For millions of Americans living with knee osteoarthritis, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and diclofenac are often the first line of defense against chronic pain. While these medications can provide short-term relief, new research suggests long-term reliance on NSAIDs may be associated with worsening symptoms and a greater likelihood of eventually needing knee replacement surgery.
A 2024 study published in Scientific Reports examined data from more than 4,100 adults across three major osteoarthritis cohorts and followed participants for four to five years. Researchers compared people who used NSAIDs long-term with those who did not and evaluated changes in pain, stiffness, disability, and progression to total knee replacement.
What the Study Found About Long-Term NSAID Use
The study found that people who used NSAIDs consistently over several years were significantly more likely to experience worsening osteoarthritis symptoms than non-users.
Compared with non-users, long-term NSAID users were:
- More than twice as likely to experience worsening knee pain.
- More than twice as likely to develop worsening disability.
- Significantly more likely to experience increased stiffness.
- More than three times as likely to undergo total knee replacement surgery.
Interestingly, researchers did not find strong evidence that long-term NSAID use accelerated structural damage within the knee joint itself. Instead, the increased likelihood of knee replacement appeared to be driven primarily by worsening symptoms and reduced function.
The Risks Beyond the Pain Relief
NSAIDs remain valuable medications for short-term pain relief, and they can play an important role in managing osteoarthritis flare-ups. However, most clinical guidelines recommend using NSAIDs at the lowest effective dose and for the shortest duration necessary.
Long-term use has already been associated with risks such as:
- Stomach ulcers and gastrointestinal bleeding
- Increased cardiovascular risks
- Kidney complications
This study adds to growing evidence that relying on NSAIDs for years may not provide the long-term solution many patients hope for.
Looking Beyond Daily Pain Medication
Knee osteoarthritis is a progressive condition, and pain often becomes increasingly difficult to control with medication alone. Many patients find themselves taking higher doses, using medications more frequently, or cycling through different pain management strategies while still struggling with daily activities.
When chronic knee pain continues to interfere with walking, exercise, sleep, or quality of life, it may be time to consider alternatives addressing the source of inflammation rather than providing short-term relief.
Could GAE Be an Option for You?
Patients who find themselves increasingly dependent on NSAIDs or other pain medications may be candidates for Genicular Artery Embolization (GAE), a minimally invasive treatment for knee osteoarthritis.
GAE works by targeting the abnormal blood flow fueling joint inflammation by precisely blocking micro-vessels that supply blood to the inflamed lining of the knee joint. The outpatient procedure is done under mild sedation, and patients typically return home the same day.
GAE may be appropriate for individuals who:
- Continue to experience knee pain despite conservative treatments
- Depend on regular pain medication to get through daily activities
- Are not ready for knee replacement surgery
- Want a minimally invasive alternative with little downtime
- Have moderate to severe knee osteoarthritis
While not every patient is a candidate, GAE offers an option for those seeking longer-lasting relief without the risks associated with chronic medication use.
When to Consider Moving Beyond Pain Medication
This study does not prove that NSAIDs cause worsening knee osteoarthritis. However, it does highlight an important concern: patients who rely on these medications for years may experience worsening pain, disability, and a greater likelihood of knee replacement surgery.
If knee osteoarthritis pain is keeping you dependent on daily medication, it may be time to explore additional treatment options. Minimally invasive procedures such as Genicular Artery Embolization can help some patients reduce pain and improve quality of life while potentially delaying the need for knee replacement surgery.
If your knee pain is persistent or affecting your quality of life, it may be time to explore treatment options that go beyond temporary fixes. A specialist can help you understand what is causing your pain and whether a minimally invasive approach like GAE could be right for you
Editor’s Note: This study identified an association between long-term NSAID use and worse osteoarthritis outcomes. Because the research was observational, it cannot determine whether NSAID use directly caused these outcomes. Patients should always consult their healthcare provider before making changes to prescribed medications.
