Osteoarthritis

TABLE OF CONTENTS

Osteoarthritis

Treatments

Non-drug

Prescription Drugs

Celebrex (Celecoxib) Tylenol (Acetaminophen)

Over-the-counter Drugs

What Leading Medical Organizations Recommend When Treating Osteoarthritis

WHAT TO TRY FIRST

The Department of Veterans Affairs/Department of Defense recommends as first-choice treatments for osteoarthritis.

  • For mild to moderate osteoarthritis Non-drug choices (weight loss if overweight, physical therapy, exercise) and drugs (initially Tylenol or NSAIDs such as naproxen as needed).
  • For severe osteoarthritis  Continue treatments for mild to moderate osteoarthritis plus steroid injections, low-potency opioids, or consult with surgeons.

In a 2015 systematic look at the evidence for all treatments found:

  • For pain - Hyaluronic acid knee injections worked best, naproxen and celecoxib were next best (and worked about the same) and Tylenol worked the least.
  • For function  - All treatments -except steroid knee injections - helped function more than placebo. Naproxen, ibuprofen, diclofenac and celecoxib were better than Tylenol.  Knee injections of hyaluronic acid was better than steroid injections.
  • For stiffness - Hyaluronic acid, naproxen, ibuprofen, diclofenac and celecoxib were better than placebo and Tylenol.
  • While Tylenol causes fewer gastrointestinal problems like ulcers or bleeding than NSAIDS, long- term use of high doses can cause liver damage.

WHAT ELSE TO TRY

If 1 approach does not work, combining approaches or switching treatments may be helpful. 

SOURCES

Department of Veteran Affairs/Department of Defense. VA/DoD Clinical Practice Guideline for the non-surgical management of hip and knee osteoarthritis. Published 2014.
Annals of Internal MedicineComparative effectiveness of pharmacologic interventions for knee osteoarthritis: A systematic review and network meta-analysis. Published January 2015.