In an analysis of 23 clinical trials, researchers found that, on
average, opioid medications were somewhat effective at easing pain in
patients with osteoarthritis. That's the common form of arthritis in
which cartilage cushioning the joints gradually wears down, leading to
swelling, stiffness and pain.
But the trials found no evidence that opioids improved patients' quality of life or helped with their depression. And any benefits for pain seemed to wane with time.
"We found that the magnitude of these effects is small and continues to decrease over time," said lead researcher Dr. Raveendhara Bannuru. He is director of the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center, in Boston.
Treatment guidelines for chronic pain, other than cancer-related pain, already say opioids should be a last resort.
With osteoarthritis, Bannuru said, the drugs are only recommended if a patient has not gotten relief from other medical therapies, and if surgery—like knee or hip replacement—is not an option.
Instead, patients should try to exercise regularly and maintain a healthy lifestyle. As for medications, Bannuru said, topical versions of nonsteroidal anti-inflammatory drugs (NSAIDs)—like ibuprofen and naproxen—are a "first choice."
These creams or ointments help people avoid the side effects that can come with prolonged used of oral NSAIDs (such as Motrin, Advil, Aleve), Bannuru noted. Injections of hyaluronic acid, a substance in joint fluids, are another option, he said.
In addition, aerobic activity, like walking, and exercises that strengthen the muscles around the arthritic joint can be helpful, according to Dr. Steven Eyanson, a rheumatologist who was not involved in the study.
And if a patient is overweight, shedding some pounds can help ease pain and improve joint function, said Eyanson, a retired adjunct assistant professor at the University of Iowa in Iowa City.
"In the case of osteoarthritis, the benefits of therapy by opioid pain relief are very limited," Eyanson said.
Bannuru was scheduled to present the findings Saturday at the American College of Rheumatology's annual meeting, in Atlanta. Research presented meetings is generally considered preliminary until it is published in a peer-reviewed journal.
But the trials found no evidence that opioids improved patients' quality of life or helped with their depression. And any benefits for pain seemed to wane with time.
"We found that the magnitude of these effects is small and continues to decrease over time," said lead researcher Dr. Raveendhara Bannuru. He is director of the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center, in Boston.
Treatment guidelines for chronic pain, other than cancer-related pain, already say opioids should be a last resort.
With osteoarthritis, Bannuru said, the drugs are only recommended if a patient has not gotten relief from other medical therapies, and if surgery—like knee or hip replacement—is not an option.
Instead, patients should try to exercise regularly and maintain a healthy lifestyle. As for medications, Bannuru said, topical versions of nonsteroidal anti-inflammatory drugs (NSAIDs)—like ibuprofen and naproxen—are a "first choice."
These creams or ointments help people avoid the side effects that can come with prolonged used of oral NSAIDs (such as Motrin, Advil, Aleve), Bannuru noted. Injections of hyaluronic acid, a substance in joint fluids, are another option, he said.
In addition, aerobic activity, like walking, and exercises that strengthen the muscles around the arthritic joint can be helpful, according to Dr. Steven Eyanson, a rheumatologist who was not involved in the study.
And if a patient is overweight, shedding some pounds can help ease pain and improve joint function, said Eyanson, a retired adjunct assistant professor at the University of Iowa in Iowa City.
"In the case of osteoarthritis, the benefits of therapy by opioid pain relief are very limited," Eyanson said.
Bannuru was scheduled to present the findings Saturday at the American College of Rheumatology's annual meeting, in Atlanta. Research presented meetings is generally considered preliminary until it is published in a peer-reviewed journal.
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