Pharmacological treatment-step 1 - does it include hydrocortisone?

Hydrocortisone is one of the treatment options for managing pain due to knee OA. But according to OARSI, EULAR and ACR guidelines it's not included in the first line treatment options and it should be considered after the use of oral and topical NSAIDs and/or acetaminophen, the use of duloxetine and in some cases tramadol.

Acetaminophen is commonly used for early OA pain management, but there are debates about its efficacy. AAOS strongly recommended acetaminophen for the treatment of knee OA.

Tramadol is a synthetic opioid and serotonin/norepinephrine reuptake-inhibitor prescribed to treat pain in patients with OA. ACR conditionally recommended tramadol for patients with knee, hip, or hand OA. While tramadol should not be used as a first-line treatment due to its limited benefits, tramadol may be suitable if patients have contraindications to other medications (e.g., NSAIDs) or lack therapeutic options (e.g., surgery)

Non-pharmacological treatments and self - management programms for pain should also be introduced to patients as part of the holistic approach for better health outcomes. 

  • You talk to the patient about non-pharmacological treatments.
  • Send the patient home with basic advice on how to manage her pain

Map: 2. Knee Osteoarthritis Management - GP_DOCTORS (868)
Node: 17106
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