Know your OA treatment options

Osteoarthritis (OA) is the most common form of arthritis. It’s marked by joint wear and tear and cartilage loss 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. 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 (swelling). This 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 give you prescription medications.

There are many different pain and anti-inflammatory drugs available to treat OA. Learn about your options here and work with your doctor to find the best one for you.

Analgesics are pain medications. They reduce pain, but they don’t treat inflammation. This class of drugs works by blocking signals in your body that produce pain. Examples of analgesics include:

Acetaminophen (Tylenol)

Acetaminophen is an OTC analgesic. You take it by mouth as a gel capsule, tablet, or liquid concentration.

In 2011, the U.S. Food and Drug Administration (FDA) set the maximum dosage for acetaminophen at 4,000 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. This can be fatal (cause death).

Don’t drink more than three alcoholic beverages per day if you use this drug. This can increase your risk of liver problems.

For more information, check out Healthline’s article on acetaminophen overdose.

The Cleveland Clinic recommends acetaminophen over other OTC pain relievers for arthritis. This is because acetaminophen may cause fewer side effects than other drugs.

Duloxetine (Cymbalta)

Duloxetine is used to treat depression. However, it’s also used off-label to treat chronic pain due to OA.

Off-label drug use means that a drug that the FDA approved for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose.

Like analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) treat pain. Unlike analgesics, these drugs also help prevent painful inflammation and joint damage. They’re the top choice of treatment for people with OA because they’re effective and non-sedating.

NSAIDs come in oral and topical forms. There are many different choices. Some are available OTC.

Your doctor will likely tell you to start with OTC NSAIDs. If those don’t work, your doctor may give you a prescription NSAID.

NSAIDs come with risks, even the OTC versions. Side effects can include:

  • stomach irritation, erosion, or ulcers (can lead to stomach bleeding and death)
  • kidney problems

If you have kidney disease, ask your doctor if NSAIDs are safe for you. You shouldn’t take NSAIDs long term without talking to your doctor. Your doctor will monitor you during your treatment. If you’re allergic to aspirin, you also shouldn’t take NSAIDs.

Examples of NSAIDs include:

Aspirin (Bayer, St. Joseph)

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, Nuprin)

Ibuprofen is an NSAID available in both OTC and prescription strengths. Taking ibuprofen long term is not recommended because of the risk of stomach bleeding and heart attack.

The FDA recommends taking the smallest dose that works for you and only taking it for up to 10 days. You should not take ibuprofen for longer than 10 days unless your doctor tells you to.

Naproxen sodium and naproxen (Aleve)

Naproxen sodium is an OTC NSAID. It’s used to treat OA pain and inflammation. Higher doses are also available in prescription forms.

This drug has the advantage that it doesn’t carry the same risk of heart attack that ibuprofen does. However, it does have some side effects. These include:

  • heartburn
  • stomach pain
  • nausea
  • diarrhea
  • headaches
  • dizziness
  • drowsiness

Diclofenac (Zorvolex, Voltaren) and diclofenac-misoprostol (Arthrotec)

Diclofenac is a prescription NSAID that comes in both oral and topical forms. Diclofenac-misoprostol (Arthrotec) combines diclofenac with a drug to protect against stomach ulcers. It, too, can cause side effects. These include:

  • stomach pain
  • diarrhea
  • nausea

Other prescription NSAIDs for OA | NSAIDs

These are prescription NSAIDs approved to treat the symptoms of OA:

Corticosteroids are also known as steroids. They’re 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 do not cause kidney problems. This means they may be a safer choice for people with kidney disease.

Injectable corticosteroids are used for people with 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 (clouding of the lens in your eye)
  • osteoporosis

Corticosteroid drugs include:

These prescription pain drugs change the way you feel pain, but they don’t prevent inflammation. They’re habit-forming and powerful. They can be combined with other treatments that aren’t sedating and habit-forming.

Opioids can make you sleepy or impair your balance. This can cause additional concerns for people with mobility problems and arthritis.

Doctors often only prescribe opioids if you have severe OA or for occasional use. They may also prescribe them if you’re recovering from surgery. Don’t drink alcohol while taking these drugs.

Opioids include:

These topical pain drugs come as ointments, gels, creams, or patches. They’re alternatives to oral or injectable drugs for OA. They’re available over the counter and as prescriptions. Some topical treatments offer immediate, short-term relief. Others offer long-term relief.

Topical analgesics include:

  • Capsaicin (Capzasin, Zostrix, Icy Hot). Derived from cayenne peppers, this OTC drug comes as an ointment.
  • Diclofenac sodium gel and solution (Voltaren, Flector Patch, Solaraze, Pennsaid). This topical NSAID is only available as a prescription.
  • Lidocaine patch. This drug 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 (Aspercreme). This topical cream contains an aspirin-like drug that relieves inflammation and pain.

There’s no cure for OA, but medications can help you manage your condition. You doctor can may prescribe analgesics, topical analgesics, NSAIDs, corticosteroids, or opioids. Work with your doctor to choose the best medication for you.