A new look at steroid injections for knee and hip osteoarthritis

Osteoarthritis is a common and potentially debilitating condition. It’s a degenerative joint disease (often called the “wear-and-tear” type) in which the smooth lining of cartilage becomes thinned and uneven, exposing the bone beneath. Although osteoarthritis is tightly linked with aging, we now know there is more to it than age alone: genetics, weight, physical activity, and a number of other factors can conspire to make it more likely that someone will develop osteoarthritis while someone else won’t. Osteoarthritis is the primary reason that more than a million joints (mostly hips and knees) are replaced each year in the US. Treatments short of surgery can help but they don’t always work well, don’t cure the condition, and may be accompanied by side effects. Surgery is usually the last resort, reserved for people who have declining function, unrelenting pain, or both despite trying other treatments such as pain relieving, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, others) or naproxen (Aleve, others), or injections of steroids or hyaluronic acid (a type of lubricant). Nonmedication approaches can also help, such as loss of excess weight, physical therapy, or use of a cane or brace. Calling steroid injections into question Steroid injections can quickly relieve inflammation in the joints, and the effects may last from several weeks to several months. I’ve seen a number of patients who got significant relie...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Arthritis Osteoarthritis Pain Management Source Type: blogs

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Publication date: Available online 21 November 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Maria P. Volpato, Izabela C.A. Breda, Ravena C. de Carvalho, Caroline de Castro Moura, Laís L. Ferreira, Marcelo L. Silva, Josie R.T. Silva
Source: Journal of Acupuncture and Meridian Studies - Category: Complementary Medicine Source Type: research
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen are and have been the go-to “benign” pain medication for doctors and patients alike. Why? They aren’t addictive, and it’s not easy to overdose. Serious side effects like gastrointestinal ulcers and bleeding seemed to be limited to high doses taken for longer periods or time, or to people with significant medical problems. Even before the era of the opioid epidemic, it was raining NSAIDs, across the country. In 2004, the manufacturer of the NSAID Vioxx pulled it from the market because the drug was associated with serious...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Drugs and Supplements Headache Health Heart Health Injuries Pain Management Source Type: blogs
This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included. Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them. Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case. While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of c...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Arthritis Drugs and Supplements Health Heart Health Pain Management Source Type: blogs
The objective of this study was to test the safety and efficacy of celecoxib for pain relief after tonsillectomy compared to placebo. METHODS: Adult subjects were randomized to 200 mg celecoxib versus placebo with a loading dose the night before surgery then twice daily for 10 days. Subjects were instructed to supplement the study drug with hydrocodone/acetaminophen liquid or acetaminophen for pain as needed. Subjects completed a daily diary regarding their pain, nausea, vomiting, diet, and activity. RESULTS: Seventeen subjects enrolled. Intraoperative blood loss was similar between groups, and no subject had pos...
Source: The Annals of Otology, Rhinology, and Laryngology - Category: ENT & OMF Authors: Tags: Ann Otol Rhinol Laryngol Source Type: research
Conclusions The safety and efficacy profile of GCSB-5 are comparable to celecoxib. These results indicate GCSB-5 is safe for a long-term treatment of knee OA patients. Trial registration ClinicalTrials.gov (NCT01604239). Graphical abstract
Source: Journal of Ethnopharmacology - Category: Drugs & Pharmacology Source Type: research
Around 1.8 million people every year opt for hip or knee replacements. But I don’t recommend surgery, unless it’s absolutely necessary. And new research reveals that in the month after they had surgery, these patients — many of whom are osteoarthritis sufferers — simply replaced their bad knees and hips with a heart attack. Osteoarthritis is the most common chronic condition of the joints. That’s why I recommend natural remedies that ease the pain of osteoarthritis in a much more effective and safer way — and in some cases they can even reverse this debilitating condition. You see, gett...
Source: Al Sears, MD Natural Remedies - Category: Complementary Medicine Authors: Tags: Heart Health Source Type: news
Osteoarthritis (OA) affects tens of millions of Americans and is a leading cause of disability and reduced quality of life across the globe. Other than joint replacement surgery, there is no known “cure” for OA, and most treatments focus on relief of symptoms such as pain. Often, the first step is non-medication-based approaches such as physical therapy, exercise, and weight loss. Most patients, however, will eventually use pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs). Other kinds of medication, such as opioids, have also been tested as treatments for OA, and there is ongoing debate abo...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Arthritis Drugs and Supplements Health Osteoarthritis Pain Management Source Type: news
This study excluded those who had had severe pain in the week prior to study enrollment. Only people with osteoarthritis — the age-related, “wear-and-tear” type of arthritis — were included. People with other types, such as rheumatoid arthritis, were not eligible. Although the improvement in those receiving surgery was greater than that for the non-surgical group, both groups improved. And the difference between them was not large. Serious side effects or complications were more common in the surgery group. For example, three of the 50 people who had surgery (compared with none in the non-surgical g...
Source: New Harvard Health Information - Category: Consumer Health News Authors: Tags: Osteoarthritis Pain Management Surgery knee pain knee replacement Source Type: news
In some not so good news, the FDA has substantially strengthened its warning on the risk of non-steroidal anti-inflammatory drugs, NSAIDS. Although aspirin is literally a non-steroidal anti-inflammatory, and has overlapping mechanisms of action with these drugs, it is not formally classified as an NSAID, basically because the term is designed to exclude it, as I will explain.NSAIDS include ibuprofen, naproxen, and celecoxib, which was at one time heavily advertised based on safety claims. These are widely used by people with osteoarthritis and other chronic pain conditions. The problem, as the FDA now concludes, is that th...
Source: Stayin' Alive - Category: American Health Source Type: blogs
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