Arthritis Pain Relief: Risks and Benefits
Other OTC Pain Relievers
In addition to medications, there are supplements and creams that you can purchase over the counter that may also alleviate arthritis pain.
Among the most popular supplements used by people with osteoarthritis are glucosamine and chondroitin. In those with moderate to severe knee pain from osteoarthritis, the combination of glucosamine and chondroitin sulfate may be effective in providing pain relief, although medical studies have not shown clear proof that they are helpful in everyone.
There do not seem to be any major side effects from glucosamine and chondroitin supplements, but because they are supplements, they are not regulated by the FDA the same way as drugs. That means that there is no way to be sure of the content and quality of supplements sold in stores.
Skin creams made from capsaicin, an extract from chili peppers, may help relieve mild arthritis pain when applied to the skin, although these creams have not shown consistent benefit in medical studies They cause a mild stinging or burning sensation in about half of people using them, which usually fades over time.
Applying ice or warm compresses to the affected joint a few times per week may also improve pain, swelling, and range of motion. Ice therapy may also be helpful immediately after activities such as exercise.
Prescription Drugs: NSAIDs
In addition to over-the-counter NSAID medications, you can also ask your doctor for a prescription for NSAIDs to treat arthritis pain and inflammation. Some of these are merely stronger versions of the NSAIDs you can buy over the counter, like prescription-strength ibuprofen. Prescription NSAIDs may also be available in topical and injectable forms. Besides ibuprofen and naproxen, other examples of prescription NSAIDs include diclofenac (Arthrotec, Cataflam, Voltaren), etodolac (Lodine), meloxicam (Mobic), and piroxicam (Feldene).
Like over-the-counter NSAIDs, long term use of these medications may cause serious side effects like heart attack, stroke, kidney disease, and stomach irritation and bleeding, particularly in elderly and other at-risk people. If you take a daily aspirin, you should not take ibuprofen and you should talk with your doctor about the safety of taking other NSAIDs.
Topical NSAIDs, such as diclofenac (Voltaren) cream, have been shown to be effective for hand and knee arthritis, and have a lower risk of side effects than oral versions.
Another class of NSAIDs is called Cox-2 inhibitors. The only drug in this class on the market is celecoxib (Celebrex). It relieves pain as well as other NSAIDs; Cox-2 drugs also reduce inflammation. Some studies have shown that Celebrex poses less risk of stomach bleeding; however, like other NSAIDs, it can increase your risk for heart disease, and higher doses are associated with a greater risk of toxicity.
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 with severe pain 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).