Analgesics for Arthritis

Analgesic and anti-inflammatory therapy in the elderly

In the United States today, the number of persons 65 years of age or older is about 25 million. Two thirds of this group have musculoskeletal complaints severe enough to cause them to use considerable quantities of over-the-counter medications to alleviate discomfort. In treating elderly patients with osteoarthritis, one of the most common rheumatic diseases of the elderly, it is imperative for physicians to be aware of the numerous physiologic aspects of aging and how these may affect the pharmacokinetic activity of various prescribed agents. Drug therapy in the elderly should be determined by the principle of least toxicity. Dosage titration is particularly advisable when pharmacokinetic activity of a drug is not known.

Use of simple analgesics in rheumatoid arthritis

The usefulness of anti-inflammatory drugs in rheumatoid arthritis (RA) is beyond dispute. The role of simple analgesics is less clear and has been disputed. A survey of 21 rheumatologists indicated that a majority sometimes supplemented anti-inflammatory treatment of RA with simple analgesics. A random sample of 120 RA patients treated by the same doctors revealed that 47% ranked pain relief as the most desirable objective of their treatment and 54% were taking analgesics regularly. Of those receiving analgesics as well as non-steroidal anti-inflammatory drugs 48% considered the former to be the more effective preparations. Almost half the patients on analgesics were taking drugs without the knowledge of the rheumatologists, who may have underestimated their patients' desire for pain relief.