Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1994; 87(Suppl 23): 22–25.
PMCID: PMC1294176

Drug management of arthritis in the elderly.


Rheumatic disorders are common in the ageing population requiring the use of DMARDs and immunosuppressive therapy as with younger patients. Indications for therapy are approximately the same in both groups, but toxic side-effects are probably more common in the elderly necessitating close supervision of indications and drug requirements. Local injection techniques The practice of local injection of corticosteroid in musculo-skeletal disorders is widespread. The literature on comparative efficacy between different preparations is scanty. These techniques can give significant relief in rheumatoid arthritis, osteoarthritis, sero negative arthropathies, crystal induced arthritis and many soft tissue lesions. Severe joint and soft tissue lesions are common in the elderly. In these patients even a small loss of physical function may have a markedly detrimental effect on independence. Such lesions should therefore be actively sought and vigorously treated. Often a simple, rapidly acting, local corticosteroid injection is preferable to a prolonged course of either NSAIDs or physiotherapy. In general, such injections should not be used if the diagnosis is uncertain, or there is any suspicion of infection, or if there has been a previous severe local reaction. Injections that are becoming too regular mean that the technique has not proved successful and other therapies should be sought. In performing the injections, antisepsis should be scrupulous and a 'no-touch' technique used. Accuracy of needle placement is necessary for good results. Injections should not be given against pressure as this generally means incorrect sitting. Some systemic absorption does occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (875K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Morgan J, Furst DE. Implications of drug therapy in the elderly. Clin Rheum Dis. 1986 Apr;12(1):227–244. [PubMed]
  • Bird HA. Drugs and the elderly. Ann Rheum Dis. 1990 Dec;49(12):1021–1022. [PMC free article] [PubMed]
  • Jones AC, Berman P, Doherty M. Non-steroidal anti-inflammatory drug usage and requirement in elderly acute hospital admissions. Br J Rheumatol. 1992 Jan;31(1):45–48. [PubMed]
  • Hunter T. Potential for drug interactions in elderly patients with arthritis. Ann Rheum Dis. 1992 Jul;51(7):926–927. [PMC free article] [PubMed]
  • Buchan IE, Bird HA. Drug interactions in arthritic patients. Ann Rheum Dis. 1991 Oct;50(10):680–681. [PMC free article] [PubMed]
  • Schlegel SI, Paulus HE. Non-steroidal and analgesic therapy in the elderly. Clin Rheum Dis. 1986 Apr;12(1):245–273. [PubMed]
  • Brooks PM. Side-effects of non-steroidal anti-inflammatory drugs. Med J Aust. 1988 Mar 7;148(5):248–251. [PubMed]
  • Brooks PM, Yeomans ND. Nonsteroidal anti-inflammatory drug gastropathy--is it preventable? Aust N Z J Med. 1992 Dec;22(6):685–691. [PubMed]
  • O'Callaghan JW, Brooks PM. Disease-modifying agents and immunosuppressive drugs in the elderly. Clin Rheum Dis. 1986 Apr;12(1):275–289. [PubMed]
  • Fleming A, Bertouch JV. Local injection techniques. Med J Aust. 1981 May 16;1(10):512–516. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press