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Dr David Liu: 07 5598 0205
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Pharmacological interventions

The use of prescription medications, over the counter supplements and even herbal- type treatments may be recommended for the treatment of pain, recovery of soft tissue or the healing and preservation of cartilage. As a general rule, prescription medications should be used short term to avoid the risk of physical and psychological drug dependence.

Discuss medication options with your doctor or pharmacist. Always be aware of the correct dose and the side effects. See below for broad groups:

Over the counter analgesics (OTC): e.g. Paracetamol, Panadol Osteo. These are good entry-level analgesics and are usually safe and effective for mild pain.

Non-steroidal anti-inflammatory drugs: These are known as NSAIDs and are found to be effective in reducing pain and inflammation in musculoskeletal conditions. There is a risk of gastritis and reflux. They work well in combination with OTC medications.

Compound Analgesics: These are usually a combination of an OTC pain medication and a weak opioid like codeine. Often muscle relaxants are added.

Weak and strong opioids: Opioids are prescribed when the use of OTC and NSAIDs do not provide symptomatic pain relief, if other treatments have intolerable side effects or when surgery is delayed or contraindicated. Opioids also come in an injectable form and even convenient patches that may last up to a week. Addiction and constipation are a concern.

Disease modifying anti-rheumatic drugs (DMARS) and biological agents: DMARDs aim at halting the progression of autoimmune diseases like rheumatoid arthritis and offer symptomatic relief. Biological agents, like Immunoglobulins, are antibodies against disease-causing agents. They are manufactured using genetic engineering technology. These agents are recommended in individuals with severe inflammatory and autoimmunediseases.

Steroids:Prednisone and cortisone are effective anti-inflammatory agents, used with caution, in controlled dosing, for recalcitrant inflammatory conditions. They have many side effects. Steroids are often used in an injectable form (Depo steroid) in musculoskeletal conditions to reduce inflammation in joints, bursae and around tendons in their sheaths.

Sedatives, muscle relaxants, neurogenic agents and antidepressants: These are less commonly used as a first line pain medication. In complex pain syndromes and resistant atypical pain, they have their place. Sedatives, like Valium, are often used in the post-operative period. Patients with pain that require these types of medications longterm are best under the care of a pain specialist.

Other treatments: Your physician may recommend the use of glucosamine, chondroitin, fish oil, vitamin supplements, herbal (e.g.turmeric capsules) and other dietary therapies. These therapies have very little scientific evidence but there are always anecdotal cases with excellent results.