Osteoarthritis (OA) is a condition where cartilage between bones in your joints breaks down, causing the bones to rub. It is one of the most common types of arthritis. It can be painful and result in a loss of join movement. OA has no cure. Treatments are designed to maintain movement and limit pain.
There are several different treatments options, including medications. Your doctor may recommend one or several different medications depending on the severity of your case. Your doctor will probably start with over-the-counter (OTC) medications before giving you prescriptions for stronger drugs.
There are several types of OTC options to relieve minor aches, pain, and swelling associated with osteoarthritis.
Acetaminophen (Tylenol) is an over-the-counter pain medicine (analgesic). It reduces pain, but not inflammation. It’s essential that you not exceed the recommended dosage of acetaminophen or take the drug if you’re consuming large amounts of alcohol. Acetaminophen can severely damage your liver if used incorrectly. Oftentimes, prescription pain medications contain some acetaminophen. It’s important to tell your doctor about all the medication that you’re taking.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in combating aches and pains associated with OA. NSAIDs do have potential risks for gastrointestinal bleeding and upset stomach, especially if taken over a long period of time. Aspirin should not be given to anyone under age 20 to avoid risk of Reye’s syndrome. Examples of NSAIDs include:
- aspirin (Bayer)
- ibuprofen (Advil, Motrin, Nuprin)
- naproxen (Aleve, Naprosyn)
There are a variety of creams and gels available to relieve osteoarthritis pain. These may contain active ingredients such as menthol (Bengay, Stopain) or capsaicin (Capzasin, Zostrix), which is made from hot peppers. Applying these ointments to aching joints can provide relief by scrambling the transmission of pain signals from the joint.
If the symptoms of OA progress in severity and start to affect your quality of life, your doctor might prescribe something stronger to manage the pain.
These injections may help relieve pain and inflammation in arthritic joints. The medication in cortisone shots varies, but typically consists of a corticosteroid medication to reduce inflammation and pain, and a local anesthetic to reduce pain immediately. These shots can be given right in a doctor’s office. Since there is concern that injections could increase the rate at which cartilage breaks down, many doctors limit the frequency of the shots per year.
Prescription Nonsteroidal Anti-inflammatory Drugs
Prescription NSAIDs do the same thing that over-the-counter ones do, just in stronger doses. Some of these drugs may have lower risks of gastrointestinal issues, but they have a higher rate of heart disease risk. Some NSAIDs are also available in creams or gels that can be applied topically. This class of drugs includes:
- celecoxib (Celebrex)
- piroxicam (Feldene),
- prescription-strength ibuprofen and naproxen
Tramadal (Ultram) is a prescription analgesic. It may cause fewer side effects than NSAIDs for some people. For others, however, tramadol can cause other problems, including nausea and constipation. Tramadol is often used in conjunction with other analgesics to provide stronger pain relief.
Stronger painkillers may be prescribed for osteoarthritis patients suffering from severe pain. These include:
- meperidine (Demerol)
- oxycodone (Oxycontin)
- propoxyphene (Darvon)
Side effects of these drugs may include nausea, constipation, and sleepiness. There is also a risk of developing a dependence on these drugs.
For patients who fail to improve their OA pain with lifestyle changes or medications, injections of hyaluronic acid may be an option. There are few side effects, but the procedure does require injection directly into the joint with a small needle.