Hip osteoarthritis: Drug treatments

Anti-inflammatory drugs are useful for reducing or even blocking the inflammation that occurs in osteoarthritis at the time of flare-ups.

They are very useful in these cases because there is evidence to show that there is a strong risk of cartilage damage during flare-ups.

The faster this flare-up is brought under control, the more you limit damage to the joint.There are two types: steroidal anti-inflammatory drugs which are derivatives of cortisone and non-steroidal anti-inflammatory drugs or NSAIDs which do not contain any. The former are used in osteoarthritis locally when injected directly into the joint.

There are numerous NSAIDs. Aspirin is one of them when used at a dose greater than 2 grams per day. All NSAIDs can be used in osteoarthritis (except those containing phenylbutazone).

Their use is reserved for treating inflammatory flare-ups of osteoarthritis. They should always be prescribed for a short duration, usually not exceeding 10 days.

There is no NSAID drug that is completely more effective than the others. In fact it is undeniable that there are susceptibilities for each individual which means that a NSAID will be very effective in one person when it will be ineffective in another.

NSAIDs are known to be responsible for digestive disorders and in particular for causing ulcers. It is an undeniable risk, particularly in the elderly and in patients who have already had an ulcer Similarly the use of tobacco or alcohol increases this digestive risk This risk is not related to taking the drug orally, but is the same even if NSAIDs are administered in the form of suppositories or intramuscular injections. However it is possible to manage this risk, because medications that protect the stomach may be associated in people at risk Lastly, you need to keep in mind that the risks are offset by the definite efficacy of these drugs. In addition there are new generation NSAIDs: coxibs. Because of their particular action mechanism, these drugs are as effective as classic NSAIDs but have the advantage of being better tolerated by the stomach.

Other side-effects are possible: allergies, impaired kidney function, coagulation disturbances.

Your doctor is aware of the side-effects of NSAIDs and only he or she is able to judge the need for taking NSAIDs.

Never combine two anti-inflammatory drugs at the same time and tell your doctor if you are taking aspirin: this combination is also contraindicated. Do not decide to take an anti-inflammatory drug by yourself without notifying your doctor.

Slow acting anti-arthritic drugs or SAARDs are drugs used specifically in osteoarthritis. They have the ability to reduce the intensity of pain. Their effectiveness on painful symptoms of osteoarthritis of the hips and knees has been proven.

Several drugs based on plant extracts are currently available in France.

Their characteristic is twofold: firstly they all have a delayed action which means that you have to take them for several weeks to several months before seeing how effective they are. Secondly, even after stopping the treatment, their effectiveness persists for some time.

In addition to efficacy, these treatments are generally very well tolerated and have few disadvantages.

Do not stop taking these drugs after a few days for inefficiency, but wait for a few weeks of treatment before assessing whether they are of interest or not.

In the event of painful osteoarthritis, while the treatment is getting underway, continue taking analgesics and/or NSAIDs.

The role of analgesics, also simply called painkillers, is to relieve pain.   

Those which act on the actual site of the osteoarthritic pain, i.e. the joint, are called peripheral analgesics. Some non-steroidal anti-inflammatory drugs at low doses can also be used for their action against pain. 

There are others that affect the way pain is perceived by the brain. These are called central analgesics. The main ones are dextropropoxyphene, codeine and caffeine. They have a superior action to the aforementioned drugs and should be offered only if the peripheral analgesics have failed to relieve pain.   

"Strong" central analgesics relate to morphine and its derivatives. They are necessary only exceptionally in osteoarthritis. If a doctor is required to prescribe them, he or she must do so according to very strict rules of use.

Taking analgesics should be based on the pain.   

if the pain is permanent, they should be taken several times at regular intervals throughout the day, usually every 6 hours. In cases of intermittent pain, the time to take them should be based on the onset of pain. Meals do not influence the effectiveness of painkillers; they can be taken at the most appropriate time in relation to pain.   

So, as you can see, you have an important part to play in managing your pain so as to determine exactly when the pain relief will be most useful

Peripheral analgesics are generally well tolerated, but care must be taken not to exceed the maximum dose recommended by your doctor on the prescription. 

Although rare, side-effects can be caused by peripheral analgesics (liver problems, allergies, etc.) Your doctor is aware of them and will choose the most suitable drug for you. Side-effects are unpredictable.   

Central analgesics may cause drowsiness, nausea, constipation and dizziness. It is important to know that these unpredictable side-effects usually stop with continued use of the drug. However, these analgesics should be monitored by your doctor. Follow your doctor's prescription to the letter and do not hesitate to ask him or her any questions that you might have.   

Do not combine two painkillers yourself as it is usually unnecessary and increases the risk of side-effects.