Therapy target
Pain relief and thus improvement of mobility.
Therapy recommendations
- Analgesia (pain relief) according to WHO staging scheme.
- Non-opioid analgesic (paracetamol, first-line agent).
- Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
- If necessary, anti-inflammatory drugs / drugs that inhibit inflammatory processes (non-steroidal anti-inflammatory drugs, NSAIDs), eg ibuprofen.
- If necessary, glucocorticoids; the effect of intraarticular (“into the joint cavity”) injection is not ensured, but can be administered in case of inflammation that cannot be controlled otherwise
- See also under “Further therapy“.
Analgesics
Analgesics are pain relievers. There are several different subgroups, such as the NSAIDs (non-steroidal anti-inflammatory drugs) to which ibuprofen and ASA (acetylsalicylic acid) belong, or else the group around the non-acid analgesics paracetamol and metamizole. They are all widely used. Many preparations in these groups carry a risk of gastric ulcers (stomach ulcers) with prolonged use.
Glucocorticoids
Physiologic – found in the body – glucocorticoids cortisol and cortisone are produced in the adrenal cortex. In addition, there are pharmaceutically produced glucocorticoids such as prednisone or prednisolone. The following main effects are similar for all glucocorticoids.
- Increase in metabolism to provide energy.
- Immunosuppression – suppression of the body’s defenses.
- Antiallergic
- Antiphlogistic – anti-inflammatory
- Antiproliferative – growth inhibitory
Glucocorticoids have a bad reputation because of the alleged many and severe side effects. However, these side effects such as osteoporosis, thrombosis tendency (formation of blupfröpfen in the veins), weight gain, hypertension (high blood pressure) and others occur only with long-term treatment.