Table of Contents
- Opiates, which are derived from natural opium (morphine and codeine)
- Opioids, which are synthetic drugs. They include oxycodone (such as Percodan, Percocet, Roxicodone, and OxyContin), hydrocodone (Vicodin), oxymorphone (Numorphan), and fentanyl (Duragesic)
Although the use of narcotics for arthritic pain is controversial, they may have a place in osteoarthritis treatment when milder drugs are not effective or appropriate. These drugs can be highly addictive, and should be prescribed at the lowest possible effective dose.
Common side effects include anxiety, constipation, nausea and vomiting, dizziness, drowsiness, paranoia, urinary retention, restlessness, and labored or slow breathing.
Corticosteroid Injections
When pain becomes a major problem and less potent pain relievers are ineffective, doctors may try corticosteroid (steroid) injections, usually by giving the patient a shot in their joint every 3 months. Corticosteroid shots are useful only if inflammation is present in the joint. Relief from pain and inflammation is of short duration, and this treatment is rarely used for chronic osteoarthritis. These drugs may not be as effective for women as they are for men.
Patients are usually advised not to have more than two or three injections a year, since there is some concern that repeated injections over the long term may be harmful. Because long-term use of corticosteroids has many potentially serious side effects, steroid medications are never given by mouth or systemically for the treatment of osteoarthritis.
Hyaluronic Acid Injections (Viscosupplementation)
Injections of hyaluronic acid (such as Hyalgan, Synvisc, Artzal, and Nuflexxa) into the joint -- a procedure called viscosupplementation -- may provide pain relief for knee osteoarthritis. Relief usually lasts several months. The most common side effects, pain at the injection site and knee pain and swelling, are usually mild and temporary.
Review Date: 06/16/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital. Also reviewed by David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
