choose a treatment for a musculoskeletal injury

Musculoskeletal Injuries
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Pharmacologic treatment is the salient mode of treatment for osteoarthritis to aid in alleviating pain and anti-inflammation (Zhang, Ouyang, Dass, & Xu, 2016). There are different types of this mode of treatment, but the focus in this paper is on acetaminophen. The drug is considered to have analgesic and antipyretic effects; thereby, alleviating symptoms and improving an individual’s functionality. Acetaminophen is accepted by the World Health Organization as a good drug to relive a variety of symptoms, most of which are evident in osteoarthritis, such as pain, muscle ache, and backache (Zhang et al., 2016).
Acetaminophen is recognized as the first-line analgesic for osteoarthritis in its mild and moderate stages. An intake of 4000mg acetaminophen every day is recommended in the treatment of mild and moderate osteoarthritis of the hip and knee. Despite the fact that there are other drugs with greater efficacy, their associated side effects render acetaminophen a more cost-effective and safer drug to use, according to a systematic review by Towheed, Hochbrg, Judd, and Wells (2003). Also, the review showed that the drug had similar effects to more potent analgesics like the non-steroidal anti-inhibitory drugs (NSAIDs) in pain as measured by the HAQ questionnaire and functional status. Acetaminophen is the common mode of treatment for osteoarthritis because of its significantly higher safety levels compared to the other drugs. On the downside, the lack of side effects is likely to increases chances of its abuse.

Acetaminophen can only relieve pain, but it cannot reverse the damage because it does not have potent anti-inflammatory effects as indicated by Towheed et al. (2003). A study conducted by indicated that the use of the drug is not worth its effect because it has a small effect at <4 based on a 0-100 point scale (Machado et al., 2015). Thereby, it is not deemed to have meaningful clinical significance to both physicians and their patients. Also, an overdose has been shown to cause liver damage due to toxicity. As a result, it is important for individuals to check products where acetaminophen is combined with other products as it should not exceed 325mg in a dosage unit (Zhang et al., 2016). These recommendations by the United States Food and Drug Administration resulted in a further adjustment through a reduction in the recommended daily usage of the drug, which clashes with recommendations by other guidelines like those of the American College of Rheumatology. More interesting is the fact that other guidelines like OARSI and the National Institute for Health and Care Excellence (NICE) are changing their views about the drug as they no longer consider it a first-line drug due to the small effect sizes in studies that have already been conducted (Machado et al., 2015; Yu & Hunter, 2015). The drug is recommended for mild and moderate symptoms of osteoarthritis and ineffective for severe symptoms.
Apparently, there are controversies revolving around the effect of acetaminophen in the management of osteoarthritis. Acetaminophen, also known as paracetamol, has been recommended as the first line drug by most guidelines, but studies are consistently showing its inefficacy due to its small effects. Whereas optimal doses are deemed important, there are concerns of safety due to toxicity. Based on the discussion presented herein, it is apparent that acetaminophen’s positive effects do not outweigh its downside. Thereby, it is not an ideal first-line drug in reference to both efficacy and safety, but a preferable option to manage chronic diseases over the long-term.
References
Machado, G. C., Maher, C. G., Ferreira, P. H., Pinheiro, M., Christine, C., Day, R. O., Ferreira, M. L. (2015). Efficacy and safety of paracetamol for spinal pain and osteoarthritis: Systematic review and meta-analysis of randomized placebo-controlled trials. BMJ, 350, h1225. Doi: https://doi.org/10.1136/bmj.h1225.
Towheed, T. E., Hochberg, M. C., Judd, M. G., & Wells, G. (2003). Acetaminophen for osteoarthritis. Cochrane Databases of Systematic Reviews. Doi: 10.1002/14651858.CD004257.
Yu, S. P., & Hunter, D. J. (2015). Managing osteoarthritis. Australian Prescriber, 38(4), 115-119.
Zhang, W., Ouyang, H., Dass, C. R., & Xu, J. (2016). Current research on pharmacologic andregenerative therapies for osteoarthritis. Bone research, 4, 15040. Doi:10.1038/boneres.2015.40.