Medications may be categorized in several ways. Is the medication topical, meaning do you apply the medication to a localized area of your body such as your skin? Is the medication designed to be taken orally, in which case the medication does its job via absorption in your gastrointestinal tract? Can the medication be injected directly into the joint? Can the medication be bought without a prescription, known as an over-the-counter (OTC) medication? Does the medication require a doctor’s prescription?
When you and your doctor are deciding on an appropriate medication to manage your OA symptoms of pain and inflammation, you should discuss and consider the side-effects associated with a particular medication, including the risk of damage to other organs of your body. Caution: Although the recommended doses of OTC medications are typically less potent than those of prescription medications, know that an OTC medication is not necessarily safe. OTC medications can be harmful especially when taken in larger than recommended doses or for an extended period of time. One essential aspect of selecting a medication is to read the label carefully; another is to talk with your doctor. This is the person who knows your medical history and can make recommendations or advise you if a medication can have an adverse effect because of conditions you have other than OA.
First try a topical: Creams and ointments, which include creams that induce heat or cold, can bring pain relief when applied to the skin of the tender joint. Some products also contain anti-inflammatory ingredients. Since creams and ointments have a much lower risk of side effects compared to oral medications exploring a topical medication is a reasonable place to start your search. The challenge is determining which topical might work for you. There are many to choose from. Talk with a pharmacist or your doctor before investing in a product.
If you find you need or prefer an oral pain medication, you can select from OTC or prescription medications. Some medications are available as both, depending on potency and dosage.
Analgesics: Available as OTC or prescription medications, analgesics relieve mild-to-moderate pain and fever but do not reduce the inflammation associated with OA. The most common analgesic taken in the United States is acetaminophen (Tylenol), known elsewhere as paracetamol (Panadol). Regardless of name, used inappropriately this analgesic can cause severe liver damage. Talk to you doctor. Opioids (narcotics) are strong prescription-only analgesics that have a lot of side effects.
Anti-inflammatories: Available as OTC or prescription medications, non-steroidal anti-inflammatory drugs (NSAIDs) can be effective in managing the inflammatory pain associated with OA. Common NSAIDS are aspirin, ibuprofen (Advil, Motrin, others), and naproxen (Aleve, Naprosyn). NSAIDs can have side effects including stomach ulcers, kidney damage, and effects on your heart and blood pressure. Talk to your doctor and pharmacist about a suitable length of time to be taking the medication (a course of 5-10 days is usually recommended) and make sure it does not interact with other medications you are taking.
Glucocorticoids: These are potent, prescription-only anti-inflammatory medications that can be injected into the painful joint by your doctor. They are often used when there is inflammation and joint fluid present.