Stopping Joint Pain with NSAIDs

Osteoarthritis medications often recommended as first line offense for joint pain

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) When joints start hurting again, individuals with osteoarthritis might not be sure what step to take first to stop the aching: take medicine, take a hot bath, or what? 

A recently published study found that several osteoarthritis organizations suggested taking topical pain medications first for the chronic joint pain under their current treatment guidelines.

The study findings showed that topical non-steroidal anti-inflammatory drugs (NSAIDs) are increasingly becoming available and are emerging "as an important therapeutic alternative for patients with osteoarthritis," according to the researchers.

"Follow your orthopedic specialist's advice."

The study, led by Steven Stanos, DO, from the Rehabilitation Institute of Chicago at the Center for Pain Management, reviewed current treatment guidelines for patients with osteoarthritis and chronic pain.

According to guidelines released in 2008 by the American Academy of Orthopaedic Surgeons (AAOS), the first line of treatment for osteoarthritis should be low impact exercises, strengthening exercises, taping of the kneecap, weight loss and physical therapy.

If these measures do not work, the AAOS suggested patients take pain medicines like acetaminophen or oral NSAIDs.

Topical NSAIDs (in lotion and cream form) can ease pain, stiffness and physical function. They can cost up to $60. 

At the same time, the National Institute for Health and Clinical Excellence and the American College of Rheumatology both suggested that for osteoarthritis of the hands or knees, oral pain relievers and topical NSAIDs should be considered first.

Several factors go into creating an osteoarthritis treatment plan, Dr. Stanos found. These considerations included looking at the pattern of flares, level of functional disability or impairment and disease progression.

In addition, Dr. Stanos said that a patient's response to treatment, current prescription medications and coexisting conditions should be taken into account.

Specifically, he said doctors should be mindful if a patient has heart disease or gastrointestinal disorders.

The treatments could be viable options for patients with increased risk of gastrointestinal and cardiovascular reactions NSAIDs and in older patients, according to Dr. Stanos.

"Although topical NSAIDs historically have not been prevalent in many of the guidelines for osteoarthritis treatment, recent evidence-based medicine and new guidelines now support their use as a viable option for the clinician seeking alternatives to typical oral formulations…," he wrote in the report.

The study was published online April 3 in the Journal of Multidisciplinary Healthcare. The author has served on an advisory board and on a speakers' bureau in a number of pharmaceutical companies. He also received a grant for research from Pfizer Inc.

Reviewed by: 
Review Date: 
April 13, 2013
Last Updated:
December 2, 2013