Is there such a thing as a plateau effect for arthritis medications?

Question: Is there such a thing as a plateau effect for arthritis medications?

It has been the experience of many arthritis patients that after taking a particular NSAID for awhile it seems to stop working or lose effectiveness. Is there such a thing as a plateau effect for NSAIDS and do you think it helps to change NSAIDS periodically for this reason?

Answer: When ever a new medication is started there seems to be an almost euphoric effect. This is due in part to the "placebo effect", but the major reason is that there is pent up pain, aching, and stiffness in an arthritic patient that begs for relief. An NSAID will quickly provide this relief. After awhile, however, the patient may note that relief is not as dramatic as hoped for. Since patients do not build up a tolerance to their NSAID, what is happening? Initial reduction of symptoms is never complete. Although a good deal of discomfort is relieved, complete relief is NSAID dependent. Each NSAID can only provide relief based on the nature and strength of the drug, and the patient's response to therapy. Since there are many classes of NSAIDS, it makes sense to change medications, if the initial drug does not provide the desired relief. (Answer provided by the late Dr. Raymond Federman, aka Dr. Bones, who passed away on September 2, 2003. The care of his patients even in retirement was always his joy.)