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I found the recent article "Treatment Options in Knee Osteoarthritis"¹ quite informative, particularly because it addressed a practical patient management issue. However, one key finding was discordant with my own experience managing this disease: in my practice, few patients have been willing to try treatment with capsaicin cream, and none has continued using it on a long-term basis. There are many barriers to the use of capsaicin: many patients prefer pills, 4 times daily dosing is difficult to comply with (this frequency is recommended for the first 2 weeks of use, as opposed to the 3 times daily "utility" the authors selected), and the cream burns (apparently ignored by the authors). It is my unscientific impression that my patients generally prefer treatment with acetaminophen (and cyclooxygenase-2 inhibitors before the recent troubles for this class of drugs) for their osteoarthritis.

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Correspondence: Dr Reinharth, 455 Lakeville Ln, East Meadow, NY 11554 (. . . [Full Text of this Article]

Daniel Reinharth, MD

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RELATED ARTICLE

Treatment Options in Knee Osteoarthritis: The Patient's Perspective
Liana Fraenkel, Sidney T. Bogardus, Jr, John Concato, and Dick R. Wittink
Arch Intern Med. 2004;164(12):1299-1304.
ABSTRACT | FULL TEXT