Topical NSAIDs in osteoarthritis

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7461.304 (Published 05 August 2004) Cite this as: BMJ 2004;329:304
  1. Cyrus Cooper (cc@mrc.soton.ac.uk), professor of rheumatology,
  2. Kelsey M Jordan, clinical research fellow
  1. MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD

    Best used for short periods during flare-ups in the disease

    Worldwide, osteoarthritis is the most common disease of synovial joints and also a major cause of locomotor pain and disability.1 Worldwide, symptomatic osteoarthritis, particularly of the knee and hip, has been estimated by the World Health Organization to be the fourth most important cause of disability among women and the eighth most important among men.

    Osteoarthritis is a disorder whose time has come. Epidemiological and clinical research have suggested a range of preventive and therapeutic strategies over the past three decades. Preventive approaches are focused on modifying risk factors in the general population.24

    Much energy has also been spent on developing non-surgical interventions to alleviate the pain and disability in patients with osteoarthritis, once the disease has become established. Non-pharmacological therapeutic options include education programmes and social support; a host of physical treatments (aerobic exercises, muscle strengthening exercises, and patella strapping); the provision of aids and appliances through occupational therapists; and advice on weight loss.5

    Pharmacological modalities that have a place in the management of patients with …

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