Your doctor may recommend one or several different medications depending on the severity of the arthritis. Usually, your doctor will start with over-the-counter medications before giving you prescriptions for stronger drugs.

Over-the-Counter Medications

There are several types of OTC options to relieve minor aches, pain, and swelling associated with osteoarthritis.

Acetaminophen

Acetaminophen (Tylenol) is an over-the-counter analgesic. It reduces pain, but not inflammation. It is essential that you not exceed the recommended dosage of acetaminophen or take the drug while (or after) consuming large amounts of alcohol. Acetaminophen, if used incorrectly, can severely damage your liver. Oftentimes, prescription pain medications include some acetaminophen, so it is important to tell your doctor about all the medication—including over-the-counter medication—that you are 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.

  • Aspirin (Bayer)
  • Ibuprofen (Advil, Motrin, Nuprin)
  • Naproxen (Aleve, Naprosyn)

Topicals

There are a variety of creams and gels available to relieve osteoarthritis pain. These may contain active ingredients such as menthol (Ben Gay, 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.

Prescription Medications

If the symptoms of OA progress in severity and start to affect your quality of life or keep you from performing normal everyday tasks, your doctor might prescribe something stronger to manage the pain and swelling.

Cortisone Shots

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, but because 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 rates 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

Tramadol

Tramadal (Ultram) is a prescription analgesic. For some, it may cause fewer side effects than NSAIDs. However, for others, tramadol comes with its own set of problems, including nausea and constipation. Tramadol is often used in conjunction with other analgesics to provide stronger pain relief.  

Narcotics

For osteoarthritis patients suffering from severe pain, stronger painkillers may be prescribed to provide relief. These include:

  • Codeine
  • Meperidine (Demerol)
  • Morphine
  • 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. 

Hyaluronic acid

For patients who fail to improve their knee pain with lifestyle changes or medications, injections of hyaluronic acid may relieve knee pain. There are few side effects, but the procedure does require injection directly into the knee joint with a small needle.