Nonprescription medications for osteoarthritis

Medicines that you can buy without a prescription can be very useful in relieving the pain of mild or moderate osteoarthritis.

• Try acetaminophen (such as Tylenol) first. Regular use of acetaminophen can provide relief of pain caused by osteoarthritis. Doctors may advise people who take acetaminophen on a regular basis to limit alcohol consumption.
• Aspirin, ibuprofen, or naproxen (nonsteroidal anti-inflammatory drugs, or NSAIDs) are also good pain relievers, especially if you are not bothered by stomach problems. Try coated aspirin (such as Ecotrin). Talk to your doctor to determine the best dose of NSAIDs for your symptoms. Also consult your doctor before use if you have had stomach ulcers, liver disease, kidney disease, heart failure, or if you will be taking NSAIDs daily for more than 6 months. People younger than age 20 should not take aspirin because of the risk of Reye's syndrome (a central nervous system complication in children).
• Capsaicin (Zostrix), available without a prescription, is a pain reliever that comes in a cream and is applied directly to the skin (topical analgesic). It has been found to relieve joint pain of osteoarthritis in some people when rubbed into the skin over affected joints.¹ To be beneficial, the cream must be applied 3 or 4 times a day, and the effects may not be seen for several weeks. The main ingredient in capsaicin is an extract from hot peppers. It appears to have no serious side effects. But some people may be allergic to capsaicin. The first time you use this topical cream, apply it to just a small area of skin to ensure there is no allergic reaction. Even those who are not allergic may note a burning sensation. Some people may not be able to tolerate the discomfort of capsaicin.
• Glucosamine and chondroitin are dietary supplements that are based primarily on components of natural cartilage (the cushion between bones in a joint). Use of glucosamine and chondroitin, which are often packaged together, may decrease pain in some people.²

Citations

1. Scott D, et al. (2004). Osteoarthritis. Clinical Evidence (11): 1560–1588.

2. Update on glucosamine for osteoarthritis (2001). Medical Letter on Drugs and Therapeutics, 43(1120): 111–112.