Orthopedic Medications

Orthopedic medications include various drugs to help relieve pain and treat musculoskeletal conditions and diseases. The three classes of drugs most prescribed by orthopedic doctors are nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and disease-modifying antirheumatic drugs (DMARDs). These medications are approved by the FDA, and most are quite safe. However, there are certainly risks and possible side effects that may occur.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

The most commonly used orthopedic medications are nonsteroidal anti-inflammatory drugs. The over-the-counter drugs aspirin, ibuprofen, and naproxen are NSAIDs. A doctor must write a prescription for other NSAIDs. Almost all of the NSAIDs are taken in pill form. These include the drugs diclofenac, etodolac, flurbiprofen, ketoprofen, oxaprozin, piroxicam, and sulindac. Most orthopedic doctors prescribe only one form of nonsteroidal anti-inflammatory medication at a time.

Nonsteroidal anti-inflammatory drugs help reduce inflammation. They also decrease pain and fever. However, they are short-acting drugs. After NSAIDs have passed through your body, inflammation, pain, and fever can return quickly. NSAIDs only lessen your pain and discomfort. They do not affect or cure the underlying disease.

Risks & Side Effects of NSAIDs

NSAIDs are considered safe drugs. However, they may have side effects. The side effects happen more often when they are used over long periods of time, which is common in arthritis patients. Some of the side effects of NSAIDs can become very serious. It is important to use the lowest doses possible to control your symptoms.

GI Effects

NSAIDs irritate the gastrointestinal (GI) tract. This includes the esophagus, stomach, and intestines. These drugs increase the production of gastric acid, and they may harm the gastric lining. NSAIDs aggravate ulcers and GI bleeding. Up to 5 percent of people who use NSAIDs for a year develop ulcers, bleeding, or tears in the GI tract. The risks are higher for older patients, patients with a history of GI problems, and patients with heart disease.

Blood Effects

NSAIDs make it harder for the platelets in your blood to clump together at the site of an injury. This can cause bleeding problems. Aspirin especially has this effect. Before you have surgery, you should stop taking aspirin for two weeks to prevent bleeding problems.

Liver Effects

NSAIDs can be toxic to your liver. You will not feel this, but elevated levels of certain liver enzymes can easily be seen in blood tests. Liver function almost always returns to normal when you stop taking NSAIDs.

Kidney Effects

NSAIDs can make it hard for your kidneys to get rid of some kinds of wastes. If you have a history of kidney problems, or if your disease may affect your kidneys, your doctor will use NSAIDs with caution.

Other Possible Side Effects

Some people get skin reactions and rashes from NSAIDs. Some get a combination of runny nose, polyps in the nose, and asthma. Different kinds of NSAIDs can have different side effects. Salicylates can cause problems with hearing. Other kinds of NSAIDs can cause headaches and confusion, especially in elderly patients. Many of the possible side effects of NSAIDs depend on your health and the disease for which you are being treated.

Individuals can react very differently to the same nonsteroidal anti-inflammatory medication. You and your orthopedic doctor must work together to find the right type and dose of medication that controls your symptoms without causing unwanted side effects.