Cartilage and Anti-Inflammatory Medications: Side Effects You May Not Know

Arthritis sufferers can manage joint pain with anti-inflammatory medications, which are usually effective but also may bring some unwanted side effects.

The type of arthritis medications taken most often to alleviate joint pain is nonsteroidal anti-inflammatory drugs, referred to as NSAIDs, WebMD said. Most of us know them as the meds we keep in our medicine cabinets and take when we have a headache or minor pains — anything with aspirin, naproxen sodium, and ibuprofen is an NSAID.

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Initially, over-the-counter NSAIDS are probably taken to treat mild joint pain. Medications like Motrin, Advil, and Aleve can be taken without a doctor's prescription and may work well for some people.

As arthritis progresses, doctors often prescribe NSAIDs that are more effective at fighting pain.

But, as with most medicines, NSAIDs can have side effects, although WebMD called them "reasonably safe."

While a warning on the package from the Food & Drug Administration about possible heart problems and strokes gets a lot of attention, and rightfully so, there is a less talked-about possible side effect of taking these painkillers. Medical researchers are turning more attention to the possibility that taking NSAIDs actually can be destructive to joint cartilage for people with osteoarthritis.

NSAIDs are the most common drugs given to the millions of people with osteoarthritis, and are taken by 20 percent to 30 percent of people older than age 64 who live in developed countries, according to an article in the Journal of Prolotherapy.

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"One of the most serious adverse reactions to NSAIDs, that is little appreciated, is that as a class of compounds they cause the breakdown of articular cartilage, thereby accelerating OA, the very disease for which they are most commonly prescribed," author Ross A. Hauser, M.D., wrote. He said cartilage breakdown appears to occur most frequently in knees and hips, and even blamed increased use of NSAIDs on the spike in hip and knee replacements in the last two decades.

But the issue is more controversial than it appears. Repeated studies have found that some NSAIDs caused cartilage problems in osteoarthritis, while others didn't, an article in the journal Inflammation reported. In some cases, the same NSAID was shown to harm the cartilage in one study, but to be protective of the cartilage in another study.

At this point, the Food & Drug Administration does not have a blanket warning on NSAIDs about the possibility of cartilage damage, although in mid-2015, it strengthened the warning about potential cardiovascular and stroke problems associated with the medicines.

Talk to your doctor about risks associated with any NSAIDs you take, and carefully read the information that comes with your medicine.

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