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If your joint pain persists after trying other methods of analgesia (pain relief), your doctor may prescribe a combination analgesic, or a COX-2 inhibitor, a corticosteroid or a DMARD (disease modifying anti-rheumatic drug).
COX-2 inhibitors are a type of NSAID (non steroidal anti-inflammatory drug) that are a little less likely to cause stomach problems - while still reducing inflammation and pain.1
Corticosteroids have strong anti-inflammatory effects and can reduce swelling and pain. They can be taken as tablets or oral liquid or they can be injected. Corticosteroids are only recommended for short term use to relieve acute symptoms such as ‘flares’, as long term use (longer than a few weeks) can be associated with thinning of bone, high blood pressure and weight gain.1
DMARDS (disease-modifying antirheumatic drugs) and the newer biological DMARDS are usually only prescribed by specialists. They reduce inflammation by acting on the immune system or on substances in the blood.1
Opiates may be prescribed for the temporary relief of moderate to severe knee pain. This group includes codeine, tramadol and morphine-derivatives. It is important to follow the directions precisely, such as dosage and length of treatment. Sensitivity to opiates can vary enormously between individuals. Some potential side effects include constipation and drowsiness.1
Articles in this series
1. The Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP, 2018.