Treatment of Shoulder Osteoarthritis with Contraindications or Intolerances to NSAIDs
When a patient with shoulder osteoarthritis has a contraindication to non-steroidal anti-inflammatory drugs — or cannot tolerate them — the standard analgesic pathway is not available. This clinical situation requires a structured alternative approach grounded in current evidence.
Clinical scenario
The patient has shoulder osteoarthritis and presents with either a formal contraindication to NSAIDs or a documented intolerance. Because NSAIDs are not a viable option in this context, management relies on strategies specifically appropriate for this population.
Approach (partial overview)
The regimen in this setting is anchored by structured non-pharmacologic interventions — including education, self-management programs, and specific exercise modalities — with a particular analgesic option considered for those who cannot use NSAIDs. The full sequenced protocol, including all components and their clinical rationale, is available via the link below.
References
DOI: 10.1016/j.rdc.2022.03.009.
- Acetaminophen is no longer considered “first-line” for OA due to its relative poor efficacy, though it is still an option for those who have contraindications or intolerances to NSAIDs.
- Education and self-management constitute a key component of OA management.
- Referral to self-management programs should be provided, and patients should receive education on OA, management approaches, joint protection strategies, and exercise.
- Patients with OA should be advised to engage in regular low impact aerobic exercise (land or aquatic-based) and to lose weight if overweight.
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