Overall Effects of NSAIDs on Osteoarthritic Joints
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It is clear from the scientific literature that NSAIDs from in vitro and in vivo studies in both animals and humans have a significant negative effect on cartilage matrix which causes an acceleration of the deterioration of articular cartilage in osteoarthritic joints. The preponderance of evidence shows that NSAIDs have no beneficial effect on articular cartilage and accelerate the very disease for which they are most used and prescribed. While the rapid deterioration of joints after long-term NSAID treatment can be from a loss of proactive pain sensations, it is much more likely that it is a direct effect of NSAIDs on cartilage. (See Figure 18.) Some of these effects can be seen in Figure 19 and include inhibition of chondrocyte proliferation, synthesis of cellular matrix components, glycosaminoglycan synthesis, collagen synthesis, and proteoglycan synthesis. Clinically this is manifested as an accelerated progression of the knee or hip osteoarthritis as seen by standard radiographs. The long-term consequence of the deterioration of the joint is a need for joint replacement. This author notes that massive NSAID use in osteoarthritic patients since their introduction over the past forty years is one of the main causes of the rapid rise in the need for hip and knee replacements both now and in the near future.
| Figure 18. Effects of NSAIDs on articular cartilage. A typical X-ray showing cartilage deterioration. Studies have shown that taking NSAIDs not only accelerates this process, but makes it more likely the person will need a joint replacement. |
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| Figure 19. NSAIDs taken long term have a negative effect on joint physiology and ultimately lead to degenerative arthritis. |
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