For the 27 million Americans living with osteoarthritis (OA), pain can be an everyday occurrence. Damaged joints can make every movement — from bending to lifting — achy and uncomfortable.

Pain relief is the goal of OA treatment. But while there are many ways to deal with OA discomfort, including exercise and surgery, over-the-counter (OTC) drugs are among the most common treatments. Let’s take a look at what they are and how they work.

According to the American Academy of Orthopaedic Surgeons, nonsteroidal anti-inflammatory drugs (NSAIDs) are the most prescribed drugs for treating arthritis pain. Examples of NSAIDs include:

  • ibuprofen (Motrin)
  • naproxen (Alleve, Naprosyn)
  • aspirin

How NSAIDs work

NSAIDs work by reducing your body’s production of substances called prostaglandins, which cause pain and inflammation in the body. By doing this, NSAIDs accomplish two goals: They help relieve pain, and they help reduce swelling in your joints.

NSAID side effects and risks

Prostaglandins do more than cause pain. They also act to protect the lining of your stomach from damage by harsh stomach acids. So, when NSAIDs reduce prostaglandins in your body, they can leave your stomach vulnerable to acids. This can lead to ulcers and stomach bleeding.

Other possible side effects of NSAIDs include:

  • rash
  • hives
  • wheezing

NSAIDs other than aspirin also may increase the risk of heart attacks and strokes. If you have a history of stomach ulcers or bleeding, heart disease, high blood pressure, or kidney disease, you should talk to your doctor about whether NSAIDs are safe for you.

Acetaminophen (Tylenol) is another OTC pain reliever that can help manage arthritis discomfort. This drug works by reducing the feeling of pain in the brain. Acetaminophen can help reduce arthritis pain, but unlike NSAIDs, it won’t decrease joint inflammation.

Acetaminophen has fewer side effects than NSAIDs. However, you should never take more than the package, or your doctor, says to take. When taken in large amounts over time, or used with too much alcohol, acetaminophen can cause liver damage.

If you’re taking other medications also, be sure to check the label to see if they contain acetaminophen. Many medications do, and taking them together with acetaminophen could lead to overdose.

Topical pain relievers are treatments that are applied to the skin. Several topical creams, sprays, and gel pain relievers are available OTC to help relieve arthritis pain. Their ingredients can include NSAIDs, which are the same active medications as the oral versions. They can also include capsaicin, which studies have shown can help ease arthritis pain.

Topical medications work to dull pain. They also often make the skin feel hot or cold. Because topical treatments don’t travel through the whole body, they have fewer side effects than oral medications.

A few herbal remedies have been studied and praised for their arthritis pain-relief properties. These include glucosamine and chondroitin and SAMe — an herb that has also been used to treat depression. However, studies haven’t confirmed that these supplements can relieve arthritis pain, according to the American College of Rheumatology. There’s also no conclusive evidence that fish oils containing omega-3 fatty acids can help ease osteoarthritis symptoms. Further studies are needed.

If you’re thinking about trying a supplement, talk to your doctor first. The Food and Drug Administration does not regulate these products, which means it can be hard to know if what you’re getting in the bottle is what’s being advertised on the label. Also, herbal supplements can cause side effects and can interact with other drugs you’re taking.

Everyone’s arthritis is different, and not everyone responds to each drug in the same way. So you may not find relief from the first arthritis medication you try.

If you’re taking an NSAID or other OTC pain reliever and it isn’t helping, talk to your doctor. They may suggest that you switch to another type of drug. They may also suggest another type of treatment, such as exercise or stretching, or prescription medication. Working with your doctor, you can find a treatment plan that can help ease your OA pain and get you moving again.