Medical Treatment Options For Osteoarthritis
What Are Medical Treatment Options For Osteoarthritis?
There are several medicines and treatments available that can make living with Osteoarthritis easier including:
Analgesics (painkillers)
There are number of different types of analgesics (painkiller) that may be prescribed or used over the counter (OTC) based on both the severity of pain, as well as any other medical or general health issues including:
· Paracetamol (acetaminophen in the
This analgesic is a general pain reliever and is globally, one of the most commonly used drugs to treat OA. For most patients, it will likely be one of the first drug treatments used to control pain and symptoms. It can be very effective to treat mild pain for many patients. Paracetamol, which has multiple brands names across the world (one brand name is-Tylenol in the
NSAIDs (non-steroidal anti-inflammatory drugs)
This a large class of medications commonly used to treat more severe arthritis pain when an analgesic (ex.paracetamol) is ineffective for controlling pain. In addition, unlike an analgesic, NSAIDs are also used to treat inflammation. Some NSAIDs are available over the counter (OTC) while others are only available with a prescription from your doctor.
However, all NSAIDs work similarly, by blocking a number of different prostaglandins. These are substances in the body responsible for triggering various signals including the pain signals. It is important to understand that each NSAID is different and will have a slightly different effect on the body. NSAIDs are available in two formulations: 1) Topical (creams for the skin) and 2) Oral (ex.capsules).
Oral NSAIDs:
All oral (ex.tablet) NSAIDs can have significant adverse side effects, especially in older people who take them on a long term basis. The long term adverse side effects can include: gastrointestinal (GI)(stomach) issues with bleeding, cramping, diarrhea, ulcers, and kidney issues. 
If your doctor prescribes an oral NSAID, they will likely also prescribe another medicine known as a proton pump inhibitor (PPI) (ex.Prilosec, Nexium) to be taken as well. This is due to the concern that regular long term use of an NSAID can injure the lining in the stomach. Basically, PPIs work by reducing the amount of acid that is produced by closing the ducts (or pumps) in your stomach that produces acid. This reduces the risk of damage from the long term use of NSAIDs. Some NSAIDs should not be used if you have a peptic ulcer or asthma. The adverse side effects from NSAIDs occur in about 2-4% of the population.
When using topical NSAID creams or gels, adverse side effects do not normally occur. However, topical NSAIDs are not as effective as the oral medications.
The Most Common Oral NSAIDs Include:
Chemical Name Brand Name
Diclofenac Cataflam, Voltaren, Arthrotec (combination with misoprostol)
Diflunisal Dolobid
Etodolac Lodine, Lodine XL
Fenoprofen Nalfon, Nalfon 200
Flurbiprofen Ansaid
Ibuprofen Motrin, Motrin IB, Motrin Migraine Pain, Advil, Advil Migraine Liquigels, Ibu- Tab 200, Medipren, Cap-Profen, Tab-Profen, Profen, Ibuprohm, Children's
Elixsure, Vicoprofen (combination with hydrocodone), Combunox
(combination with oxycodone)
Indomethacin Indocin, Indocin SR, Indo-Lemmon, Indomethegan
Ketoprofen Oruvail, Orudis, Actron
Ketorolac Toradol
Mefenamic Acid Ponstel
Meloxicam Mobic
Nabumetone Relafen
Naproxen Aleve, Naprosyn, Anaprox, Anaprox DS, EC-Naproxyn, Naprelan, Naprapac
(copackaged with lansoprazole)
Oxaprozin Daypro
Piroxicam Feldene
Salsalate Disalcid
Sulindac Clinoril
Tolmetin Tolectin, Tolectin DS, Tolectin 600
Topical NSAIDs
Some NSAIDs are available in a topical formulation that you apply directly to the skin of the affected joints (see other topical creams in Nonmedical Treatments). Research suggests that the benefit of these drugs seems limited when compared to oral NSAIDs. The amount of drug in Topical NSAID’s that reach the affected joints is much less when compared to oral NSAIDs. As a result, any benefit is unlikely to last more than a few weeks. Most of the topical NSAIDs are available over-the-counter (OTC) with the exception of one recently approved topical and the first ever approved NSAID patch, both of which must be prescribed by a doctor.
Over the counter (OTC) Gels:
- Nurofen Gel (Ibuprofen 5%)
- Difflam Gel
- Feldene Gel
- Orudis Gel
- Nurofen Gel
- Voltaren Emulgel
- Voltaren Gel (diclofenac sodium topical gel 1%)
- The Flector Patch (diclofenac epolamine); the first prescription topical NSAID (non-steroidal anti-inflammatory drug) patch approved by the FDA in the United States.
COX-2 Inhibitors-Selective NSAIDs:
These are another type of prescription NSAIDs which substantially reduce the risks of GI bleeding and other risks. These drugs work differently than traditional NSAIDs because they block (or “inhibit”-hence the name) specific prostaglandins. COX-2 Inhibitors are “selective” in only blocking the pain mechanisms where as traditional NSAIDs also block other mechanisms. However, COX-2 Inhibitors carry an elevated risk of Cardiovascular Disease in certain people. Due to this risk and other safety concerns, two of them have been withdrawn from the market in the U.S.
Chemical Name Brand Name
Celecoxib Celebrex
Valdecoxib Bextra-withdrawn from the market
Rofecoxib Vioxx-withdrawn from the market
Opioids or Narcotics
This class of analgesics, which must be prescribed by a doctor, is typically used only to control severe Osteoarthritis pain. Although Opioids are effective in relieving pain and symptoms, they can be addictive and cause adverse side effects including: drowsiness, nausea, and constipation. It is common for a laxative to be prescribed for those taking an Opiod. It is also important to drink more water and eat more fiber while taking an Opiod.
Some of the common Opioids include:
Chemical Name Brand Name
Codeine Tylenol #3 or #4
Hydrocodone Vicodin, Lorcet
Oxycodone Percocet, Percodan
Propoxyphene Darvocet, Darvon
Did you Know? Opioids are made from the opium poppy plant which is the same plant that the narcotic drug Opium is made from.
Intra-Articular Injections:
Corticosteroids
In this procedure, medicine is injected directly into the joint cavity when severe pain can not be controlled with an analgesic (painkillers). Corticosteroids are strong anti-inflammatory medications and are the most common drugs used to reduce swelling and pain. Pain relief from these types of injections can last several weeks to months. However, long term use has been shown to damage joints; as a result, this procedure is only used in severe cases and injections are limited to three per year per joint.
Viscosupplementation
In this procedure, Hyaluronic acid substitutes, called Viscosupplementations are injected directly into the joint cavity. These drugs are designed to replace a normal component of the joint responsible for joint lubrication and nutrition. These drugs have only approved for use in the knee joint. These injections are a relatively new treatment and involve regular injections. 
The benefits of these injections are not fully understood. Although these injections do not relieve pain, they are used in cases when other severe symptomatic relief is needed.
The most commonly used Viscosupplementation injections include:
- Euflexxa
- Synvisc
- Nuflexa
- Orthovisc
- Supartz
- Hyalgan
Transcutaneous Electrical Nerve Stimulation (TENS)
Transcutaneous electrical nerve stimulation (TENS) is a technique that is used sometimes for the treatment of Osteoarthritis pain. 
The procedure consists of small electrical pads, applied to the skin over the affected joint, which deliver mild electric pulses. The effectiveness of TENS is limited and works by numbing the nerve endings on the skin which control pain.
Treatment can be arranged by a number of different types of doctors including Physiatrists (medical doctors’ who specialize in pain and rehabilitation) or physical therapists.
Home About Us Disclaimers Privacy Policy Site Map
