July 21, 2018

There is good news if you are living with the constant pain of knee osteoarthritis. A new research study shows that an inexpensive, over-the-counter medication is best for relieving the pain of knee osteoarthritis.

A new study in the Journal of American Academy of Orthopaedic Surgeons published in May 2018 examined a variety of pain treatments for knee osteoarthritis (KOA). It found that the over-the-counter medicine, naproxen, sold as Aleve, Naprosyn, and other brands was the best treatment for pain and a good choice for improving function. [1]


KOA Is Often Constant

Individuals with KOA already know how extremely painful this condition can be and how it limits your ability to get through daily activities. There is currently no cure, but there are lots of ways to treat the pain, including over-the-counter and prescription drugs, injections, and in some cases, total knee replacement surgery.

Study Compared Oral and Injection Treatments for KOA

In their study, the researchers analyzed data from 56 previously conducted studies that compared two or more treatments, including oral medications and intra-articular injections such as hyaluronic acid, corticosteroids, and platelet-rich plasma.

  • The oral medications included:
  • Acetaminophen (Tylenol)
  • Diclofenac (Cambria, Voltaren, and others)
  • Ibuprofen (Advil, Midol, and others)
  • Naproxen (Aleve, Naprosyn, Motrin, and others)
  • Celecoxib (Celebrex)
  • Combination drugs (Advil PM, Aleve PM, Combunox, Vicoprofen, and others)
  • A placebo drug


Naproxen Determined Best Treatment for KOA Pain and Function

After combining all the data from the studies and analyzing the results, the researchers concluded that naproxen ranked first for improving both pain and function, followed by corticosteroid injection, plasma injection, celecoxib, and ibuprofen.

When researchers looked at pain and function separately, they found that naproxen was best for improving function followed by diclofenac, celecoxib, ibuprofen, and plasma injection. For pain alone, corticosteroid injection was ranked first followed by ibuprofen, plasma, naproxen, and celecoxib.

During this comparison study, the analysis also found the hyaluronic acid injection was no better than placebo for pain and function. Acetaminophen also did not score well for either pain relief or improved function.

In an interview, lead author David Jevsevar, MD, department chair of orthopedics at Dartmouth-Hitchcock Medical Center, New Hampshire, spoke about how the Arthritis Foundation can help patients use the information from the study.

“There are multiple treatments out there for management of knee OA,” Dr. Jevsevar said. “Some work better than others. Some work well for pain, and some work well for function. Our study showed that naproxen works best for both pain and function, and it is one of the least expensive, non-steroidal anti-inflammatory drugs.” [2]


Side Effects and Diet and Exercise Not Considered

While the study did not consider side effects of drugs like naproxen, including the well-known effects on the heart, vascular, and intestinal systems, Dr. Jevsevar noted that naproxen has the lowest risk of cardiac events compared to similar drugs.

The study also did not include weight loss and exercise, which a 2005 study in Arthritis & Rheumatism found to be two of the most effective ways to manage KOA. [3]

The good news is that for many people with KOA, taking naproxen to ease the pain enough to allow you to participate in an exercise and weight loss program could be the best way to achieve long-term relief from your knee osteoarthritis.

It should be noted that Dr. Jevsevar receives research support from DePuy Synthes, a maker of joint reconstruction products, a subsidiary of Johnson & Johnson, the makers of naproxen.

At Healthcare Associates of Texas, we specialize in finding the optimal treatment for you. Our osteoarthritis specialists will help you manage your pain and find the best long-term therapy for your KOA.  Book an appointment today.


[1] Journal of American Academy of Orthopaedic Surgeons, May 1, 2018 – Volume 26 – Issue 9

[2] Osteoarthritis blog of the Arthritis Foundation, <http://blog.arthritis.org/osteoarthritis/treatments-ranked-knee-oa>

[3] Arthritis & Rheumatology, Volume 52, Issue7, July 2005, pages 2026-2032

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Posted in: Orthopaedics