Osteoarthritis Health Center

Arthritis Pain Relief: Risks and Benefits

Prescription Drugs: Narcotics

A variety of prescription narcotic medications such as codeine may be prescribed to help reduce osteoarthritis pain. These can be used in cases when patients cannot use or tolerate NSAIDs or Cox-2 drugs. In some instances, narcotics are combined with acetaminophen to provide added pain relief. Examples include prescription drugs that contain hydrocodone (Lortab, Norco, Vicodin) or oxycodone (Endocet, Percocet, Tylox).

A narcotic-like medication called tramadol (Ultram) may also be used to provide osteoarthritis pain relief in those who do not respond to other treatments.

Keep in mind that long-term use can result in physical dependence. Yet studies have shown that, when taken exactly as prescribed, narcotic pain relievers are safe, can manage pain effectively, and rarely cause addiction.

Prescription Drugs: Steroids and Cymbalta

If over-the-counter or prescriptions NSAIDs or narcotics do not relieve arthritis pain, you may consider other prescription treatments.

Steroid medications reduce pain by reducing inflammation. To provide pain relief and reduce inflammation, they will usually be injected in the affected area, such as the knee.

Steroids do have side effects, although local injections help to minimize these side effects compared with taking the drug by mouth. Some of the side effects that could be seen include infections, allergic reactions, local bleeding, skin discoloration, and the rupture of a tendon near the injection site.

In addition to the prescription drugs already mentioned, the antidepressant Cymbalta (duloxetine) has been approved for chronic musculoskeletal pain such as chronic pain from osteoarthritis. 

Prescription Hyaluronan Injections

A substance called hyaluronan, found in normal joint fluid, helps to lubricate and cushion the joints and keep them working properly. Treating osteoarthritis with joint injections of hyaluronic acid has been found to minimally help relieve arthritis pain in people with mild to moderate knee osteoarthritis. In studies, this treatment has led to few side effects, mostly localized pain around the injection area. Examples of hyaluronic acid injections include Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc

There are also many complementary and alternative treatments for osteoarthritis pain, ranging from heat and cold therapy, orthotic shoe inserts, knee bracing, massage, and biofeedback to mobility exercises like yoga, tai chi, and stretching. Most of these, if done with proper supervision and your doctor’s guidance, have few if any risks.

If your osteoarthritis reaches a point where you are unable to do the things you want and need to do in your daily life without disabling pain, and none of the pain relief options described here provide significant relief, then it may be time to talk with your doctor about other options such as surgery.