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Understanding Your Osteoarthritis Medications

Osteoarthritis treatments aim to relieve pain and reduce stiffness.

Osteoarthritis (OA), also called degenerative joint disease, most often affects weight-bearing joints, such as the knees and hips. It also can affect the hands and spine. OA usually appears after age 45, in both men and women, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Joint trauma, obesity, and repetitive joint use also can bring on OA.

Treatment includes exercise; heat or cold; not overworking the joint; weight loss, if needed; and medication.

The medication your health care provider recommends depends on the severity of your OA, your health risks, your age, and your health history.

Here is information about specific kinds of medication for osteoarthritis.

Pain relievers

Over-the-counter (OTC) pain relievers, or analgesics, are often the first medication prescribed for people with OA.

Acetaminophen (Tylenol) is often the first medication recommended to treat the pain associated with osteoarthritis. It is available without a prescription, and your doctor may recommend it. Acetaminophen is effective for mild to moderate pain, is inexpensive, and is safe when taken as directed.

Acetaminophen does not reduce inflammation or swelling, however, and it can cause serious side effects if taken in too large a dose, or if a person drinks too much alcohol.

For severe pain, doctors sometimes prescribe codeine,  hydrocodone, or other opioid pain relievers. Like acetaminophen, they do not reduce inflammation or swelling.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve both pain and inflammation and are widely recommended for people with OA. A common side effect of NSAIDs is stomach irritation, which can often be reduced by changing the dosage or medication.

NSAIDs fall into two categories:

1. Nonprescription or OTC NSAIDs: Examples are aspirin, ibuprofen, naproxen, ketoprofen, and others. They can have serious side effects, such as stomach bleeding, easy bruising, and nosebleeds if taken in high doses or with some other medications. Check with your health care provider if you take these medications frequently or at higher doses.

2. Prescription-only NSAIDs: These include higher doses of ibuprofen, naproxen, or ketoprofen than are  available OTC. They also include other NSAIDs that may be less likely to cause stomach bleeding or other side effects. Check with your doctor to determine the safest drugs for you.

Other treatments

OA also can be treated with surgery, steroid injections, preparations injected into the knee that mimic hyaluronic acid, a naturally occurring body substance that lubricates the knee joint.

Transcutaneous electrical nerve stimulation (TENS) can help reduce pain. TENS blocks pain messages to the brain by directing mild electric pulses to nerve endings that are associated with the painful joint.

Other treatments that have been evaluated in medical research studies and may be effective for some people include pills containing glucosamine alone and with chondroitin, acupuncture, capsaicin creams, or ointments.