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
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
Jerry Wade used to love bird-watching with his wife, an avid birder.
"I'm not a birder myself, but I like being active and getting out there
with her," he says. "Bird-watching puts you into natural areas and some
rough terrain -- it's not an easy physical activity."
But in the fall of 2005, the 66-year-old Columbia, Mo., resident, who had
retired in 2000 from a career in community development, started noticing
"pains and twinges" in his knees. A visit to his doctor in January 2006
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
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
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
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.
Steroid injections: Quick pain relief is possible when
glucocorticoids (a type of steroid) are injected into the joint for
osteoarthritis treatment. These are typically advised for moderate-to-severe
knee pain or for inflammation that is not relieved by an NSAID.
Hyaluronan injections: Hyaluronic acid is a substance found
in joint fluid. Given as weekly injections directly into the joint, it
increases mobility. Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc are
approved for mild-to-moderate knee arthritis.
Narcotic pain relievers: These strong pain relievers
contain narcotics and are often combined with Tylenol. The drugs work on pain
receptors on nerve cells, not on inflammation. There is risk of dependency with
these drugs. They include: Darvocet, Darvon, Lorcet, Lortab, Morphine,
Oxycontin, Percocet, Tylenol with Codeine, and Vicodin.