One of the benefits of modern medicine is the large selection of pain relievers available. The challenge is finding the right one at the right dose to reduce your osteoarthritis (OA) pain. With so many available, which is the most effective?
Researchers analyzed 74 studies involving a total of 58,556 people with OA pain in their knees and hips. The studies looked at pain relievers available in the United States, including acetaminophen (Tylenol) and the nonsteroidal anti-inflammatory drugs (NSAIDs) celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Advil, Motrin) and naproxen (Aleve). It also covered medications not available in the U.S., such as etoricoxib, lumiracoxib and rofecoxib.
The results, published online in The Lancet in March 2016, suggest that while the NSAIDs studied reduced OA pain better than taking nothing, diclofenac, at the maximum approved daily dose of 150 mg per day, may be the most effective. The researchers also found that, in general, the higher the dose, the better the drugs worked.
But there are caveats, says Marcus M. Reidenberg, MD, professor emeritus of pharmacology at Weill Cornell College of Medicine in New York: “The average follow-up was 12 weeks. Osteoarthritis is a lifetime disease. Sometimes people use a drug for a while and then it stops working, so they switch to another,” says Dr. Reidenberg, who was not involved with the study. Plus, the age of the study participants was, on average, 58 to 71. Also using oral NSAIDs for a long time can result in stomach problems like bleeding, ulcer, and stomach upset, as well as high blood pressure and kidney problems. Other harmful side effects that increase with age include a higher risk for cardiovascular and gastrointestinal events.
“The bottom line is that it may come down to cost and medical history, including your individual risk of side effects,” Dr. Reidenberg says.
A chronic condition, such as OA can be challenging to treat. Experts believe that a multidisciplinary team of health care providers using different pain management approaches is the most effective strategy rather than relying on a particular medication.
September is Pain Awareness Month! Visit our Breaking the Pain Chain Toolkit, sponsored by Biofreeze, for practical tips on how to create and enact a personalized pain management plan to help you manage your pain and preserve your quality of life.
Author: TERRI D’ARRIGO
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