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The overall goal of treatment is early elimination of risk factors, early diagnosis and surveillance of the disease, and appropriate treatment of pain. It's also important to help people regain their mobility. These goals may be reached through a logical approach to care, including the overlapping of treatment that does not involve medications and treatment with medication and possibly surgical management.
Treatment that does not involve medications includes education, physical and occupational therapy, weight reduction, exercise, and assistive devices (orthoses).
Initially, simple over-the-counter pain relievers such as acetaminophen are recommended, followed by NSAIDs. Prescription NSAIDs may be needed if the over-the-counter medications are ineffective. A new generation of prescription NSAIDs are the COX-2 medicines (celecoxib [Celebrex]). The COX-2 drugs have fewer reported gastrointestinal side effects but similar results compared to the typical NSAIDs.
The antidepressant duloxetine (Cymbalta) is now approved by the Food and Drug Administration (FDA) for chronic musculoskeletal pain (joint and muscle pain). This medication works on neurotransmitters in the brain that control pain perception and has been shown to decrease chronic low back pain and pain caused by knee osteoarthritis.
Medically Reviewed by a Doctor on 8/11/2015
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