• Hip Pain Success with Prolotherapy
  February 5, 2012
• Prolotherapy for Tendinopathy
  February 4, 2012
• Epidural Steroid Injections for Low Back Pain
  February 3, 2012
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It is important to remember that pain has a physiologic function: if a joint produces pain when it is used, it is a signal for the body to use that joint less or else the structure eliciting the pain will be further damaged. One study focused on a group of patients with hip osteoarthritis who needed to have a joint replacement in the not-too-distant future. They were randomly prescribed an NSAID, aspirin-like drug, or acetaminophen. Over the next months, the patients were asked about their joint pain, and radiographs of their hips were taken. The patients given the NSAID had more progression of their hip radiographs and needed to have joint replacements performed in half the time as the group given acetaminophen. The authors speculated why this occurred. They noted that the NSAID might have prevented normal cartilage turnover and repair, and accelerated the joint degeneration; or, more likely, the potent medication decreased joint pain and those subjects were therefore more active. This has led to the suggestion that potent NSAIDs can lead to “analgesic joint,” which can develop when pain is relieved by the NSAID, thus increasing the joint use and subsequent load on the joint, causing accelerated joint degeneration and ultimate need for joint replacement, especially if the excessive joint load continues.¹²¹ This latter notion has actually been studied: patients who take NSAIDs for knee OA put increased joint forces on their knees with walking because of pain relief, compared to those who do not have pain relief taking nothing, or just a placebo. As one researcher put it, “Of particular concern is the fact that anti-inflammatory or analgesic relief may actually be associated with an increase in joint forces.”^{122, 123} Other researchers have confirmed that the same type of knee joint loads that cause knee osteoarthritis are increased significantly during walking with NSAID use.^124-126 The net effect of increased pressure on the damaged joint would be accelerated osteoarthritis and need for knee or hip replacement. One research team confirmed that NSAID use increases the risk of getting a hip replacement due to primary osteoarthritis by 50% during a two year period.¹²⁷ These researchers raised the question of the deleterious effect on cartilage resulting from NSAID intake in osteoarthritis. Other researchers have also confirmed that NSAID users need total joint replacements sooner than those who do not take them.¹²⁸