Popular Pain Reliever Doesn't Work for Osteoarthritis Patients

Patients suffering from complications associated with osteoarthritis often reach for over-the-counter pain relievers.

However, a recent study published in the Lancet found that paracetamol, sold in the US as acetaminophen under the brand name Tylenol and as a generic, does not effectively reduce pain and improve movement in patients with osteoarthritis of the knee and hip.

To understand the efficacy of different types and doses of pain relievers for treating osteoarthritis pain, researchers reviewed 74 randomized trials published between 1980 and 2015, which included a total of 58,556 patients with osteoarthritis.

The studies assessed 22 treatments, including many different dose levels of paracetamol, and seven different non-steroidal anti-inflammatory drugs (NSAIDs) that included aspirin and ibuprofen.

Findings suggested a daily dose of 150 mg of NSAID diclofenac is the most effective NSAID available.

However, physicians are urged to carefully consider long-term NSAID prescriptions, as they carry risks such as serious gastrointestinal and cardiovascular side effects.

Sven Trelle, MD, University of Bern in Switzerland, said in a news statement, “NSAIDs are usually only used to treat short-term episodes of pain in osteoarthritis, because the side effects are thought to outweigh the benefits when used longer term. Because of this, paracetamol is often prescribed to manage long-term pain instead of NSAIDs. However, our results suggest that paracetamol at an dose

The researchers said, “We see no role for single-agent paracetamol [acetaminophen] for the treatment of patients with osteoarthritis irrespective of dose.”

According to Nicholas Moore, PhD, University of Bordeaux, the study has its limitations, especially since other popular NSAIDs weren’t included in the study, “probably because no recent trials have been done of these drugs or because any recent trails that did assess them were too small.”

Allyson Shrikhande, MD, physiatrist at Lenox Hill Hospital, said, “The classic teaching in residency in medical school for first line treamtne tof osteoarthritis is to start with Tylenol. At this point, physicians are starting to see that it may be outdated.”

According to Shrikhande, although acetaminophen can certainly help reduce the pain, it doesn’t have any effect on inflammation.

As such, this is why NSAIDs are preferable for two-week intervals, since it works better to decrease pain and improve inflammation. However, for long-term chronic pain, there still seems to be no good oral medication on the market.