mental health [9].

This means, osteoarthritis can potentially lead to depression and depression needs to be diagnosed then treated to improve patient’s quality of life.

In relation to pain relief, antidepressants have shown efficacy in managing pain [1] but they are far more useful in treating mental issues caused due to OA.

 

OVERVIEW OF MEDICATION USE

All of these options as discussed above have been deemed as a cost-effective option for managing chronic pain. These options can come with severe side effects if used for long periods of time [1], [2]. In some cases, eliminating pain only masks signals and causes further damage in the long run.

 

Read about more treatment options for osteoarthritis on this page.

 

All references can be found in our list of references page here.