- Topical pain relievers, which are applied to the skin, offer one alternative for mild pain relief. Creams containing salicylate, such as Aspercreme or Bengay, and others containing capsaicin, such as Zostrix, are available over the counter.
- Oral drugs. Doctors often recommend acetaminophen (Tylenol) first because it's effective for mild pain and easy on the stomach. Nonsteroidal anti-inflammatory drugs (NSAIDs) are generally considered more effective than acetaminophen in treating osteoarthritis because they reduce inflammation as well as pain. The arsenal of NSAIDs includes over-the-counter medications such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) as well as prescription drugs diclofenac (Voltaren), indomethacin (Indocin), meloxicam (Mobic), and nabumetone (Relafen). Because the NSAIDs, particularly aspirin and indomethacin, inhibit the enzyme that protects the stomach lining and interfere with blood clotting, they increase the risks of bleeding and gastric ulcers. Some of the prescription NSAIDs, particularly nabumetone, meloxicam, and diclofenac, seem to be relatively gentler on the digestive system. Some formulations, such as Arthrotec or Prevacid NapraPAC, combine an NSAID with a medication that protects the stomach.
- Glucosamine and chondroitin. These supplements shouldn't hurt you, but their effectiveness is still under study. As always, if you choose to take these or any other alternative preparations, be sure to inform your physician.
- Injections. Corticosteroid injections into the joint can relieve inflammation quickly, but usually only for a short time. They are recommended no more than two to three times a year, and only when absolutely necessary, because these drugs may increase the risk of infection and can further damage the joints. Another alternative, hyaluronate (Hyalgan, Synvisc), is a synthetic version of a natural lubricant in the joint. It can be injected directly into the knee at weekly intervals for three to five weeks. However, the modest benefits experienced by some patients may not be worth the discomfort of the injections.
A Answers (1)
Celeste Robb-Nicholson, Internal Medicine, answeredMedication for osteoarthritis (degenerative joint disease) works best with other pain relief strategies, such as exercising to build your muscles and protecting your joints from injury or overuse. Options include the following:
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