Osteoarthritis treatment update: Are NSAIDs still in the picture?

Although NSAIDs are the most effective treatment for persons who experience the pain of osteoarthritis (OA), the risk of adverse effects with NSAIDs may outweigh the benefits in many older patients. The GI risk is well known; increased attention has been paid recently to the cardiovascular risk. The goals of OA management are pain reduction and improvement or preservation of mobility. A multidisciplinary approach to treatment is recommended. There often is a poor correlation between symptoms and radiological findings. Evidence suggests that NSAIDs are slightly more efficacious than acetaminophen, but acetaminophen has a more favorable adverse effects profile. Recommendations for NSAIDs include using the lowest effective dose for the shortest possible period.