NSAID Use for Osteoarthritis is a Point of Contention Between Cardiologists and Rheumatologists

In the June 2007 issue of the Harvard Heart Letter, the American Heart Association (AHA) offered step-by-step recommendations for choosing a medication to treat osteoarthritis. The AHA recommended starting with aspirin and acetaminophen (Tylenol) for muscle pain or joint pain. If either of those medications do not relieve pain, the next step for most people is to try an NSAID. Of the NSAIDs, the AHA recommends trying them in a particular order:

1 - Naproxen (or over-the-counter Aleve)
2 - Ibuprofen (or over-the-counter Advil)
3 - Diclofenac
4 - Celebrex

The AHA recommended that tramadol (Ultram), codeine, or fentanyl (Actiq or Duragesic) may be tried for short-term pain. Here's the problem - rheumatologists (doctors who specialize in treating arthritis) don't necessarily agree with the perspective of cardiologists. In an editorial which appears in the August 2007 issue of Osteoarthritis and Cartilage arthritis experts argue that NSAIDs and coxibs (i.e., Celebrex) must remain a significant part of the tools used to treat osteoarthritis. The editorial questions recommendations made by the AHA. The editorial suggests the AHA re-visit their recommendations especially the recommendation that high-dose aspirin be first line treatment for osteoarthritis. Experts writing the editorial suggest a careful look at the pros and cons of these medications so that everyone will understand. To best understand what the dispute is about, you should learn about NSAIDs as a treatment option for osteoarthritis.

Related Resources:

• Osteoarthritis Medications
• Osteoarthritis Treatments
• 10 Things You Need to Know About NSAIDs

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