Medications for Osteoarthritis
Medications for osteoarthritis may include NSAIDs, pain relievers, and steroid injections, among others. It’s important to consult a doctor about the potential side effects.
Treatment for osteoarthritis can involve both over-the-counter (OTC) and prescription medications aimed at:
- Reducing inflammation
- Relieving pain
- Slowing the progression of the disease
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) help relieve pain and prevent joint damage by reducing inflammation. They are available in both oral and topical forms.
OTC NSAIDs are one of the first-line treatment methods for osteoarthritis. If these are not effective, a doctor may prescribe stronger NSAIDs.
According to the Arthritis Foundation, the most commonly used NSAIDs for treating osteoarthritis include:
- Ibuprofen (Advil, Motrin, IBU-Tab)
- Naproxen (Naprosyn, Aleve)
- Diclofenac (Zipsor, Voltaren)
These medications are available over-the-counter (OTC) or by prescription for stronger, longer-lasting doses.
It’s important to inform your doctor about any medications you are currently taking and any underlying health conditions you may have. NSAIDs can interact negatively with certain medications or exacerbate health conditions such as kidney disease.
If you require long-term use of NSAIDs, you should also discuss other osteoarthritis treatment options with your doctor, as prolonged use may result in potential side effects. Short-term symptoms might include diarrhea, headaches, and stomach irritation, while more severe, chronic complications could include:
- Stomach ulcers
- Kidney problems
- Heart attack
- Heart failure
- Stroke
Several other prescription NSAIDs are approved for the treatment of osteoarthritis, including:
- Celecoxib (Celebrex)
- Diflunisal
- Etodolac
- Fenoprofen (Nalfon)
- Flurbiprofen
- Indomethacin (Indocin)
- Ketoprofen
- Ketorolac
- Meclofenamate
- Mefenamic acid (Ponstel)
- Meloxicam (Mobic)
- Nabumetone
- Oxaprozin (Daypro)
- Piroxicam (Feldene)
- Sulindac
- Tolmetin
Analgesics (Pain Relievers)
Analgesics, also known as pain relievers, are medications that alleviate pain but do not treat inflammation. They are available in both topical and oral forms. The most commonly used analgesic for osteoarthritis is acetaminophen (Tylenol). This over-the-counter (OTC) medication is available in various oral forms such as gel capsules, tablets, and liquid concentrations.
Duloxetine (Cymbalta) is sometimes used off-label to help manage chronic pain associated with osteoarthritis. Analgesics may offer a long-term alternative to NSAIDs due to their lower risk of potential side effects. However, it is important to note that analgesics do not provide pain relief for as long as NSAIDs and do not reduce inflammation.
While generally safer, analgesics can still cause side effects ranging from mild to severe, including:
- Skin irritation, such as rash and hives
- Facial swelling that affects the throat, tongue, and lips
- Swelling of the limbs, such as hands, feet, and ankles
- Difficulty breathing or swallowing
It is crucial to monitor your daily intake of acetaminophen. High doses taken over a prolonged period can lead to liver damage or liver failure, which can be fatal. In 2011, the Food and Drug Administration (FDA) set the maximum daily dosage of acetaminophen at 4,000 milligrams (mg). Following this, McNeil Consumer Healthcare, the maker of Tylenol, recommended a maximum daily dosage of 3,000 mg.
Topical Medications
Topical pain medications come in various forms, including:
- Ointments
- Creams
- Gels
- Patches
These are alternatives to oral or injectable drugs for treating osteoarthritis.
For instance, a doctor may recommend a topical NSAID instead of an oral one because topicals allow for targeted treatment of a specific area without the medication circulating throughout your entire system.
Topical medications are available both over-the-counter (OTC) and by prescription. Some topical treatments offer immediate, short-term relief, while others provide long-term relief.
Examples of topical pain medications for osteoarthritis include:
- Capsaicin cream
- Diclofenac sodium gel
- Methyl salicylate and menthol (Bengay)
- Trolamine salicylate (Aspercreme)
It’s important to consult a healthcare professional before using topical treatments for osteoarthritis. The choice of treatment may depend on the affected body part.
For example, the American College of Rheumatology and the Arthritis Foundation (ACR/AF) recommend topical capsaicin for knee osteoarthritis but not for hand osteoarthritis.
Corticosteroids
Corticosteroids, also known as steroids, are sometimes used to manage severe osteoarthritis flare-ups.
They are often injected directly into the affected joint to quickly reduce inflammation.
However, long-term use of corticosteroids can pose several risks. Some potential side effects include:
- High blood sugar levels
- High blood pressure
- Bruising
- Infections
- Vision changes, such as blurry vision
- Stomach ulcers
Some corticosteroid medications that may be used to treat osteoarthritis include:
- Betamethasone (Celestone Soluspan)
- Cortisone
- Dexamethasone
- Hydrocortisone (Solu-Cortef)
- Methylprednisolone (Depo-Medrol, Solu-Medrol)
- Prednisolone
- Triamcinolone acetonide (Kenalog-40, Zilretta)
Opioids
Opioids are prescription pain relievers that alter your perception of pain but do not prevent inflammation.
These medications are powerful, sedative, and habit-forming, which can lead to dependency if used on their own.
The American College of Rheumatology and the Arthritis Foundation (ACR/AF) conditionally recommend tramadol (Ultram) for the treatment of knee, hand, or hip osteoarthritis that is unresponsive to other treatments. However, they conditionally recommend against using all other opioids for osteoarthritis.
In such cases, opioids may be combined with non-habit-forming and non-sedative treatments.
Opioids can also impair balance, and their sedative effects can present additional concerns for individuals with mobility issues and osteoarthritis.