LNSLNS

The authors recommend paracetamol as first-line treatment as well as long-term treatment for symptomatic osteoarthritis of the knee, in accordance with the analgesic/therapeutic guideline set out by EULAR. In 30 years of clinical practice, I have found paracetamol almost completely ineffective for arthritis pain. Non-steroidal anti-inflammatory drugs (NSAIDs) were notably more effective, if necessary in combination with proton pump inhibitors and for short-term combination treatment with metamizole. At low dosages, NSAIDs have a low side effect profile, even during long-term treatment. With paracetamol, there is a risk of liver damage if maximum doses are taken regularly. This is one of the reasons why paracetamol is now available on prescription only. In own my clinical practice, intra-articular injection of a steroid has always proved the best treatment for acute severe pain.

DOI: 10.3238/arztebl.2010.0602a

Dr. med. Alexander Weiss

Im Vogelsang 11

30989 Gehrden, Germany

dralexanderweiss@arcor.de

Conflict of interest statement
The author declares that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.

1.
Michael JWP, Schlüter-Brust KU, Eysel P: The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee [Epidemiologie, Ätiologie, Diagnostik und Therapie der Gonarthrose]. Dtsch Arztebl Int 2010; 107(9): 152–62. VOLLTEXT
1.Michael JWP, Schlüter-Brust KU, Eysel P: The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee [Epidemiologie, Ätiologie, Diagnostik und Therapie der Gonarthrose]. Dtsch Arztebl Int 2010; 107(9): 152–62. VOLLTEXT