We treat one thing…
Osteoarthritis progresses against the background of painkillers
Pain and stiffness in large joints are the most common symptoms of osteoarthritis, the most common form of inflammatory diseases of the musculoskeletal system. It has recently become clear that drugs usually prescribed to relieve pain and relieve inflammation, on the contrary, can worsen the course of this disease in the long term.
Osteoarthritis is a rheumatological disease characterized by inflammation and damage not only to articular cartilage, but also to underlying tissues, including bone. This form of arthritis in the world affects more than half a billion people, mostly older: almost half of people over 60 years old and almost all over 80 years old.
Modern medicine does not know how to radically cure or even noticeably slow down the progression of osteoarthritis. As an analgesic, nonsteroidal anti-inflammatory drugs (NSAIDs) are usually prescribed, which, as the name implies, relieve not only pain, but also inflammation. Often it is ibuprofen (nurofen) and naproxen. But such prescriptions are ambiguous: now there is no consensus among doctors about how these drugs affect patients with osteoarthritis.
Scientists from the University of California in San Francisco (USA) analyzed the relationship between the use of NSAIDs and the development of synovitis - inflammation of the inner, synovial membrane of the joint and the appearance of effusion in it. This pathology appears in many cases of osteoarthritis.
The study used medical data from 277 patients with osteoarthritis of the knee joint – participants in a four-year study in whom this disease occurred in moderate or severe form. All these patients received NSAIDs for at least a year between the start and end of follow-up. All participants underwent MRI of the knee joint at the beginning and end of the study to assess the thickness of cartilage and other structural changes of the joint.
The results of the analysis did not find a long-term benefit from the use of NSAIDs compared to the same patients who did not take these drugs. Moreover, in those taking NSAIDs, the indicators of the "quality" of cartilage and markers of inflammation were even worse.
Based on these results, scientists propose to revise the recommendations for the use of NSAIDs in patients with osteoarthritis. As for the causes of such negative consequences, the researchers put forward two assumptions.
Thus, the anti-inflammatory effect of NSAIDs may be insufficient in relation to synovitis. The second option is that patients taking painkillers may become overly active against the background of a decrease in pain syndrome, which can lead to the progression of the disease. And if the latter is true, then it turns out that a person must endure pain so that it protects him from normal physical activity or, in other words, a full life?
Purely humanly, it looks cruel. But the question of a "good" way out of this stalemate remains open.
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