Therapeutic target
Relief of symptoms
Therapy recommendations
- For non-active polyarthrosis: analgesic/pain reliever paracetamol (best tolerated).
- In activated polyarthrosis (abraded cartilage or bone material inflamed): non-steroidal anti-inflammatory drugs (NSAIDs), e.g. diclofenac [no long-term therapy!]Note: No diclofenac in cardiovascular risk! Affected are patients with heart failure (cardiac insufficiency) of NYHA classes II to IV, coronary artery disease (CAD, coronary artery disease), peripheral arterial occlusive disease (PAVD) or cerebrovascular disease.
- Glucocorticoids, if necessary; the effect of intra-articular (“into the joint cavity”) injection is not assured, but may be administered in cases of inflammation that cannot be controlled otherwise.
General notes
- Intravenous administration (administration) does not confer any advantages over oral administration
- Continuous therapy should not be administered
- Different NSAIDs should not be combined!
- Alternative therapy for high cardiovascular/gastrointestinal risk → conventional NSAIDs + low-dose acetylsalicylic acid (ASA) + proton pump inhibitors (PPI; acid blockers) (recommendation of the Drug Commission of the German Medical Association).
Supplements (dietary supplements; vital substances)
Usually, medications from the above groups are taken in combination with chondroprotectants/cartilage-protecting agents (e.g., glucosamine sulfate, chondroitin sulfate) to inhibit cartilage-degrading substances and provide relief or improvement of pain.
For more information on chondroprotectants, see the following chapter.
Note: Chondroprotectants should preferably be taken in combination with other bone-active vital substances, such as vitamins (C, D, E, K) and omega-3 fatty acids (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)), if appropriate.
