Osteoarthritis is a chronic, degenerative disorder
characterised by loss of articular cartilage and peri-articular bone remodelling. It is primarily a non-inflammatory disorder
of movable joints and is generally caused by an imbalance between the synthesis and degradation of the articular cartilage,
leading to the classic pathologic changes of wearing away and destruction of cartilage. The disease process results in pain
and dysfunction of affected joints and is a major cause of disability in the general population.
Current Therapies:
The goals of treatment of osteoarthritis include:
- Controlling pain
- Improving mobility and joint use
- Minimising disability and returning normal function
- Slowing the progression of osteoarthritis
- Protecting other joints from developing osteoarthritis
Currently, paracetamol is the oral analgesic of
first choice and, if successful, should be taken long-term. In one study, paracetamol and ibuprofen were comparably effective
in patients with mild-to-moderate pain, but ibuprofen was statistically superior to paracetamol in patients with severe pain.
Therefore, ibuprofen and other NSAIDs should only be considered for patients who do not obtain adequate pain relief
with paracetamol. On some occasions, the combination of codeine and paracetamol can be used as it provides better
analgesia than paracetamol alone.
