Osteoarthritis Treatment Options
Most people who are looking for osteoarthritis pain relief first turn to a group of medications known as nonsteroidal anti-inflammatory drugs(NSAIDs). Some NSAIDs, including ibuprofen (Motrin, Advil), naproxen (Aleve), and aspirin, are available over-the-counter at your local drugstore. For other NSAIDs, you'll need a prescription. Prescription NSAIDs target both pain and inflammation. The lower-dose, over-the-counter NSAIDs can also help with pain, but they won't relieve inflammation.
Be careful when you use NSAIDs, because they can have side effects such as stomach bleeding and an increased risk for heart attack and other cardiovascular problems. Read the package label and talk to your doctor to make sure you're using the lowest effective dose for the shortest possible period of time.
Even though NSAIDs are the most popular form of osteoarthritis pain relief, treatment guidelines actually recommend starting with acetaminophen (Tylenol), because it doesn't come with the cardiovascular and stomach bleeding risks of NSAIDs, and it's good for easing arthritis pain. Because acetaminophen can harm the liver and kidneys (at high doses), make sure to stick with the recommended dosage and talk to your doctor if you need longer-term pain relief. Some people, such as those with existing liver disease or heavy drinkers, may not be able to take acetaminophen.
An alternative, or addition to pain relievers you take by mouth, are creams or gels that you rub on your affected joints. These topical pain relief options include:
- Capsaicin, the ingredient that gives hot peppers their kick, is also good for relieving osteoarthritis pain. It works by affecting the release of substance P, which is involved in transmitting the sensation of pain.
- NSAIDs also come in topical formulations, some of which are only available by prescription. Recently, the FDA issued a warning that the topical NSAID diclofenac can be harmful to the liver. If you're using this drug, your doctor will need to check your liver function four to eight weeks after you start treatment.
- Counterirritants use ingredients like camphor, menthol, and eucalyptus to help relieve OA pain.
If you've already tried a variety of pain relievers and your joints are still painful, or you just can't tolerate NSAIDs or acetaminophen, your doctor may recommend a stronger opioid pain reliever like codeine, oxycodone, hydrocodone, or tramadol, or one of these drugs combined with acetaminophen. Narcotic medications can become habit-forming and cause constipation and sedation, so it's important that you keep in close touch with your doctor while taking them.
Corticosteroid injections into the knee joint offer fast relief from joint pain and inflammation, and their effects can last for a few weeks to months.
Hyaluronic Acid Therapy (Viscosupplementation)
Your joints contain a natural lubricant and shock absorber called hyaluronic acid, but people with osteoarthritis have less of this substance than normal. Hyaluronic acid is injected in the knee joint using products such as Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc-One, which may ease osteoarthritis pain in the knees, shoulders, and hips. This treatment may also help your joints move more smoothly. Side effects from viscosupplementation are usually mild and may include pain or swelling at the injection site.