Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Osteoarthritis (OA)

June 28, 2002

Millions of individuals with OA have experienced joint pain relief and

improved mobility after taking an NSAID. This type of drug has become the

drug of choice in treating OA. Even though this drug has proven to be

effective, there are some controversial issues surrounding NSAIDs.

Several NSAIDs used in treating OA have been shown to inhibit processes that

occur normally in cartilage, and may cause further damage and further

breakdown in the joint. Because patients with OA often present to the

physician after joint pain develops, it makes it difficult to gather

information about early changes in the cartilage. Studies are currently

being conducted to gather more information about NSAIDs and OA.

The major reason patients with OA seek medical treatment is because of pain.

It is unclear why there is pain in OA, but some suggest that it may be due

to inflamed fluid in the joint, stretching of the nerve ending, decreased

blood flow to the joint, distention of the joint, or muscle spasm. The

belief that NSAIDs provide pain relief indicates that these medications have

pain relief effects that work in other ways besides anti-inflammatory

effects. It has been said that NSAIDs relieve joint pain in OA by affecting

blood flow or pressure in the bone.

Relief of joint pain can be achieved with analgesics such as acetaminophen,

or with low doses of aspirin or other NSAIDs. In many patients, a pure

analgesic will be as effective as an NSAID in providing pain relief. Some

patients may benefit from acetaminophen, while some patients may see

benefits from NSAIDs. It is difficult to determine who will respond to what

medication. Because of side effects, it is reasonable that acetaminophen is

used as the first line treatment. Studies are still being conducted to

determine the effects of NSAIDs on cartilage. New research is also being

conducted to find new drugs that affect other factors than the inflammatory

response that may be important in the cause of OA.

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