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Painkiller creams used to treat osteoarthritis pain appear to offer only short-term relief

Summarizing the results of 13 previous studies, Weiya Zhang and colleagues, in a report in the July 31 issue of the "British Medical Journal", note that after using the drugs for two weeks there was no evidence of continued efficacy. The drugs used ranged FROM over-the-counter medications such as aspirin and ibuprofen, to prescription drugs such as diclofenac (Cataflam, Voltaren) and piroxicam (Feldene, Nu-Pirox). The trials had included in all nearly 2,000 patients and had lasted up to four weeks. Doctors often prescribe non-steroidal anti-inflammatory drugs (NSAIDs) to be aplied externally in the form of a cream, to avoid the intestinal bleeding that can occur when such drugs are taken orally.

Osteoarthritis generally occurs later in life, as the cartilage that cushions joints is degraded over the years. It's the most common form of arthritis and a major cause of disability in older people. The damaged joints generally are in the fingers, knees, hips and spine, and the pain can be intense. There is a great need for some sort of long-term treatment for this disease. A newer class of drugs, Cox-2 inhibitors, can be an alternative to NSAIDs. But these drugs, the first of which were Celebrex and Vioxx, are expensive; and in some people they can cause intestinal problems.

The new study results "coincide with the experience of those who use topical NSAIDs", said Dr. Frank B. Kelly, a member the American Academy of Orthopaedic Surgeons who is also in private practice. Those drugs are more effective for soft-tissue problems such as tendonitis, he said.

Kelly said his treatment regimen for the pain of osteoarthritis starts with lifestyle changes. "About 90 percent of what we do is nonsurgical", he said. Weight loss can help someone who is obese, as can an exercise program aimed at strengthening muscles, Kelly said.

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