Patients with osteoarthritis have limited knee pain and function. Is it better to get closed injections or take medicine? Doctors' opinions are also different. According to a survey published in the Journal of the American Academy of Orthopedics in 2018, a collection of statistics on the effects of various therapies for osteoarthritis was collected. collected 53 randomized controlled trials of in . Each trial treated knee osteoarthritis for at least 28 days, and the number of people studied was at least 30. The following results were obtained:
• From the pain relief alone, cortisone injections were the fastest, followed by non-steroidal anti-inflammatory drugs (anti-inflammatory painkillers), such as ibuprofen , naproxen and celecoxib, and PRP injections.
• Naproxen ranks the highest in improving function, followed by diclofenac , celecoxib, ibuprofen and PRP injections.
• Naproxen is most effective in improving pain and function, followed by cortisone injection, PRP injection, ibuprofen and celecoxib.
celecoxib and naproxen
Although naproxen has the highest efficacy in this study, celecoxib is also a common medicine for arthritis and has smaller side effects. In a controlled trial of 514 patients with gastric ulcer and duodenal ulcer , celecoxib The incidence of upper gastrointestinal bleeding is half less than that of naproxen, and the incidence of adverse renal events is also lower. Therefore, many doctors of will still recommend safer celecoxib. The figure below is a comparison of the adverse effects of the two drugs:
Whether celecoxib or naproxen, non-steroidal anti-inflammatory drugs can effectively relieve joint pain and inflammation. They also have potential side effects. NSAIDs can irritate the stomach wall and may cause ulcers or other stomach problems . It may also impair renal function. Some nonsteroidal anti-inflammatory drugs can increase blood pressure. Increases the risk of heart disease.
Therefore, it is not recommended to take non-steroidal anti-inflammatory drugs for a long time. You can choose two ways to take them. The first one is that you can take them regularly when pain occurs (for example, every four to six hours). according to the doctor's requirements, take for several days or weeks, and then stop the medication. The second type can be taken for a long time but not continuously, not taken every day or just occasionally. In short, no matter which method, each patient's condition is different and needs to be carried out under the guidance of a doctor. In addition, in order to reduce the use of oral drugs, topical non-steroidal anti-inflammatory drugs, such as diclofenac, can also be selected, which have fewer potential side effects.
cortisone injection
is also called corticosteroid injection. is commonly called blocking injection . Its advantage is that it is immediate. It directly injects a mixture of corticosteroids and anesthetics into the inflammatory site. For tenosynovitis , arthritis, ligament inflammation , etc., can quickly reduce inflammation and swelling, but it also has side effects, which may cause blood sugar fluctuations. Too much injection will have a destructive effect on joint cartilage. A few patients have more severe pain after injection. Injection should not exceed three or four times a year.
Comparison of the two
NSAIDs may have mild side effects, such as nausea and vomiting , or allergic reactions such as rash. However, steroid injection of may cause more serious side effects, such as immunosuppression, hypertension and various body dysfunctions.
. Nonsteroidal anti-inflammatory drugs and steroid both have anti-inflammatory characteristics.
2. NSAIDs have fewer anesthetic properties compared to steroids.
3. Compared with steroids, nonsteroidal anti-inflammatory drugs have less side effects. Which treatment method is used in
or the two are used in combination, depending on the patient's condition. There is no best plan, only the most suitable plan.
Medical science popularization, for reference only.
Reference:
"NSAID is rated as the most effective non-surgical treatment for knee osteoarthritis", Rheumatology Network, 2018.
"Celecoxib and Naproxen in cardiovascular disease and arthritis patients after upper gastrointestinal bleeding", Lancet, 2017.
"Celecoxib and Naproxen: Differences, Similarities, and Which One Is More Suitable for You", Checkup, 2019.
