Ask a doctor

I have arthritis. However, since being diagnosed, I have had difficulty finding pain medication that makes my joints feel better. Is there a painkiller that works best for arthritis?

Doctor’s Response

There is no one-size-fits-all pain relief for arthritis. Effective pain relief depends on how severe your arthritis is.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil Motrin, Motrin), naproxen(Aleve), or pain relievers like acetaminophen (“Tylenol”) are common OTC medications. Sometimes, it is possible to temporarily take NSAIDs and stop using them for some time. This reduces the chance of experiencing recurrent side effects. This is easier with osteoarthritis, as symptoms can vary in intensity and may be intermittent. Side effects of NSAIDs include stomach discomfort, cramping, diarrhea, and ulcers. These and other side effects are more common in older adults. Cox-2 inhibitors, a newer NSAID, have less toxic effects on the stomach and bowels.

Prescription medications include biologics like Enbrel and tofacitinib.

Cortisone can be used in many ways to treat arthritis. You can take it by mouth (in the form of prednisone [Deltasone]) or intravenously (in the methylprednisolone]). It is injected directly into inflamed joints to reduce inflammation and pain and restore function. Patients with more severe symptoms should not receive repeated cortisone injections as they can cause damage to their bones and tissue.

If severe osteoarthritis persists in the knee, exercise or medication does not work, then a series of injections of hyaluronic ( Synvisc, Hypergan, and others) can sometimes help. These products may temporarily restore the joint fluid’s thickness, improving joint lubrication and impact ability and possibly even affecting pain receptors.

Arthritis characterized by an overactive, misdirected immune system (such as rheumatoid arthritis or ankylosing spine) often requires medication to suppress the immune system. Examples of drugs that suppress the immune system include methotrexate (Rheumatrex and Trexall), sulfasalazine (Azulfidine), and sulfasalazine. Biologics, or biological response modifiers, are newer medications that target specific areas in the immune system. Sometimes, multiple drugs may be combined. These medications all require regular monitoring and dosing.

Topical creams and gels are also available for pain relief.

Some studies have shown that food supplements with glucosamine or chondroitin may relieve osteoarthritis pain and stiffness symptoms. These supplements can be purchased in pharmacies or health-food shops without a prescription. However, there are no guarantees about the quality of these products and the dosage of active ingredients as they are not monitored closely by the FDA. The U.S. National Institutes of Health studies chondroitin and glucosamine in osteoarthritis treatment. Initial research showed no benefit to pain relief for people with severe osteoarthritis. It is hoped that further research will clarify many questions regarding the safety and efficacy of these products for

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