My mother had osteoarthritis, took NSAIDS and other prescription anti-inflammatory agents, developed a duodenal ulcer and then had surgery to remove the damage to her stomach. The internist told me NSAIDS do not work well to control pain. The lead authors answer to "not give up on nonopioids too soon" should not be taken without a grain of salt.
2
My 90 year old mother suffered for years with severe pain caused by cervical spondylosis, spinal stenosis and arthritis through most of her body. Over the years she had cortisone shots, treatment to kill nerve ends in her back, and took Tylenol and Tramadol, an opioid. None of these treatments lasted any significant length of time and ultimately she got to the point where she could not stand for more than 5 minutes without being in excruciating pain. I registered her for medicinal cannabis and she received her license in January 2018. We found a strain of medicinal cannabis that had a high content of CBD, the compound that is the anti-inflammatory, and a very low percentage of THC, the psychotropic compound, which we were told needs to be present in at least a minute amount to enable the CBD to work effectively. Once we had the right strain, she experienced IMMEDIATE relief. Within a week she stopped taking Tramadol and two weeks later she stopped taking the Tylenol. The medicinal cannabis helped her cope with the withdrawal from the Tramadol. She has been pain free ever since she started using the medicinal cannabis and has NONE of the side effects she experienced from using Tramadol., for example, her cognitive function immediately improved.
And then there are some of us who can't take NSAIDs because of ulcers. I can't take them, not even once a day, not even with food. I tried, and my ulcer (which I thought was healed after 7 years) came roaring back. Tylenol does not do anything for me. So it's heating pads or opiates. I try very hard not to take the pills but I do need them on occasion.
1
I used to use Tylenol almost exclusively, because at that time we were advised it was the safest. Then all the press came out about how easy it is to overdose with Tylenol and ruin your liver, and even die. I have never taken a single Tylenol since that day. I look back ruefully on my years of carefully giving liquid baby Tylenol to my infant for fevers, thinking I was doing the right thing. Not to mention at the time there were very confusing and misleading dosing instructions for infants on different forms of baby Tylenol.
3
The dirty little secret of pain studies is that pain responds at the highest level to placebos - at about the 40% range. That means that almost half of any cohort receiving some type of treatment will see an alleviation of their pain.
So when your uncle Bill talks about eliminating sugar as a miracle cure - he may simply be enjoying a placebo effect or when aunt Martha talks about acupuncture - it may be the same placebo effect.
The good news is that it also points to the power of the mind to regulate pain if only we can ever harness it.
1
Yes, I wish more research was being done. I have had the experience many times of drifting upward out of sleep to wakefulness, feeling great, then when I am awake suddenly being slammed with the resumption of a headache that I had when I went to bed. I assume that means I slept without my headache, but it came back (with a vengance) as soon as I awoke. Does that mean my body can just "turn off" pain when it wants to? What is going on with this?
1
Continued.
In addition to all I've mentioned I have arthritis which has caused my finger and toe joints to swell and hurt. Some calcium has deposited on my cervical part of my spine. The NSAIDS have little effect on the pain. I also have Calcium pyrophosphate crystal deposition disease which hurts my elbows and knees. Add in eczema and psoriasis to help aggravate.
I want to be part of one of these studies. I can give them a run for their money.
Tylenol is dangerous to the liver. Doctors have known this for years. If you have liver disease most doctors will not recommend Tylenol. The writer of this piece is not a doctor and the reader should proceed with caution!
6
Opioids, tylenol, advil...all these pills! I have severe arthritis and just a year ago, after watching Sugar Coated (Netflix) and doing some research online about fructose, I stopped eating sucrose, glucose (carbs) and fructose (fruits, honey) and SURPRISE(!) all my bodily pains disappeared!!! It's all about the sugars in our diet, which causes inflammation plus all sorts of metabolic diseases. Doctors sure in hell won't tell you, much less ask you WHY...they only treat the WHAT. Name the WHAT and they can give you a pill. Ask WHY and they don't have a clue. How much water do you drink, what are you eating, how much of it is processed, twice cooked "food" or are you eating real food...vegetables, meat and fat. That what I've been eating for a year and I'm painfree, able to run my 220 acres ranch, milk goats, make cheese, do wild fermentation, grow my own beef and pork at 74 years old. No doctors, no meds. Folks, just say no to sugars in all it's forms!! It works.
7
I manage my painful neuropathy solely with medical marijuana. No side effects. My doctor here in NY knows how to prescribe. I don't have to worry about the purity as the dispensary is monitored by the state . I believe mmj could be available to all were it not for the power of big pharma to continue to push dangerous synthetic "pain killers" that ultimately create more harm than good. Folks need to challenge this and demand access to mmj.
8
I wish including what is being eaten as there is huge Association with what you eat and any medication you’re taking. If people are eating a high carbohydrate diet it contributes to inflammation. Sugar drives inflammation. If you don’t know the parameters of what the subjects are eating , the study is flawed. It’s pretty basic stuff.
3
"...a high carbohydrate diet it contributes to inflammation."
Which medical journal did you read this in?
2
I find the side effects of opioids, not the threat of addiction, to be devastating. They eased my arthritis pain, but I was flat on my back for days. Acetaminophen (generic Tylenol) works quite well. The lidocaine patches worked well, too, but my health insurer won't pay for them anymore. They're available over-the-counter, and these work, too, but the adhesive gives up the ghost quickly and they peel off quite messily.
1
OK, you are the lead researcher, so you should know better. However, when I check the study via the link in the article, it seems consistent with what the article reports. However, your statement that the article is about opiods vs Tylenol is not what the article says. It describes various "nonopioid pain relievers (such as Tylenol, topical lidocaine or nonsteroidal anti-inflammatory drugs)."
Please explain?
3
Oh baloney. As an age 70 Vietnam veteran, I've now taken low doses of hydrocodone for 13 years, and I've tried and tried over the last three years to get below 15-20 mg per day without success. Motrin and tylenelol don't cut it and give me gastric side effects. With very low doses of HC, I do perfectly fine, but as I get below that threshold the pain returns and makes life miserable. I exercise and do everything else they suggest, but a tiny bit of hydrocodone is what keeps me comfortable...and the stupid politicians are turning me into a pariah.
14
Assuming you are suffering from a form of arthritis, that comes with pain. Pain is something you must (and can) get used to. You're a veteran - largely irrelevant in this context, but your medical care is taken care of, so that's good. The rest? You're addicted, badly so, and should see an addiction specialist to take care of that. Sorry, but you got to quit the excuses.
2
"Assuming you are suffering from a form of arthritis"
You went wrong on the word "assuming".
None of you people who aren't suffering from pain or even if you are have a right to tell others what is good for them or not. Our pain is OUR pain and we know a lot better what helps and doesn't. This assumption that all opioid users are addicts is why we have problems getting the medications that will actually work for us.
4
The arrogance & ignorantce of callous people like this --who tell others to "get used to their pain", and label then as addicts for their judicious use of medications.
Stop trolling the internet with such inane comments.
Quit judging people you don't even know.
And please refrain from telling them how to live their lives and survive their struggles as best they can.
2
The headline is a farce, so why read on? Wrong, wrong, wrong, from a user, not abuser.
4
Why can't someone invent a pain killer that is both effective and side-effect-free?
1
I suggest that patients try using Aspirin with 12 oz. of water.
1
I suggest you not lump all people into one panacea pile. I have an intractable, untreatable genetic condition that, due to faulty collagen in my body, causes me pain from doing things like keeping my head upright and moving my legs to walk. I have tried OTC medications, herbal medications, nerve blockers, massage, physical therapy, muscle relaxants, diet change and nothing works for me except for a low-dose of an opiate. Sorry I don't fit into your cookie-cutter definition of what pain is. No two of us are the same.
6
This is the type of study that gets my Irish Up. Were was it when the Drug Companies we’re promoting Opiods?
1
And CBDs work as well as Tylenol.
Tylenol is the number one cause of liver failure in the US. NSAIDS kill over 17,000 people per year compared to 16,000 opiate pai pill related deaths. So Otc meds for long term pain management are not safer than opiate pain meds.
As far this "study" this is not a revelation that we should treat people with Otc meds instead of opiates for chronic pain issue. There is a lot of information left out, like the cause of their pain, duration,intensity, etc.
I thought we were suppose to be treating pain with "evidence based treatment". The definition of EBT involves not just what research or studies says. That is only one component. The other two components are the doctor and his/her knowledge and experience and most importantly the PATIENT. EBT is supposed to be individualized to each patient and treatment is supposed to be individualized to meet each ones unique needs. It is to be tailored to each person based on what works for them.
Unfortunately for millions of people who suffer in pain policies that dictate access to pain medication have done away with anything resembling EBT. The doctors no longer have a say in how they can treat their patients in pain. Their treatment is dictated to the doctors now from NON MEDICAL personnel through the cbc guidelines and other policies designed to cut opiate prescribing. These policies give no thought to the individual patients they are affecting. They are hurting patients and tying the hands of doctors with one size fits all mandates.
20
Not just liver failure, even internal bleeding. My 70+ brother in law took tylenol for flu 10 days and ended up with bleeding gut. He did not realize he was so sensitive to acetaminophen, forget stronger pain killers like advil, ibuprofen that are already notorious.
3
I've suffered with spinal stenosis for 15 years. I've had two surgeries to relieve pressure on nerves and now a third situation has come up and I'm avoiding the surgery.
Both sciatic nerves are damaged and there is radiating pain from my buttocks to my toes. The soles of my feet are dead and I have trouble keeping my balance because I can't feel the floor. I've lost 90% of nerve conductivity and my legs and feet are swollen because my lymphatic system no longer works without muscle action. At times a pulsating pain comes to the toes of one foot that can take up to 10 minutes to stop. I cannot sweep or mop the floor without stopping to straighten my back to stop the pain. I climb the stairs one step at a time using a cane. My feet are ice cold and feel like they're soaking in ice water. Right now I'm having pain from a bone spur on my left heel. I've put off the surgery because it will put me in a walker for two months. I had one on my right heel in 2013 that caused the replacement of my Achilles tendon because it was frayed from rubbing on the spur.
I haven't had an increase in my pain medications in over 10 years because of the paranoia caused by busy bodies like Dr. Kolodny and interference with prescribing by the DEA. I use NSAIDS on occasion when the pain gets too great but they have little effect. I alternate between aspirin, acetaminophen and ibuprofen to minimize the bad effects from each.
Make me laugh. Tell me I can survive this pain without opioids.
2
It is exactly headlines like these that translate directly to Tall Men Standing Proud passing laws that make opiod prescriptions increasingly difficult to get. A begets B begets C, as reliably as clockwork. Almost six year ago, I fell off a porch, crushing six vertabrae. The damage is irrepairable. Thanks to opiods, I can get out of bed and get through the day, though at a constant pain level of 7-8. Yes, I have a regime of non-opiod practices, but the opiods--very tightly managed by a hospital pain clinic--keep me--us--going. And it gets harder every week to keep that prescription going: I fully expect it'll end someday. That'll leave me with illegals or alcohol. Not good choices. Please be careful what you print: non-medical politicans are watching.
18
Scrambling to divert the blame in this crazy "opiod crisis" . . . . You need more definitive and more intelligent studies. I read the JAMA. 240 is a drop in the bucket, a group of similar people. Doesn't tell me anything. Obvious point about the exercise and therapy. Who doesn't know that? But some people ache and can't sleep after exertion or over exertion for what ever reason. Not sure what the answer is but I know the drug companies need to come up with better drugs that are not addictive and don't cause as many side effects as non-steroidal anti-inflammatories like Celebrex and Mobic. They are good effective drugs but not for everyone. Frankly, low dose opiates taken only as needed can be very helpful with no addiction if you know what you're doing.
Don't take it out on people in pain or discomfort. Just find a solution that makes sense. If you want studies . . .bring me 2400 people studied over several months given different classes of drugs. Don't give me over the counter . . I already know about those. Tell me something I don't know. And give me more details!
3
More power to the people who can use Tylenol to combat pain that’s 7 or above on the 1/10 pain scale. Opioids used properly are going to be better at high level pain management for most people. We just had a family member pass away due to cancer. I’m glad that he got morphine to kill the pain in the final days before passing away.
13
My condolences, but the article is about osteoarthritis, not cancer.
9
Sorry - but the article us really about generating excuses for limiting the availability of opiods to those need them.
These people did not create the "opiod crisis". Don't make them another one of it's social victims.
This kind of opiod witch-hunt will negatively affect everyone living -and dying- in pain.
My condolences to YOU, when and if you are so affected...
2
OK - it's obvious that the authors did not read the study!
1) The "non-opioid" group included opioids! 10% (13) of the non-opioid group ended up on Opioids by the end of the study.
2) The opioid group had the most stable medication regime staying on 1-2 drugs through the 12 months. The non-opioid group average 4-5 medication changes. This also explains why the opioid group initially had better pain control but the non-opioid group eventually caught up when opioids were introduced
3) The non-opioid group had twice the rate of illegal drug use and alcohol use during the study (although outside the study's level of confidence)
4) The initial opioid doses were conservative (50MME) and were sufficient for most of the opioid group (over half stayed on this dose)
5) This sample group is the "average" back pain patient, not the intractable pain patient that can no longer work, is on disability, or forced to retire due to back pain.
That being said, doctors should always start with non-opioid options prior to opioid options - if that doesn't work, low dose opioids work well for may that may have failed non-opioid options.
25
I think there's enormous variability between people in what works for osteoarthritis pain relief. Tylenol does nothing for me. Aspirin however works extremely well. Physical therapy and stretching also works well.
And before you say that I have mild osteoarthritis, I have had it for over 40 years and have no cartilage left in my left shoulder.
11
Does nothing for me either, because of Kidney disease it is the only OTC
medicine I can take.
4
Andrographis, a very bitter herb, has been shown to be as effective as Tylenol for sore throats tied to infection from flu or cold. In my experience, it is superior to OTC pain relievers for acute joint pain and, especially, pain due to infections.
In one instance, I developed a gum infection while traveling in an area where I had no access to dental care. It was extremely painful to eat. However, by taking a loading dose of 1,200 mg. of andrographis extract and then 400 mg. every 6 hours, the pain and swelling was reduced to a barely noticeable level until I could seek proper care for the infection. I include andrographis in my travel and backcountry first aid kits, now, and have found it to be a reliable pain killer and anti-inflammatory.
A small number of people are allergic to andrographis (they tend to be allergic to many other foods and airborne allergens), so it is a good idea to try a small dose before relying on andrographis. Also, it should not be used for more than a week because it slows the process of cell division in endothelial cells, which could lead to risks in the long term.
2
That's very nice, but what does it have to do with an article about pain treatments for osteoarthritis?
3
That is a fair and good question.
First, the study pits opioids against non-opioid pain relievers like Tylenol and finds them not worth the risk. Tylenol has risks of its own, which andrographis and other whole herb remedies that suppress are block cytokines do not.
Which leads to the second point. The future of arthritis pain relief is to stop the immune system signals that lead to inflammation and destruction of the joint. Those would be cytokines and chemokines. Unfortunately, research funded by big pharma insists on ignoring the pile of research on whole herbs that work on several cytokines at once and, instead develop drugs that overpower a select cytokine while leaving others that form an effective matrix unchecked. That does not work well, but natural herbs that can be had in bulk for a few dollars don't pay for big marketing budgets and long-term clinical trials, so arthritis sufferers wait and continue to suffer.
The following articles make for useful starting points for those interested in connecting the dots between herbal remodulation of cytokines and relief from chronic pain and injury due to arthritis:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3344210/
https://nutritionreview.org/2013/04/traditional-chinese-herbs-arthritis/
1
They randomized two groups for twelve months of treatment: one group was on opioid treatment for twelve months. TWELVE MONTHS???? And how many of these folks later had a problem with the opioids themselves, and coming off them if desired, never mind the pain??? The linked article only has an abstract and brief summary. The full text is behind a pay wall. The patients enrolled were from outpatient clinic at a Veterans Adminstraion Medical Center.
In what world does randomizing patients to twelve months of opioid treatment for arthritis pain pass muster with an Institutional Review Board?
8
This story does not accurately describe the trial we conducted. It was not a comparison of opioids vs Tylenol. I have asked the author to correct it, to no avail so far.
49
Can you provide some background on what the authors got wrong? Many news outlets are telling the same story about your study.
7
Dr. Krebs, you need to be more specific in your objections.
Sure, the article title is wrong in using the word "Tylenol." Tylenol is a trademarked, particular formulation of acetaminophen—which was not used, although acetaminophen and NSAIDs were.
You compared opioids vs non-opiods, so the title should be: "For Some Arthritis Pain, Non-Opiods Work as Well as Opioids."
But other than that, I have to defend Mr. Bakalar here.
Your abstract states: "For the nonopioid group, the first step was acetaminophen (paracetamol) or a nonsteroidal anti-inflammatory drug. Medications were changed, added, or adjusted within the assigned treatment group according to individual patient response."
But other than that, how did this summary misrepresent your study or its conclusions?
Your abstract states: "Conclusions and Relevance: Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain." Overall, the blurb is a pretty good summary of your study and its results, right?
4
For me, naproxen works best for sciatica and back pain. I've even tried to fool myself by mixing in a minimal amount of Tylenol in place of naproxen. It doesn't work.
2
What a joke! Tylenol has no anti-inflammatory activity and that is what arthritis is all about. Tylenol gives me 0 pain relief; it is like a placebo for many people.
23
Sure, and when they have surgery maybe they'll be offered a choice between "positive thinking" and massage.
13
This is abysmally poor science- and poor journalism, also. You do recall - about 50% of all "studies" published in JAMA and other top medical journals - are rescinded later? According to... JAMA, I believe.
"The first study" - oh, my god. Give it a google- there's an entire field of study comparing pain relievers; with its own name - equianalgesics. Look up 'compare opiods and nsaids" , and sort through the 134,000 results.
7
I hear a lot of talk about physical therapy being a good pain management tool. However, when I was in horrific pain before my hip replacement and sent to physical therapy, I was in so much pain I was unable to do the therapy.
The physical therapist I worked with said that lack of pain medication made it impossible for many people in pain to do much of anything. They have explained that to doctors, but the doctors aren't listening.
The idea that Tylenol works well for pain is a sick joke. Besides not being an effective pain killer for people who are in genuine pain, it is an extremely dangerous drug, especially for people with liver or kidney problems.
Perhaps the article should have mentioned that the most popular opioids that are prescribed are loaded with Tylenol.
33
Agree. Prior to my hip surgery I had extreme (up to 8) pain from the hip to my ankle. (And I walked like Freddy Krueger.) Advil, aspirin, etc. had NO effect on the pain. Fortunately post-surgery I got an Rx for Oxycontin which helped my recovery.
11
"Fortunately post-surgery I got an Rx for Oxycontin which helped my recovery."
Yes indeed, Oxycontin. When my mother was dying of lung cancer, I'm glad her physicians didn't offer her a Tylenol. She was on enough Oxycontin to put an elephant to sleep; but it kept her relatively pain-free and alert.
As for regular old pain -- joint pain, headaches, bumps -- Advil seems to be pretty good. I'd be chary of strong stuff unless my pain were excruciating.
3
I used Oxycontin for a few years until my insurance stopped paying for it. Now I'm on Morphine ER which not as effective and I'm held to the same schedule as for the Oxycontin. It's not just Dr. Kolodny, the DEA, the medical boards and doctors but even out insurance companies are working against us.
1
I think what this means is, neither of these drugs works well, at all. Where is the research that will come to the rescue of severe osteoarthritis sufferers? There are so many of us . . .
12
You have got to be kidding. I have used opioid pain relievers for over TEN YEARS. Before receiving opioid pain relievers, I suffered pain that made getting out of bed so intense, I was unable to work. My hands were literal claws that could nearly hold a pen. My neck was was so stiff, I could not look over my shoulder when changing lanes while driving. I was seriously contemplating suicide. Strong opioid pain meds changed all of that. They so reduced my chronic pain, that I was able to function as well as before I became ill. Prior to receiving my opioids, I was seriously contemplation suicide. I was taking OTC MEDS at very high doses. Now I lead a normal life.
29
Importantly, this was a study of "Eligible patients had moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use."
In plain English, this is a study of people with chronic back, hip, or knee pain that doesn't respond to, doesn't get better with, the use of analgesic medications. Specifically and ONLY people whose pain already does not respond to normally administered pain medication.
I have had a diagnosed chronic back problem most of my adult life, and have tried, over the years, most everything -- I have settled for a routine that "takes the edge off" -- pain-free apparently not an option for me.
It is unclear what this study means for people with chronic pain that does respond to medication....NSAIDs of Opiods?
4
Tylenol is also a dangerous drug. Never take more than the recommended amount without a doctor telling you to. It's not as dangerous as opioids, but it still kills hundreds of people every year.
We need some serious research on better pain relief. What we have is either dangerous or not effective enough. All the NSAIDS (except maybe aspirin) are linked to heart problems, and many people don't get enough relief from them alone. Those three ratings are still not making people comfortable.
Maybe now that marijuana is becoming legal more places we can do some good research on it and its derivatives as pain relievers. I hope there are also other avenues that are being researched as well, we need more options.
16
I recently moved to Maine, got the card, and have been using medical marijuana for the past 4 months. I actually was quite a skeptic, but it's proven to be incredibly effective. I have fibro, severe spinal stenosis, and systemic arthritis from lupus, and anything that allows me to take less Percocet is a good thing.
2
"Curry ingredient turmeric is MORE effective than paracetamol or ibuprofen at easing painful injuries"
2
No way.
3
Did you take it for three weeks?
"After less than three weeks, taking a key component of the Indian staple spice, known as curcumin, eases injured rugby players' discomfort just as much paracetamol or ibuprofen, but without their side effects, a study found."
2
Having severe osteoarthritis in my knee( after ACL/meniscus surgery) lead me down a long road with Advil - up to 8 or 9 /day to get relief. I'd have to stop for a few days every month or so because of stomach pain....
I started taking Curamin (Terry Naturally Brand) which is a turmeric/boswelia/ DLPA supplement for pain.
i sometimes use the extra strength- using 3/day depending on the day. i have been off advil for a year.
To me, camphor menthol patches are much better than Tylenol. I rarely see them discussed.
3
Also, exercise, foam rolling, stretching and rest! Try to keep your muscles as strong and flexible as you can.
7
Personally, I've found over the counter pain relievers work for me only occasionally whether I am taking them for headache or, in recent years, for arthritic back pain. That said, I use hot pads and do core exercises. I have no interest in opioids for my chronic pain, though I did take one for a few days when I broke my arm about 15 years ago.
4
You've got to be kidding me. I don't think opioids are a good idea in many cases, but to state that TYLENOL is superior to opioids for pain relief over any measurement protocol is pretty hard to believe
27
That's the beauty of randomized trials. They provide objective evidence to confirm or disprove what intuition leads you to believe in. Hard to swallow maybe. But evidence is evidence.
6
little fooch-
that is probably why it's a news article
1
Well yes, but is this a replicable, confirmed, peer-reviewed study? I'm not convinced, and it reeks of bias.
1
50 years ago as residents we were told that a placebo is 30% as effective as morphine in pain management, it would have been illuminating had there been a placebo group in the study.
While it is important to stress that opioids are by and large be avoided in chronic pain management; this study should not be taken as an endorsement for Tylenol. Tylenol has no anti- inflammatory activity, and the non-opioid group received both Tylenol and NSAIDs. Patients in this study may have had, or not, inflammation as part of their pathology.
5
I find that I have a greater tolerance for pain when I know that I have a solution for it if I need it. I feel the same amount of pain. I just don't have the same amount of anxiety about it. So having the opioid on hand helps even if I don't take it. Perhaps there is a similar dynamic with the so-called placebo effect you cite. When people feel that their pain is being addressed they simply have a greater tolerance for it.
9
While I agree that opioids should be of last resort. Why is it insurances refuse to pay for any other therapy other than that pill. Things like butyrates, exercise, massage, meditation, occupational and physical therapy have all been proven to work yet the copay is not what the patient can afford. They will not cover lidocaine patches or TENS units either. NuTsO and especially now. The companies will gladly pay for the pills or antidepressant to get you better and back to your activities of daily living. Those are on the formulary. Then graciously the insurance will pay for one rehab stint after you get hooked. Ugh...Time for an intervention.
14
You are so totally right.
3
and why wouldn't you use an anti-inflammatory?
3
Because so many of them damage the stomach. That's my fate, after years of taking them.
5
Wondering, GayLee, because I take an aspirin every day with a very tall glass of milk -- did you try the milk route and still develop stomach problems?
1
An enteric coated aspirin will not hurt your stomach.
1
The JAMA abstract says: "Medications were changed, added, or adjusted within the assigned treatment group according to individual patient response."
That sounds like some patients could have been switched from Tylenol to NSAIDs like ibuprofen which in my experience, works a lot better than Tylenol for osteoarthritis. Anyone disagree with that?
15
My research findings were that for osteoarthritis take NSAIDS if you can't get opioids - not Tylenol.
6
I think the tille is very misleading. Tylenol does not work for me while non-steroidal anti-inflammatory drugs do. Don't group the two types of drugs together.
23
While true that OTC medications are often effective pain relievers, using Tylenol (or any acetaminophen) based product for any form of arthritis pain will not relieve this type of pain. Medical diagnoses ending in "itis" indicate the disease is caused by inflammation somewhere in the body. OTC medications that are effective for treating pain from inflammatory conditions are salicylic acid based such as aspirin and NSAID's (Advil, Aleve etc). Titling this column as using Tylenol for osteoarthritis pain is just plain wrong. However, these medications,like all others,come with risks and must be used with a risk/benefit assessment. I have both osteo & rheumatoid arthritis plus scleroderma which is a autoimmune disease that is also inflammatory in natur and for most of the past 20 years I have avoided opioid drugs but I have taken these are times. I totally agree that opioid drugs are very dangerous and should only be used in special circumstances and for very limited times. But discounting their effectiviness completely is also a mistake - sometimes they are the only option.
13
PatO-
" using Tylenol (or any acetaminophen) based product for any form of arthritis pain will not relieve this type of pain"
Just because you say this doesn't make it true. Have you asked every single person in the world? Because if there is a single person who get pain relief, you statement is nonsense.
2
Any physician suggest Plaquenil to you for autoimmune inflammation? I think it's quinine-based.
The headline mentions Tylenol but the study also used NSAIDs. Are we to infer that Tylenol works better than an NSAID? Was there a difference between the two? Which NSAIDs were used? I have always assumed NSAIDs work better than Tylenol because of their anti-inflamatory effect. It has already been established that opioids are not good for chronic pain so what is new? This article leaves out too much important information.
13
I can confirm the results after two THR's - once the surgical pain was gone NSAIDS worked just fine without the very negative side effects of Opiates. OIC is not fun.
6