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Oan is a 61-year-old female with severe osteoarthritis who is not a candidate for total hip replacement. Due to a previous GI bleed, she is unable to take Ibuprofen. Previous attempts of physical therapy have made her pain worse. She has tried diclofenac gel which has not offered pain relief. Her pain is currently impacting her quality of life. According to the American College of Rheumatology (ACR), What is a reasonable next option?

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