Medication

The good, the bad, and the downright ugly…

Well, it’s all a bit of a minefield, so where to begin?  The purpose of this page is to consider potential prescription medication which is intended to alleviate pain and other symptoms of osteoarthritis.

Once diagnosed with osteoarthritis, an individual would probably be offered a variety of prescription medication in the hopes of finding something which works for them.  It is not a cure; if you are lucky, you might find something which could alleviate some of the symptoms and enable effective pain management, but it is most likely that medication will be necessary in varying degrees for the rest of your life.  The purpose of the medication is to address the two main symptoms of osteoarthritis – pain and inflammation.  These symptoms are inextricably linked; the more inflammation present in your joints, the more pain you will experience.  Consequently, the medication can be broadly categorised into two specific groups: painkillers and anti-inflammatories.

Personally, I am not a happy pill-popper and hugely dislike the idea of taking medication not only on a regular basis, but also in the long-term.  However, I have come to accept that I need to take medication in order to achieve even the most basic quality of life.  My attitude towards prescription meds has resulted in quite limited experience of what is available, but I will be writing posts relating to my own first-hand experiences of specific drugs.  It is important to remember that everyone is different and that our bodily or psychological responses to a specific medication may range from being ‘as anticipated’ to ‘highly unusual’.

For posts about natural healing and alternative therapies, click here

Anti-inflammatories

• NSAIDs  (Non-Steroidal Anti-Inflammatory Drugs)

NSAIDs are widely prescribed for the treatment of osteoarthritis, the purpose being to reduce inflammation in the body and consequently reduce the levels of pain experienced.  NSAIDs are most often sold under brand names, the most commonly known types being Ibuprofen, Naproxen, and Diclofenac.  Click here for the NHS information about NSAIDs

For more about NSAIDs, click here

• Steroids   (Corticosteroids)

Steroids can be used to treat inflammation, and are available in tablets and solutions or syrups.  Steroid injections are also available.  The most commonly used for anti-inflammatory purposes are prednisolone, betamethasone and dexamethasone.  For arthritic conditions, steroid injections can be used; when injected into a muscle or joint, the steroid can reduce inflammation in the surrounding area, and when injected into the blood, inflammation is reduced throughout the body.  Steroid injections are commonly used for arthritic inflammation, but they are not suitable for everyone – for example, you cannot have a steroid injection if there is metalwork in the surrounding area, ie. a joint replacement.  Click here for the NHS information about steroid injections.

Painkillers

Painkillers are also known as Analgesics.  Analgesics block pain by interfering with the pain receptors and nerve pathways to the brain – in other words, the brain is unaware that pain is present in the body.

• Non-Opioid Analgesics

These are the most commonly known analgesics and most are available without prescription – Paracetamol, Aspirin, etc.  This medication is recommended for low level pain, but is often used alongside NSAIDs for the management of more chronic arthritic pain.  Nefapam Hydrochrloride also belongs to this group.  This is available on prescription in the UK and is a pretty decent analgesic; it appears to be more effective than the others in this group and is helpful if opioid analgesics are not an option, however, it can cause unpleasant side effects.

• Compound Analgesics

These compounds are a mixture of simple analgesics with opioid content, and are intended to treat moderate to severe pain symptoms.  A typical example of a ‘low dose’ compound analgesic would be a compound comprising paracetamol with, perhaps, 8mg of Codeine Phosphate, which would probably be available without prescription.  The higher the level of pain, the higher the opioid content – for example, for more chronic pain, a compound of 500g paracetamol with 30mg codeine would be advisable, and would only be available on prescription.  Co-codamol works by transforming the Codeine into Morphine in the liver, thus producing pain relief.  These compounds bring with them numerous side effects, the most commonly known being constipation, but other side effects include drowsiness, nausea, vomiting, respiratory depression and, of course, addiction.  There are growing concerns about the use of opioids as painkillers; Coproxamol is no longer licensed (according to NICE), and there has been an ‘Opioid Crisis’ in the US and the UK for some time now.  Click here for an NHS article on addiction and opioid medication.

• Strong Opioids