Correspondence
Almost Ineffective


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.
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