Background The use of low-dose colchicine in the orthopedic treatment of non-crystalline arthropathy conditions is not well-explored. Colchicine is an antimitotic drug that inhibits neutrophils and has demonstrated anti-inflammatory properties. Colchicine lacks many of the adverse effects associated with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including upper gastrointestinal bleeding, nephrotoxicity, and hypertension exacerbation. This study evaluates the safety and effectiveness of low-dose colchicine as an alternative to NSAIDs in the conservative treatment of orthopedic patients.

Methods A retrospective chart review was conducted at a single orthopedic clinic from March 2024 to February 2025. Patients treated for orthopedic conditions with colchicine 0.6 mg orally once daily, who had patient-reported Visual Analog Scale (VAS) pain scores recorded at the initial and first follow-up visit, were included. Patients with crystalline arthropathies were excluded. Descriptive analyses were performed to assess the mean and standard deviation of VAS-pain scores before and after treatment. A subgroup analysis was performed after excluding patients who received procedures or injections at the initial visit to evaluate the impact of this confounding variable.

Results Of 306 patients reviewed, 144 met the inclusion criteria. The mean age was 62.93 ± 14.21 years (101 females, 43 males), with an average follow-up of 56.21 ± 35.82 days. The mean VAS-pain scores at the initial and first follow-up visit were 6.76 ± 2.33 and 5.35 ± 2.88, respectively. The mean reduction in pain (follow-up - initial) was -1.42 ± 3.02. Two patients reported side effects, including joint pain and gastrointestinal symptoms. No serious adverse events were reported. After excluding patients who had procedures or injections (n = 117), the mean VAS-pain scores were 6.53 ± 2.40 initially and 5.35 ± 2.99 at follow-up. The mean reduction in pain for this group was -1.18 ± 3.08.

Conclusion These results suggest that low-dose colchicine may represent a safe alternative to NSAIDs in the conservative treatment of orthopedic patients. While a modest reduction in pain scores was observed, further controlled studies with larger cohorts and longer follow-up are needed to determine efficacy and statistical significance.