Understanding Arthritis Painkillers
Weighing the Risks and Benefits
Common Medicines for Arthritis Pain continued...
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 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.
Prescription narcotic painkillers -- such as codeine, fentanyl, morphine, and oxycodone -- are used for severe pain that is not relieved with other medications. The drugs work on the nerve cells' pain receptors and are very effective in controlling severe pain.
In rare cases, White prescribes a narcotic for arthritis pain relief, she says. "If the only way to get someone up and out of bed is a mild narcotic, then I'll do it. I do it only to help people get over a hump, and only rarely. There are a lot of side effects."