What Medications Treat Osteoarthritis?

Osteoarthritis (OA) is a disease of the bone joints that can cause severe pain and swelling. The cartilage around the ends of your bone joints wears away over years of use and leaves the bones rubbing against each other. This can make them inflamed and painful.

Your doctor may ask you to make lifestyle changes like exercise, losing weight, and changing your eating habits. In addition to those options, there are several medications that may help you. Some are available over the counter while others need a prescription. They can be pills, creams, lotions, or injections.

Here are some of them and how they work:

Analgesics: These are medicines that relieve pain but don't reduce inflammation. They work to change how your body responds to pain. Popular options include acetaminophen, tramadol, and prescription opioids containing oxycodone or hydrocodone. The opioids can be addictive.

Your maximum daily dosage of acetaminophen should be 4,000 milligrams (mg), if you don't have any liver disease. Too much can cause liver damage or even death.

Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs reduce inflammation as well as ease pain. These are some of the most popular medications given for arthritis. NSAIDs include aspirin, ibuprofen, naproxen, and celecoxib. They are usually taken in pill form but may cause stomach upset or bleeding. Make sure to follow the maximum daily dosage limits for each medication. Some are also available as creams to rub on your joints (for instance, Aspercreme). Some NSAIDs may increase your risk of heart disease or stroke. It's actually recommended that you don't use NSAIDs if you have an ongoing health condition such as heart disease, liver disease, or kidney disease. NSAIDs are non-narcotic and non-addictive.

Whether you should take opioids or NSAIDs is up to you and your doctor. One study showed that opioids and NSAIDS were equally effective for reducing the pain of OA of the knee -- about 30% pain reduction for each.

Counterirritants: These are creams and ointments containing ingredients like menthol or capsaicin, the ingredient that makes hot peppers burn. Rubbing these on your painful joints may stop the pain signals from the joint to the brain.

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Glucosamine and chondroitin: These are over-the-counter dietary supplements that are taken by mouth. Study results show no significant benefits, so taking these may or may not help you.

Corticosteroids (steroids): These are powerful medications (like prednisone and cortisone) that reduce swelling and suppress the immune system. Your doctor may give you a prescription for a pill or inject it directly at the site of your pain. The effects can be felt in a few days and will last for about 2 months.

Doctors say you shouldn't get more than four steroid shots a year and you shouldn't stay on them indefinitely. Corticosteroid injections can cause nerve damage and thinning of your bone near the site of the shot, as well as the breakdown of more cartilage.

Hyaluronic Acid: This naturally occurs in the fluid of your joints and acts as a lubricant. However, hyaluronic acid breaks down in people who have arthritis, so your doctor may give you injections of this fluid. The doctor injects you at the site of your pain (usually the knee) once a week for 3 to 5 weeks. Getting these injections could be an alternative to taking an NSAID. However, it takes about 5 weeks to feel any pain relief, unlike cortisol. Results from the shots are mixed. There are recommedations against getting these shots because of their unproven benefits and their cost. 

WebMD Medical Reference Reviewed by Minesh Khatri, MD on May 07, 2019

Sources

SOURCES:

Arthritis Foundation: "Analgesics," "Corticosteroid Overview," "Hyaluronic Acid Injections for Osteoarthritis," "Osteoarthritis Treatment," "Understanding Over the Counter Medication."

Mayo Clinic: "Arthritis: Treatment." "Osteoarthritis."

Harvard Health Publications: "Is there a 'best' pain reliever for osteoarthritis?"

American Academy of Orthopaedic Surgeons: "Treatment of Osteoarthritis (OA) of the Knee, 2nd edition, Summary of Recommendations."

OrthoInfo: "Arthritis of the Knee."
 

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