While there's no cure for osteoarthritis, you can still do much to relieve pain and stay active. Your osteoarthritis treatment will depend on several factors, including the severity of your pain -- and how much it affects your everyday activities.
Osteoarthritis often progresses slowly, with periods when there's little or no change. If you have mild-to-moderate osteoarthritis, you can probably control your symptoms with nonprescription pain relievers. When those don't work, your doctor will advise you on the next steps in your osteoarthritis treatment.
After a skiing injury 30 years ago, Bert Pepper, MD, got osteoarthritis in his left knee. "I stopped skiing and gave up tennis, running, and other sports that are tough on the knee," he says. "I turned to speed-walking to stay fit, but the knee kept me from walking at a good pace."
As his pain got worse and walking became harder, he looked into having a knee replacement. It's not a decision to make lightly, says Pepper, who is a psychiatrist. "It's a major life event. You have to be prepared to...
Analgesics: Drugs like Tylenol, which contains acetaminophen, relieve mild-to-moderate pain with few side effects in most people. Tylenol is typically the first drug people take for treatment of osteoarthritis pain.
Topical pain relievers: Creams, salves, or gels are analgesics that relieve mild pain when just a few joints are involved -- like your hand. They can also be used in addition to oral painkillers. Active ingredients include capsaicin (found naturally in hot peppers), camphor, eucalyptus oil, menthol, and salicylates. ArthriCare, Aspercreme, BenGay, Capzasin-P, Eucalyptamint, Flexall, Icy Hot, and Zostrix are all topical pain relievers for osteoarthritis treatment.
Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs relieve pain by blocking chemicals that cause inflammation. They are reasonably safe drugs -- but, because of potential side effects like stomach irritation and gastrointestinal bleeding, it's best to take low doses for brief periods. Over-the-counter NSAIDs include: Advil, Aleve, Anacin, Aspirin, Bayer, and Motrin.
Glucosamine-chondroitin supplements: These compounds are natural substances found in joint fluid. They are thought to trigger cartilage production and reduce inflammation. The latest studies show potential in slowing the progression of knee osteoarthritis and relieving moderate-to-severe osteoarthritis pain.
Prescription NSAIDS: These are stronger versions of NSAID painkillers, and are prescribed when simple over-the-counter pain relievers aren't effective. These are reasonably safe, but there are potential side effects when taken in large doses over months or years. The FDA requires a label warning of risks like heart attack, stroke, and stomach bleeding. Clinoril, Disalcid, Feldene, Indocin, Lodine, Mobic, and Relafen are prescription NSAIDs.
Cox-2 drugs: This newer type of NSAID was developed to relieve inflammation without the stomach irritation of traditional NSAIDS. These drugs are reasonably safe, but there is still some risk to the stomach. The FDA requires a label warning of increased risk of cardiovascular side effects and gastrointestinal bleeding. Two other Cox-2 drugs were removed from the market because of increased risk of stroke, heart attack, and life-threatening skin reactions. Celebrex is the only Cox-2 drug still on the market and is prescribed in osteoarthritis treatment.