Definition
Among the rheumatic diseases, osteoarthritis (or osteoarthritis) is certainly one of the most common: we are talking about a chronic pathological condition affecting the joints, in which there is a progressive degeneration of the articular cartilages.
Causes
In all likelihood, arthrosis depends on a set of predisposing factors (multifactorial etiology), therefore it is not possible to identify a single cause. Risk factors include: haemophilia, advanced age, recurrent joint injuries, hip dislocation, genetic predisposition, obesity / overweight, scoliosis, dangerous sports.
Symptoms
More than symptoms, osteoarthritis is diagnosed mainly on the basis of radiological and pathological criteria: in patients suffering from arthrosis damage is observed on the surface of articular cartilage and bone remodeling. In the event of severity, arthritis is characterized by a marked reduction in joint space. Osteoarthritis generates joint pain, swelling and bone stiffness.
Diet and Nutrition
Information on Osteoarthritis - Drugs for the Treatment of Arthrosis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Arthrosis - Arthritis Treatment Medicines.
drugs
Like rheumatoid arthritis, even osteoarthritis cannot be cured permanently; however, compliance with certain precautionary rules and the administration of pain-relieving drugs can alleviate pain and, above all, prevent the degeneration of the disease.
In general, non-pharmacological therapies must be encouraged, such as the reduction of body weight (indispensable in an obese affected by arthrosis) and constant exercise, in order to maintain good joint mobility.
As far as pharmacological measures are concerned, paracetamol is the first choice drug for pain control; in case of medium and severe pain, it is possible to combine more drugs (eg paracetamol and ibuprofen). Sometimes the pain that accompanies osteoarthritis is so strong that opioid medication is needed.
Hyaluronic acid and chondroprotective drugs are used for osteoarthritis in the infiltrative treatment of the knee: these active, in addition to delaying the damage to the cartilage, are able to defend the joints, making them less fragile.
Oral anti-inflammatory drugs for pain control:
- Paracetamol or acetaminophen (Acetamol, Tachipirina, Sanipirina, Efferalgan, Normaflu): paracetamol is considered the first-line drug for the treatment of pain control associated with osteoarthritis. The efficacy of this drug is comparable, in this case, to that exerted by acetylsalicylic acid, although - it must be remembered - it does not carry out any anti-inflammatory activity. Formulated tablets with both active ingredients are available: to control the pain, take orally 2 capsules (formulated with 250 mg of paracetamol and 250 mg of acetylsalicylic acid) every 6 hours. It is recommended not to exceed 8 capsules per day. In monotherapy, paracetamol is administered at a dose of 0.5-1 gram, every 4-6 hours (do not exceed 4 grams per day).
- Ibuprofen (eg. Brufen, Moment, Subitene): to treat pain associated with osteoarthritis, it is recommended to start therapy with 400-800 mg of drug, to be taken orally, every 6-8 hours. The maintenance dose can increase up to a maximum of 3200 mg, based on the patient's response.
- Naproxen (eg. Aleve, Naprosyn, Prexan, Naprius): indicatively, take 250-500 mg of naproxen or 275-550 mg of naproxen sodium orally, twice a day. For the maintenance dose, it is possible to increase the dosage up to 1500 mg of naproxen or 1650 mg of naproxen sodium, fractionated in two doses, for a period of six months.
- Indomethacin (eg Difmetre, Indom, Liometacen): for the treatment of pain associated with osteoarthritis, it is possible to take the drug in the form of immediate-release tablets (25 mg orally, every 8-12 hours, up to a maximum of 150-200 mg), on a full stomach, immediately after meals. It is possible to combine antacid drugs to buffer the acidity created by the drug (typical side effect). For slow-release tablets, take 75 mg of active, per os, once a day; for the maintenance dose, it is possible to increase the dosage up to 75 mg twice a day. The drug is also available as suppositories to be taken rectally: in this case, the expected dose is 50 mg, every 8-12 hours.
- Nabumetone (eg. Nabuser, Artaxan, Relifex): this anti-inflammatory-painkiller drug is generally taken orally, at an initial dose of 1 gram per day, before going to bed. The maintenance dose is expected to take 1.5-2 grams of the drug a day. Do not exceed 2g / day.
- Piroxicam (eg Feldene, Piroxicam EG, Artroxicam): take 20 mg of the drug orally, once a day; alternatively, take 10 mg of active, twice a day. Do not exceed 20 mg daily.
- Glucosamine (eg Xicil): indicated for treating mild and moderate knee pain in the context of arthrosis. Indicatively, take 1.5 grams of active once a day. In case of lack of effectiveness after 2-3 months of therapy, it is possible to change the drug. This drug can also be used for knee infiltration.
- Celecoxib (eg Aleve, Naprosyn, Prexan, Naprius): the drug is a selective inhibitor of cyclooxygenase 2, indicated to treat pain in the context of osteoarthritis when paracetamol is not sufficient to guarantee a beneficial effect, and when other NSAIDs they increase the risk of bleeding on the gastro-enteric apparatus. Take 200 mg once a day, even splitting the load into two separate doses.
Local application / infiltration drugs for pain control in osteoarthritis:
- Capsaicin (eg Qutenza): for the symptomatic treatment of osteoarthritis it is possible to apply an ointment formulated with capsaicin 0.025% on the skin, for 1-2 weeks, 3-4 times a day, or until the pain is remitted. The drug can cause a burning sensation, especially during the first applications; however, the side effect is generally transitory. Avoid contact with eyes and irritated or injured skin.
- Methylprednisolone acetate (eg Medrol, Urbason, Solu-Medrol): the infiltration of corticosteroids on the knee can benefit the patient with arthrosis; however, the therapeutic effect is often transient, particularly when the disease is associated with inflammation of the soft tissues. As an indication, the dosage plans to inject 4 to 120 mg of drug weekly or monthly. The dosage and frequency of injections should be established by the doctor based on the severity of the osteoarthritis and the intensity of the pain.
- Sodium hyaluronate (eg Artz injectable): the drug is injected into the joint affected by osteoarthritis. The analgesic effect varies from 1 to 6 months, depending on the severity of the condition; in the short term, infiltration of sodium hyaluronate can aggravate knee inflammation. The drug is available in 2.5 ml vials; injections can be made weekly or monthly, depending on the severity of the osteoarthritis. Consult your doctor.
