What is the best medicine for arthritis pain?

Pain is one of the most commonly reported symptoms of arthritis. Several over-the-counter and prescription medicines can help, as can self-care strategies and alternative treatments.

Chronic arthritis pain affects 1 in 4 people in the United States. This pain can be severe and located in the joints.

Several medicines can manage arthritis pain. The best treatment depends on various factors, including:

  • the type of arthritis
  • its severity and symptoms
  • overall health

This article explores the best approaches to arthritis pain and other symptoms, including medications, home remedies, lifestyle changes, and alternative treatments.

Some of the medications we discuss can cause an allergic reaction, which can be severe.

For someone with arthritis, pain and stiffness in the joints can make moving difficult. Medicines aim to manage pain, prevent joint damage, and maintain or improve mobility.

These drugs may be available over-the-counter (OTC) or by prescription. Most of the medications are oral, but people can apply or inject others to the skin.

A person can buy these at grocery stores and pharmacies without a prescription. These are generally safe, but having certain health conditions or taking other medications can make them less safe.

Acetaminophen

Acetaminophen (Tylenol) treats fevers and mild-to-moderate pain.

It works by reducing the production of prostaglandins, compounds made from fats that can increase sensitivity to pain.

A person may be choosing between Tylenol and a nonsteroidal anti-inflammatory drug (NSAID) such as Motrin or Advil. Arthritis usually causes inflammation in the joints, and NSAIDs combat inflammation, while acetaminophen does not.

For adults, doctors warn against taking more than 4 grams of acetaminophen per day to prevent an overdose. Many medicines contain acetaminophen, so is crucial to check all drug labels carefully and stay below this limit.

Acetaminophen is safe for pregnant people and children, but during pregnancy, take the lowest effective dose for the shortest necessary amount of time. This is to prevent rare but serious complications.

This drug can also cause serious adverse effects, including:

Anyone experiencing shortness of breath or nausea and vomiting needs urgent medical attention.

NSAIDs

NSAIDs are considered one of the most effective OTC drugs for pain stemming from osteoarthritis, which causes inflammation. These drugs reduce pain, stiffness, and swelling from arthritis.

A common examples of NSAIDs include ibuprofen (Advil, Motrin).

Side effects can include:

NSAIDs also put a person at a higher risk of stroke, heart attack, and renal damage.

A person should only use these drugs when needed. If this is on a daily basis, doctors prescribe proton pump inhibitors or H2 blockers to prevent gastrointestinal problems stemming from NSAID use.

To avoid complications, people who are pregnant, breastfeeding, or over 65, or who have other ongoing health conditions, should speak with a healthcare professional before taking these medications.

Aspirin

Non-prescription aspirin can treat mild to moderate pain. It is a unique type of NSAID because it prevents the formation of blood clots.

Taking ibuprofen within several hours after taking aspirin may interfere with aspirin’s cardiovascular benefits, and it can increase the risk of side effects.

Read more about possible side effects of mixing these NSAIDs.

Topical

Medicated creams, gels, liquids or patches may help people when arthritis only affects the small joints, such as those in the fingers.

These products may contain NSAIDs, capsaicin, an anesthetic called lidocaine, menthol, camphor, or a combination.

Topical NSAIDs may work for people who cannot take these drugs orally because the body absorbs less through the skin. Doctors consider topical NSAIDs to be safer in the management of arthritis.

Read more about precautions to take with oral NSAIDs.

For some people, treating arthritis also requires medications that a doctor prescribes.

Prescription NSAIDs

These are more potent than those available OTC. Examples of prescription NSAIDs are:

Prescription opioids

Doctors only prescribe opioids when other, safer pain relievers do not work. These drugs can help ease persistent, moderate-to-severe pain otherwise limits the quality of life. It is crucial to take the lowest effective dosage for the shortest effective period of time.

Examples of opioid medications include oxycodone, codeine, and tramadol.

Opioids can have serious risks, including overdose and addiction, and they are not appropriate for everyone. An overdose can be fatal, and long-term use can increase the risk of addiction and withdrawal. The doctor will describe the risks, possible benefits, and alternatives.

Opioids may also cause side effects, including:

  • drowsiness and dizziness
  • nausea
  • constipation
  • slowed breathing
  • impaired thinking, memory, and concentration
  • a low sex drive
  • reduced fertility
  • erectile dysfunction
  • more difficulty fighting off infections

Working with the doctor to establish goals and guidelines for safe use is key. An opioid pain agreement consent form may be a good idea before the treatment begins.

Steroids

Steroids reduce the activity of the immune system to lower inflammation.

They are fast-acting, which makes them useful as an initial treatment before other medications take effect. It is important to note that steroids do not treat all causes of pain, only inflammatory disorders.

Doctors prescribe steroids as oral or injected medications. Steroid injections can cause infections, bleeding, skin discoloration, an allergic reaction, and tendon damage.

Corticosteroids are best for short-term use, if possible, because they can have a number of side effects.

Long-term use of any steroids can cause:

Glucocorticoids are a type of corticosteroids, and they can cause avascular bone necrosis. They can also play a role in the development non-alcohol-related fatty liver disease.

Injections

Hyaluronan, or hyaluronic acid, is a fluid that cushions and lubricates the joints. Doctors can inject it to treat osteoarthritis in the knee.

Studies, such as research from 2015, have concluded that hyaluronic acid can help manage this condition by reducing pain and improving joint function. However, the effects may only be moderate and short term.

Antidepressants

Doctors may prescribe antidepressants to manage chronic pain due to osteoarthritis.

Antidepressants can cause side effects, including:

  • abdominal pain
  • nausea
  • bleeding in the digestive tract
  • dry mouth
  • a risk of suicidal thoughts or behavior

Read more about side effects of antidepressants.

The following approaches may help reduce the symptoms of arthritis:

Exercise

Regular physical activity may reduce joint stiffness and pain and improve mobility for people with arthritis. A person might try low-impact exercises, such as:

Supplements

According to the Arthritis Foundation, some vitamins and supplements can help with arthritis symptoms.

Although studies have found mixed results, glucosamine and chondroitin may relieve joint pain and help maintain cartilage structure.

Another option is curcumin. This is the active ingredient in turmeric. Its anti-inflammatory properties mimic the effects of ibuprofen, but without the side effects.

Read more about the best supplements for arthritis here.

Maintaining a moderate weight

Having extra weight can place added stress on weight-bearing joints, such as the knees and hips.

For some people who are overweight, losing 1 pound (lb) can relieve 4 lb of pressure on the knees. This can reduce pain and help improve function and mobility.

Heat and cold

Cold compresses can soothe painful, swollen joints. And adding heat therapy to a morning routine can help loosen the joints and reduce muscle spasms and stiffness.

Assistive devices

Crutches, a cane, or a walker can help relieve pressure on the joints, preventing overuse and promoting healing. These can also help improve balance and prevent falls for people with arthritis.

Adaptive equipment

Using dressing aids, grabbers, and other long-handled equipment can reduce straining and help people with limited mobility.

Learn more about the best home remedies for arthritis here.

Several promising alternative treatments are available for people with arthritis. But limited studies support their effectiveness.

  • Acupuncture: This involves using fine needles, pressure, and heat to release or redirect the body’s energy, which can lead to pain relief.
  • Yoga: This involves stretching and strengthening movements and postures, which can help improve muscle strength, flexibility, and the range of motion.
  • Massage: This can improve blood flow to the joints, temporarily relieve pain, and reduce muscle and joint stiffness.
  • Omega-3s: These fatty acids, available in fish oil and other supplements, may block certain sources of inflammation. A 2020 study concluded that they can help treat arthritis.

Read more about fish oil for arthritis.

While arthritis has no cure, a range of medications and self-care strategies can help manage symptoms and reduce the likelihood of flare-ups.

Treating arthritis involves managing pain, maintaining or improving function and mobility, and delaying joint damage. The best approach involves a mix of medications and alternative therapies, including self-care strategies.

A healthcare professional will consider the severity of arthritis and a range of factors specific to each person before they recommend a course of action.

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