Osteoarthritis (OA) is the most common form of arthritis. It’s marked by joint wear and tear and loss of cartilage that causes bones to rub against each other. The damage can’t be reversed.
OA can occur naturally with age, but younger adults can have it too.
It can also result from frequent injury.
Obesity is a risk factor for OA because the extra weight can push down on your joints. OA causes pain and inflammation, which can make everyday movement challenging.
Medications can help by easing pain and inflammation.
Your doctor will likely suggest over-the-counter (OTC) pain relief and anti-inflammatory medications to start. If those drugs don’t work or if you have a severe case of OA, your doctor may start you on prescription medications.
There are many different pain and anti-inflammatory medications available to treat OA.
Learn about your options here and work with your doctor to find the best one for you.
Nonsteroidal anti-inflammatory drugs (NSAIDs) treat pain. They also help to prevent painful inflammation and joint damage. They’re the top choice of treatment for OA because they’re effective and nonsedating.
NSAIDs come in oral and topical forms. There are many options, and some are available over the counter.
Your doctor will likely tell you to start with OTC NSAIDs. If those don’t work, your doctor may start you on a prescription NSAID.
NSAIDs come with risks, even the OTC versions.
Side effects can include:
- stomach irritation, erosion, or ulcers (this can lead to stomach bleeding and death)
- kidney problems
If you have kidney disease, ask your doctor if NSAIDs are safe for you.
If you’re allergic to aspirin, you shouldn’t take NSAIDs.
Don’t take NSAIDs long term without talking with your doctor. Your doctor will monitor you during your treatment.
Examples of NSAIDs include:
Aspirin is an OTC NSAID that treats pain and inflammation. It can help treat your OA symptoms to enhance your quality of life.
Ibuprofen (Advil, Motrin, IBU-Tab)
Ibuprofen (Advil, Motrin, IBU-Tab) is an NSAID available in both OTC and prescription strengths. Taking ibuprofen long term isn’t recommended because of the risk of stomach bleeding and heart attack.
Naproxen (Naprosyn) and naproxen sodium (Aleve)
Naproxen (Naprosyn) and naproxen sodium (Aleve) are used to treat OA pain and inflammation.
Naproxen is only available by prescription. Naproxen sodium is available over the counter, and higher doses are also available in prescription forms.
Some side effects of naproxen and naproxen sodium include:
Diclofenac (Zipsor, Voltaren) and diclofenac-misoprostol (Arthrotec)
Diclofenac (Zipsor, Voltaren) is an NSAID that comes in both oral and topical forms.
The oral drug Zipsor is available by prescription, while the topical drug Voltaren is available over the counter.
The oral drug diclofenac-misoprostol (Arthrotec) combines diclofenac with a drug that protects against stomach ulcers.
Diclofenac can cause side effects, which include:
- stomach pain
Other prescription NSAIDs for OA
These prescription NSAIDs are approved to treat the symptoms of OA:
- celecoxib (Celebrex)
- fenoprofen (Nalfon)
- indomethacin (Indocin)
- mefenamic acid (Ponstel)
- meloxicam (Mobic)
- oxaprozin (Daypro)
- piroxicam (Feldene)
An analgesic is another type of pain medication. Unlike NSAIDs, analgesics don’t treat inflammation.
This class of drugs works by blocking signals in your body that produce pain.
Examples of analgesics include:
Acetaminophen (Tylenol) is an OTC analgesic. You take it by mouth as a:
- gel capsule
- liquid concentration
In 2011, the FDA set the maximum dosage for acetaminophen at 4,000 milligrams (mg) per day.
After the FDA made its announcement, McNeil Consumer Healthcare, the company that makes Tylenol, set its maximum daily dosage for acetaminophen at 3,000 mg.
It’s important to monitor your daily intake of acetaminophen. Taking high doses of acetaminophen for a long time can lead to liver damage or liver failure, which can be fatal.
Don’t drink more than three alcoholic beverages per day if you use this drug. Drinking more than the recommended amount can increase your risk for liver problems.
Duloxetine (Cymbalta) is used to treat depression. However, it’s also used off-label to treat chronic pain due to OA.
Side effects include:
OFF-LABEL DRUG USE
Off-label drug use means a drug that’s approved by the FDA for one purpose is used for a different purpose that hasn’t yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
These topical pain medications come as:
They’re alternatives to oral or injectable drugs used to treat OA.
They’re available over the counter and by prescription. Some topical treatments offer immediate, short-term relief, while others offer long-term relief.
Topical analgesics include:
- Capsaicin (Capzasin, Zostrix, Icy Hot). Derived from cayenne peppers, this OTC drug comes as a cream.
- Diclofenac sodium gel and solution (Voltaren, Solaraze, Pennsaid). This topical NSAID is available over the counter and by prescription.
- Lidocaine patch. Lidocaine can treat a specific area of pain in OA, but it’s not usually given as a first treatment.
- Methyl salicylate and menthol (Bengay). This drug cream is made from mint plants and also contains a topical aspirin-like NSAID.
- Trolamine salicylate (Aspercreme). This cream contains an aspirin-like drug that relieves inflammation and pain.
Corticosteroids, also known as steroids, are sometimes used briefly for severe OA flare-ups. However, they have many risks if they’re used for long-term treatment.
Like NSAIDs, steroids reduce inflammation but are hard on the stomach. Unlike NSAIDs, they don’t cause kidney problems. This means they may be a safer choice for people with kidney disease.
Injectable corticosteroids are used to treat OA. They’re injected directly into the joints.
Side effects of all steroids can include:
- high blood sugar levels
- stomach ulcers
- high blood pressure
- irritability and depression
- cataracts, or the clouding of the lens in your eye
Corticosteroid drugs include:
- betamethasone (Celestone Soluspan)
- hydrocortisone (Solu-Cortef)
- methylprednisolone (Depo-Medrol, Solu-Medrol)
- triamcinolone acetonide (Kenalog-40, Zilretta)
These prescription pain medications change the way you feel pain, but they don’t prevent inflammation.
Opioids are habit-forming, powerful, and sedating. They can be combined with other treatments that aren’t habit-forming and sedating.
Opioids can also impair your balance. This, along with their sedative effect, can cause additional concerns for people with mobility problems and arthritis.
Doctors often only prescribe opioids for severe OA or for occasional use to treat the condition. They may also prescribe them if you’re recovering from surgery. Don’t drink alcohol while taking these drugs.
There’s currently no cure for OA, but medications can help you manage your condition.
Your doctor can may prescribe a variety of oral, injectable, or topical treatments based on your specific healthcare needs.
Work with your doctor to choose the best medication for you.