Ask the Doctors April 2003 Issue

Ask Dr. Marks: 04/03

There seem to be a lot of NSAIDs (non-steroidal anti-inflammatory drugs) on the market. Are they really very different from one another?

All NSAIDs, which are designed to relieve arthritis pain and inflammation, have different side effects. Substantial research has gone into not only reducing these drugs’ side effects but into improving a patient’s response to these medications. The newest are called COX-2 inhibitors, which work through a different mechanism than traditional NSAIDs to limit gastrointestinal problems and produce a more positive response. Additionally, some NSAIDs need only be taken once a day, which makes them more convenient for the user. Another reason for the apparent overabundance of these drugs, of course, is that they have become very popular and many companies are now attempting to develop their own products.

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An acquaintance gets acupuncture treatments once a week and says they have helped her osteoarthritis pain. Is there any proof that acupuncture works?

Although there is anecdotal evidence that supports the efficacy of acupuncture, I know of no conclusive scientific evidence that shows that acupuncture actually helps ease arthritis pain. However, since the procedure does not appear to cause risk or problems, it would not be unreasonable—as a last-chance effort to avoid the need for surgery—to try the procedure.

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What’s considered an “alternative” arthritis treatment? How is it different from an “experimental” treatment?

An alternative treatment is a surgical or non-surgical procedure that departs from a standard treatment but represents a proven approach to solving a specific problem. In arthritis of the hip, for example, a hip replacement is considered a standard treatment, whereas an injection followed by an exercise program and medication would be considered an alternative treatment. Both standard and alternative treatments have a long track record of proven results, with well-documented data and the literature to support them. An experimental treatment is generally a new treatment that, in theory, is thought to provide satisfactory results for a given problem but has no long-term data to support it. However, given other available scientific data, it is believed to be a viable treatment. An experimental treatment often involves a procedure or program that is still under study. If you elect this type of treatment, you then become part of the study.

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Is it acceptable to take arthritis medication with coffee or juice instead of water?

It’s always best to take any medication with water. Juice contains acid, coffee contains caffeine—and in certain types of medication, these substances may interact unfavorably. They may also interfere with the absorption of the medication, making the medication less able to do its work. Water is an inert substance, which means it will not affect absorption of the action of the medication.