St Thomas University W7 Osteo

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Bernadin Cherazar.

Osteoarthritis is a form of arthritis that occurs when there is a degeneration of cartilage protecting bones’ end. It mostly affects joints in the hands, knees, spine, and hips. The damage it causes to the joints is irreversible; there could be intense pain, swelling, and eventually joint deformity and inability to move, the joints are hard to move. OA, as known, could be caused by; an injury, obesity, weak muscles as there is not enough support, inheritance from parents with genes that carry Osteoarthritis—aging as the middle-aged group suffers most the sex as women are more vulnerable than me. The patients can manage the disease by maintaining a healthy lifestyle, losing weight, physical therapies, self-care, and when it is worst, surgery in which replacement of the damaged tissues occurs.

Acetaminophen is the first-line treatment for mild Osteoarthritis; this is for the outpatients who continue their day-to-day lives. Non-steroidal anti-inflammatory drugs(NSAIDs) like ibuprofen and celecoxib that doctors use to moderate to severe Osteoarthritis have side effects like cardiovascular problems, stomach pains, bleeding, liver and kidney damage. For the most severe cases, medics recommend Duloxetine. Along with the treatment, physical therapy involves exercising to strengthen muscles around the affected joints, reducing pain, and increasing flexibility. The second type of therapy is occupational therapy, in which an occupational therapist helps the patient devise ways of handling daily tasks without stressing the already painful joints. From clinical evidence, the NSAIDs are more toxic than Acetaminophen(APAP). The intra-articular (IA) hyaluronic acid (HA) treatment uses various mechanism actions like chondroprotection, which is the most preferred, proteoglycan and glycosaminoglycan synthesis, mechanical and analgesic in worse situations(Nero et al., 2020).

Our patient Sally, 50 years old, complained of stomach pain because it is a side effect of the NSAIDs Ibuprofen, so the care provider prescribed celecoxib (Celebrex). Though it worries Sally that there has been a rise of cardiovascular issues tagging along with celecoxib, she must know that medical research carried out gave low-quality evidence on whether the heart problems came from administering them. Though they both reduce pain with the same amount, celecoxib improves physical function than ibuprofen. The side effects earlier mentioned could be the same, but celecoxib has the benefit of improved physical function(KILIÇ et al., 2014).

Ibuprofen and Celebrex are in the same category of first-line treatment of Osteoarthritis. They are both Non-steroids; clinical trials of both have shown cardiovascular attacks, sometimes stroke and myocardial infarction, bleeding, stomach ulcers, abdominal pain, diarrhea, and headaches. The significant difference is that Celebrex only works on the COX -2 factor, which least affects the stomach. In contrast, ibuprofen works on both COX-1 enzymes more excellent because Sally complained of stomach pain after only three months of the administration. Finally, celecoxib has the added advantage of improved physical function as compared to ibuprofen(Gupta, 2016).

In conclusion, Sally is indeed vulnerable due to her age and gender. Because she has been leading a healthy life, it is easier for her to manage, and with the help of the doctor’s prescription celecoxib 200mg daily, she will overcome. Osteoarthritis is incurable and has four main stages, from the minor-mild-moderate and finally to severe. Still, it is sure that Sally will manage it in the best way with the right treatment and therapies. Risk may be there with the celecoxib, but the benefits outweigh the risks as it is clinically proved to be the best. With this, Sally will have no fears whatsoever.

References

Gupta, A. (2016). What are the benefits and harms of single-dose oral ibuprofen plus codeine compared with ibuprofen alone in adults with acute postoperative pain?. Cochrane Clinical Answers. https://doi.org/1.1002/cca.1132

KILIÇ, B., ZEKİOĞLU, A., ÇATIKKAŞ, F., & YÜCEL, A. (2014). Evaluation of Application Results of Osteoarthritis in young patients and Hyalinotic Acide Injection with knee joint Lavage and Local Anesthesia at Same Session. International Referred Journal of Orthopedics Traumalogy and Sports Medicine, 01(2), 21-21. https://doi.org/10.172/otshd.201428928

Nero, H., Lohmander, S., & Dahlberg, L. (2020). Improved patient outcomes by a first-line osteoarthritis self-management program delivered digitally. Osteoarthritis And Cartilage, 28, S4-S165. https://doi.org/10.016/j.joca.2020.02.267

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