Anti-inflammatory drugs are used in the medical treatment of arthrosis, osteoarthritis, and arthritis to reduce tissue swelling and pain and promote cell regeneration.
These drugs are divided into two main groups: nonsteroidal drugs (i.e., nonsteroidal anti-inflammatory drugs or NSAIDs) and corticosteroids (steroid hormones).
The nonsteroidal drug group has gained popularity and has reduced consumer interest in hormonal medications. Such drugs can stop inflammation of the joints and decrease pain levels without the need for intervention in the endocrine system. Thus, the risk of complications and side effects after treatment is reduced.
Features of NSAIDs
Prior to taking an NSAID, the patient should visit their doctor and find out the limitations of the treatment.
- It is not recommended to take a long-term course (as, despite the higher degree of safety associated with these medications, the risk of side effects still remains).
- Nonsteroidal drugs are contraindicated in diseases of the digestive tract (e.g., ulcer, colitis, gastritis, enterocolitis, increased acidity), kidney, and liver as well as in cardiovascular pathologies.
- Individual sensitivity to the components of the drugs is possible. The dosage should be increased only with the permission of the attending physician.
- Oral NSAIDs irritate the sensitive gastric mucosa, so it is necessary to take them with a significant amount of liquid.
- It is forbidden to combine two or more types of NSAIDs during treatment (due to the risk of stratification of side effects).
- During therapy with nonsteroidal drugs, the consumption of alcohol is prohibited.
- These drugs should not be used in pregnant women.
Types of NSAIDs
All NSAIDs medications are divided into two main groups, i.e., inhibitors of cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2).
The following drugs belong to the COX-1 type.
- Aspirin. Aspirin is the oldest medication for the treatment of arthritis and arthrosis. It is a cheap drug that which loses in efficiency to stronger synthetic drugs. Cons of its use include the facts that it liquefies the blood and doesn’t have a pronounced analgesic effect, respectively.
- Diclofenac. This drug is also a proven but more effective medicine that is available in the form of tablets, ointments, transdermal patches, and injectable solutions, among others. The medication demonstrates a good anesthetic effect and reduces swelling and redness of tissues. Preparations based on diclofenac include Voltaren®, Cambia®, Cataflam®, Zipsor ®, and others.
- Ibuprofen. Ibuprofen is an active substance that is well-tolerated by the body. Due to this, medications based on ibuprofen (e.g., Nuprin®, Nurofen®, Cuprofen®, Advil®) can be prescribed even for use in pregnant and lactating women with the permission of the treating gynecologist.
- Indomethacin. This is one of the most powerful NSAIDs available and has a pronounced analgesic effect. It is produced in the form of ointments, rectal suppositories, and tablets and has a wide range of effects that is complemented by an impressive list of side effects and complications. Drugs based on this active substance (e.g., Indocin®, Tivorbex®) are considered the most effective option in the treatment of arthrosis and arthritis.
- Ketoprofen. In terms of efficiency and method of action, ketoprofen is close to ibuprofen. It is available in the form of tablets, injectable solutions, suppositories, creams, gels, and aerosols. Medications with ketoprofen include Oruvail®, Orudis®, and Actron®.
Inhibitors of COX-2 include modern drugs that selectively affect the body with decreased side effects of the gastrointestinal tract. However, according to the literature, inhibitors of this group have an adverse impact on blood vessels and heart muscle.
- Meloxicam. This substance differs from COX-1 inhibitors in terms of the availability of long-term administration (months or years). It is produced in the form of solutions, tablets, ointments, and suppositories. Drugs based on meloxicam include Mobic® and Vivlodex®.
- Celecoxib. This is a powerful medicine with a minimum number of side effects affecting the gastrointestinal tract and internal organs (e.g., kidney, liver, spleen, gallbladder). Celecoxib is produced in the form of capsules as Celebrex® (Pfizer, New York, NY, USA).
- Nimesulide. In addition to having the standard analgesic and anti-inflammatory properties, nimesulide acts as an antioxidant, preventing the oxidation and decay of cartilaginous tissue, proteoglycans, and collagen fibers. It is produced in the form of a solution for oral administration, tablets for resorption, and a gel for local use.
- Etoricoxib. Prior to incorporating this drug during treatment, it is necessary to accurately calculate the dosage (not more than 150 mg per day). The well-known brand name of etoricoxib is Arcoxia®.
In addition to nonsteroidal drugs, anti-inflammatory properties are also possessed by natural medications, which contain chondroitin and glucosamine as active elements. Natural compositions and affordable prices make these medicines popular for the treatment of acute and chronic forms of arthrosis, arthritis, and osteoarthrosis.
Glucosamine and chondroitin provide:
- Regeneration of cartilaginous tissue
- Reduction of hyperemia (i.e., redness and swelling of tissues)
- Restoration of joint sensitivity
- Reduction of pain syndrome
- Restoration of mobility and range of movements of joints
- Reduction of “crunches” in the joints
Chondroitin stimulates the production of hyaluronic acid, which is the basis for connective tissue. It helps restore cartilage, ligaments, and tendons. Chondroitin also reduces inflammation.
Glucosamine prevents the destruction of joint tissues due to aging, mechanical friction, or in conjunction with various metabolic disorders.
Steroid preparations for the treatment of arthritis
Corticosteroids are a synthetic analog of the primary hormone of the adrenal glands, which is cortisol. Cortisol regulates the work of internal systems of the body and supports immunity.
Hormonal drugs reduce the concentration of prostaglandins and disrupt the reaction of some leukocytes. Due to this, the inflammatory process passes quickly and the pain decreases.
In comparison with NSAIDs, corticosteroids produce a stronger anti-inflammatory effect in the treatment of arthritis and its autoimmune causes. However, this weakens the body’s defense against infections and increases the frequency of allergic reactions.
The most well-known corticosteroids include the following: prednisolone and hydroxychloroquine. They are available in oral (e.g., capsule, pill, drop), topical (e.g., sprays, injections, cream, gels, ointments), and rectal (e.g., suppository) forms.
Before taking hormonal drugs, the patient should remember that:
- Steroid drugs can be combined with other medications.
- It is undesirable to select and especially to exceed a dose of corticosteroids without consulting a doctor. A deviation from the recommendation can lead to a critical reduction in the natural secretion of cortisol.
- Treatment with hormones cannot be abruptly stopped. Dose reduction should occur gradually, which will allow time for the adrenal glands to adapt to new working conditions.
- In rheumatoid and other types of arthritis, small doses of corticosteroids are prescribed for a long time.
Whatever the choice of the patient, it is important to remember that the treatment should be carried out with the permission and under the supervision of a doctor, in strict accordance with the established scheme.