This protocol addresses shoulder osteoarthritis in patients who have no contraindications and no reported intolerances to NSAIDs. Oral NSAIDs are among the most recommended pharmacologic agents for osteoarthritis; in this population, their use is not precluded by safety concerns or prior intolerance.
This protocol includes an oral agent that carries conditional recommendations across major guidelines for osteoarthritis pain management. The complete regimen — including agent selection, sequencing, and clinical criteria — is available in the full protocol.
DOI: 10.1016/j.rdc.2022.03.009.
Oral and topical NSAIDs are the pharmacologic agents most recommended for OA, though oral formulations should be avoided in those with contraindications and intolerances, and topical formulations are not appropriate for a deep joint such as the hip.
Though duloxetine is approved for OA in some countries, there were only conditional or weak recommendations for its use across all guidelines, reflecting general concerns about efficacy and tolerability.
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