Osteoarthritis Pain Medicine: Risks and Benefits
Because there is no cure for osteoarthritis (OA), medications focus on pain relief. If you have OA, consider the following risks and benefits of different pain relievers to make the decision that is best for you.
Analgesics for Osteoarthritis Pain
Analgesics are a class of drugs designed specifically to relieve pain. They do not reduce swelling or inflammation associated with OA. However, they can be quite effective as pain medications.
One of the most commonly used analgesics is acetaminophen (Tylenol). Acetaminophen is inexpensive and a safe arthritis pain reliever when taken correctly. However, too much acetaminophen can cause liver damage. Adults should not take more than 3,000 milligrams of acetaminophen in a day. People with existing liver disease and people who drink more than three alcoholic drinks a day may not be able to take acetaminophen.
There are stronger types of pain medications called narcotic analgesics, which are available by prescription. Narcotic analgesics include codeine, hydrocodone, and oxycodone. Although narcotics are effective in treating moderate to severe arthritis pain, they do have side effects, including nausea, constipation, dizziness, and drowsiness. Some people build tolerance to narcotic drugs, leading to the need for an increased dosage. Narcotics also can be habit-forming.
Because some prescription pain drugs may contain a narcotic ingredient along with acetaminophen, it is important to monitor the total amount of acetaminophen taken in a day if you are taking both prescription and over-the-counter pain relievers.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for Osteoarthritis Pain
NSAIDs are also commonly recommended for arthritis pain relief. NSAIDs are available over the counter and by prescription. Over-the-counter NSAIDs help relieve pain but do not have a significant effect on inflammation and swelling at these lower doses. NSAIDs available over the counter include aspirin, ibuprofen, and naproxen.
Prescription NSAIDs have the ability to reduce swelling and inflammation caused by arthritis. There are many prescription NSAIDs, including diclofenac (Voltaren), ibuprofen (Motrin), naproxen (Naprosyn), and oxaprozin (Daypro). NSAIDs can increase the risk of heart attack or stroke, especially in higher doses. They can also cause kidney problems and liver problems as well as stomach issues in some patients, including ulcers with serious stomach bleeding. Taking the medicine with food is advised. Some research suggests that taking another medication called a proton pump inhibitor can greatly reduce the incidence of this problem. Other medications include an NSAID and a drug to help protect the stomach in one pill, such as diclofenac sodium/misoprostol (Arthrotec) and naproxen/esomeprazole magnesium (Vimovo), though they can be taken separately at a lower cost.