At present Mrs Scott is taking paracetamol 1g as needed, but is not experiencing significant relief from arthritic pain. She has no previous history of heart disease, high blood pressure, diabetes, stomach ulcers, asthma, gastrointestinal disorders, kidney disease or liver disease, so it is reasonable to consider celecoxib 100mg bd prn. This may help to reduce pain and inflammation associated with arthritis. However regular paracetamol is the first line therapy recommended.
Mrs Scott may benefit from the introduction of fish oil in her diet as there is some evidence that this effects the inflammatory process and can result improving pain and stiffness. Mrs Scott may also benefit from non-pharmacological methods for managing arthritis. Mrs Scott has a BMI of 28, indicating that her weight exceeds the healthy weight range for her height. Being overweight is likely to be contributing to her worsening arthritic pain. Eating a healthy, balanced diet and maintaining regular physical activity will be crucial in facilitating weight loss. Acupuncture and massage may also be worth exploring as natural pain relief methods.