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Understanding Arthritis Painkillers

Weighing the Risks and Benefits
By
WebMD Feature
Reviewed by Louise Chang, MD

When you have arthritis pain, you need relief. But with so many warnings in the news about painkillers, it's hard to know the best choice. Many medications that ease arthritis pain have the potential for health risks, including increased risk for heart attack, stomach problems, or infections.

You have difficult decisions to make, whether you're fighting pain from osteoarthritis that comes with age -- or pain from rheumatoid arthritis, a debilitating immune disorder. Do you somehow tough out the pain? Or do you accept the risk because your pain requires it, and take the drug for arthritis? Which drug is right for your body? And which medicine may work best for your type of arthritis?

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First, says Patience White, MD, chief public health officer for the Arthritis Foundation, it's important to keep in mind that the risks of arthritis drugs are really quite low. "There are risks," she says, "but depending on the drug you may have a greater chance of getting hit by a car crossing the street than having side effects of the drugs we're talking about."

Second, many people with arthritis need pain relief in order to go about their daily lives and get the exercise that could improve their condition.

Easing arthritis pain can help someone with osteoarthritis "get up and going, and get walking," White tells WebMD. "If you have osteoarthritis, losing 15 pounds will stop the progression of your disease and reduce your pain. Then you can quit taking the pain medication!"

Although pain from rheumatoid arthritis cannot be reduced through weight loss, the risk of not treating this immune disease is even more dramatic. Without treatment, RA tends to progress and worsen. New drugs called biologics can stop the damaging effects of the disease. "These drugs carry a slight risk of cancer, because they suppress the immune system," says White. "Yet if you don't take them, you are going to be disabled. You have to put that risk-benefit ratio on the table."

She offers an analogy: Would someone decide against cancer treatment that offers a possible cure simply because they were afraid of chemotherapy drugs?

Deciding on Arthritis Pain Medicine

White advises people to make their decisions only after talking with a trusted health care provider. Ask key questions so you fully understand the benefits and risks of your medication, says White: "What are my risks? What is the chance this could happen?"

Also, get the emotional and practical support you need to cope with arthritis pain during treatment, says Nortin Hadler, MD, a rheumatologist and professor of medicine at the University of North Carolina at Chapel Hill, and author of Worried Sick.

Hadler has researched the mind-body connection in arthritis pain, and has found that people who may be lonely or depressed feel pain more acutely.

To help you understand your options, here are common medicines for arthritis pain. Keep in mind, different drugs are often used to treat osteoarthritis, rheumatoid arthritis, and other less common forms of arthritis. This information covers the most commonly prescribed painkillers. Talk to your doctor to learn about more options.

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