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Understanding Arthritis Painkillers

Weighing the Risks and Benefits

Common Medicines for Arthritis Pain

Acetaminophen

Acetaminophen (also known by the brand name Tylenol) may be used to treat mild arthritis pain from osteoarthritis or rheumatoid arthritis. It can be just as effective as some prescription anti-inflammatory pain relievers for mild pain -- and is easy on the stomach.

Other medications sometimes include acetaminophen as an ingredient, so make sure you don't end up taking too much of it. Overdoses of acetaminophen can damage the liver. People who drink alcohol regularly, or already have a damaged liver, should consult their doctor before taking acetaminophen.

Anti-Inflammatory Painkillers (NSAIDs)

Nonsteroidal anti-inflammatory drugs called NSAIDs help relieve joint swelling, stiffness, and pain -- and are among the most commonly used painkillers for people with any type of arthritis. You may know them by the names such as ibuprofen, naproxen, Motrin, or Advil.

While NSAIDs are reasonably safe, when taken for months or years, they can cause stomach ulcers and may increase your risk for heart attack. Cox-2 inhibitors like Celebrex are more stomach-friendly, but may have a slightly higher risk of heart problems than milder NSAIDs such as ibuprofen or naproxen.

Recent research also indicates that people who take daily aspirin for their heart should talk to their doctors before taking any NSAID regularly for pain. NSAIDs may alter the effect of aspirin.

But here's the question that White at the Arthritis Foundation tells her patients to ask themselves: "How does a slight risk of heart disease compare to the risk of arthritis pain itself?"

To reduce the chance of side effects, turn to NSAIDs as a short-term solution if possible, says White. Ask your doctor to prescribe the lowest effective dose, or a combination of drugs.

To protect your heart, it also helps to control other risk factors of heart disease such as high blood pressure and elevated cholesterol.

Steroids

Steroids such as Decadron and prednisone are strong anti-inflammatories that calm swelling, inflammation and pain.

For osteoarthritis, steroid injections are primarily injected into the joint for a direct effect on the painful joint. They can also be used for this purpose for people with rheumatoid arthritis.

High doses of steroid pills can be taken temporarily to treat severe flare-ups of rheumatoid arthritis. Low-dose pills may be used longer term to help tame inflammation and pain.

Especially with rheumatoid arthritis, steroids can "make a huge difference," says White. "Steroids decrease the pain and swelling very rapidly." After treating rheumatoid arthritis with steroids, White often follows up with biologic medicines.

However, when taken long-term, steroids can increase a person's risk of infection, increase blood sugar levels, and thin a person's bones. Most doctors recommend steroid pills for short-term use. Steroid injections help avoid side effects outside the joint, and may be used for longer-term use.

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