adverse effects. However intra - articular corticosteroid temporarily improve symptoms as discussed below. Opioid analgesics For moderate to severe pain a  opioid analgesic  such as  morphine  or  codeine  may be useful. Topical There are several NSAIDs available for  topical  use (e.g.  diclofenac ,  ibuprofen , and  ketoprofen ) with little, if