Osteoarthritis Pain Relief : now paracetamol is in question!

Osteoarthritis Pain Relief

Paracetamol has been shown to cause liver toxicity. But what are the alternatives for osteoarthritis pain relief?

Many people all over the world are prescribed paracetamol (also called acetaminophen) for osteoarthritis pain relief. It has been the go to drug for many years. It can be bought over the counter in large quantities and is also a very cheap.

However new research has shown long term use of it causes liver toxicity and that is exactly what people looking for osteoarthritis pain relief do- they take the maximum dose 365 days of the year.

There was a very good interview on News Medical. April Cashin-Garbutt talks to Professor David Hunter who is the Florance and Cope Chair of Rheumatology and Professor of Medicine at University of Sydney. He is also a Staff Specialist at Royal North Shore Hospital and North Sydney Orthopaedic and Sports Medicine Centre so you can be pretty sure he knows his stuff!

In the interview Professor Hunter answers lots of pertinent questions regarding paracetamol and osteoarthritis pain relief but the most important one for me was:

There has been a lot of concern regarding the toxicity of paracetamol lately. Please can you give an overview of the recent studies that have prompted this?

The study that prompted the media release suggested that about 150 people every week, which is about 8,000 people every year in Australia, are being hospitalized as a consequence of taking paracetamol at toxic doses.

It’s not a particularly new finding that paracetamol causes quite a lot of toxicity, but I think the study is the last in a number of studies looking at the damage caused by paracetamol toxicity, particularly liver toxicity.

That’s a lot of people hospitalised EVERY WEEK and this is NOT a new finding? Why were we not told the risks?

How Good is Paracetamol for Osteoarthritis Pain Relief?

Actually it is a mild analgesic and recent studies have shown that it is no more effective than a placebo.

Many society osteoarthritis treatment guidelines no longer suggest paracetamol as a first line treatment but suggest topical anti inflammatory creams and gels instead. These are not risk free and some people still have side effects from them but they are lower than with the oral version.

However but as Professor Hunter said:

Although the guidelines have now been revised, I’m fairly sure most clinicians, pharmacists and others who advocate the use of paracetamol are probably not aware of the changes. It may well take a number of years to get the information out there, so that paracetamol is no longer advocated as the first-line analgesic for osteoarthritis.

Really? With so many osteoarthritis sufferers surely information should not take years to get out there to the healthcare professionals looking after us?

What Other Treatments Do The Guidelines Suggest?

These are the latest ones:

Osteoarthritis Treatment Guidelines Updated in the UK from the National Institute for Health and Care Excellence

Knee OA Treatment Guidelines Updated from the American Academy of Orthopaedic Surgeons

Osteoarthritis Treatment Guidelines Finally Updated  from the American College of Rheumatology (ACR)

All of these suggest exercises are the core of any treatment plan. Click on this link to learn more about how exercises work for osteoarthritis pain relief.

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