Best medication for arthritis



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Medications Used to Treat Arthritis Symptoms

Arthritis can produce many symptoms and joint problems, including inflammation, swelling, stiffness, and certainly joint pain. But arthritis medicines are available to help ease nearly all types of arthritis aches and pains.

When your doctor is considering which arthritis medicine might be best for your pain, she has many options to choose from. Here, you’ll find information on common classes of arthritis medicines, what their potential side effects are, and how they can help you to manage joint pain and other arthritis symptoms.

Acetaminophen for Arthritis

Sold over-the-counter under the brand name Tylenol and others, acetaminophen is often one of the first medications recommended to manage pain, including joint pain caused by arthritis. If taken correctly, acetaminophen has no side effects. However, taking too much can lead to liver damage.

NSAIDS for Arthritis

NSAIDS, or nonsteroidal anti-inflammatory drugs, are commonly prescribed for arthritis pain and other symptoms. They are available over-the-counter as aspirin (such as Bayer), naproxen (such as Aleve), and ibuprofen (such as Motrin). NSAIDS are also available by prescription; two common brand names are Celebrex (celecoxib) and Vioxx (rofecoxib). These are effective in alleviating pain, swelling, and inflammation, but they do come with side effects, particularly in prescription varieties. These potential side effects include:

  • Bleeding in the gastrointestinal tract
  • Increased risk of stroke
  • Increased risk of a heart attack
  • Kidney damage
  • Ulcers in the stomach

Corticosteroids for Arthritis

These steroid medications work against the body’s immune system to help reduce inflammation and are recommended for autoimmune arthritis conditions like rheumatoid arthritis. These medications can also be helpful for inflammation caused by osteoarthritis, and are usually given occasionally as injections into a specific joint. Corticosteroids can also be taken in pill form; they are not available over the counter. Brand names include Deltasone, Medrol, and Entocort.

Corticosteroids have been associated with some serious side effects, including:

  • Bone thinning
  • Cataracts
  • Increases in blood pressure
  • Stomach pain or nausea
  • Bleeding in the gastrointestinal tract
  • Greater risk of infection

Disease-Modifying Anti-Rheumatic Drugs for Arthritis

These drugs, known as DMARDs, are used to manage the pain of rheumatoid arthritis and other autoimmune arthritis conditions. Medications in this class include:

  • Arava (leflunomide)
  • Trexall and Rheumatrex (methotrexate)
  • Plaquenil (hydroxychloroquine )
  • Cuprimine and Depen (penicillamine)

These drugs help to manage arthritis pain and symptoms by controlling abnormal immune system reactions.

Side effects may include:

  • Liver damage
  • Reduction in red blood cell production
  • Damage to the lungs, intestines, mouth, or stomach

Biologic Medications for Arthritis

Biologic medicines are made with organic molecules. These are some of the newest arthritis medicines available and are used to treat rheumatoid arthritis. Names of some common drugs in this class, which are all given by injection, include:

  • Humira (adalimumab)
  • Enbrel (etanercept)
  • Orencia (abatacept)
  • Rituxan (rituximab)
  • Remicade (infliximab)

These medications block an immune system protein that otherwise leads to painful inflammation.

Their side effects include:

  • Increased risk of infection
  • Fatigue
  • Symptoms of the flu
  • Increased risk of tuberculosis

Finding Relief From Arthritis Pain

From pain-relieving pills to inflammation-reducing injections, arthritis medicines offer a wide range of arthritis symptom relief. Medications aren’t the only treatment option available for arthritis, but they’re often a mainstay for managing pain. These medications can effectively reduce inflammation and stiffness, giving you the boost you need to start exercise and other therapies to help further minimize your arthritis symptoms.

Difference Between Osteoarthritis and Rheumatoid Arthritis

There are several different types of arthritis. Osteoarthritis and rheumatoid arthritis are two of the most common forms. Although the symptoms of these two types of arthritis can be similar, it’s very important to distinguish between them in order to determine the proper treatment.

At the University of Michigan Health System, our experienced rheumatologists will do appropriate tests to determine which type of arthritis you have. Then we will develop an effective treatment plan and will explain your options.

Osteoarthritis occurs when the smooth cartilage joint surface wears out. Osteoarthritis usually begins in an isolated joint.

Rheumatoid arthritis is an autoimmune disease, which means that the immune system malfunctions and attacks the body instead of intruders. In this case, it attacks the synovial membrane that encases and protects the joints. Rheumatoid arthritis often targets several joints at one time. The symptoms of rheumatoid arthritis include:

  • the symmetrical nature of the disease (arthritis in both hips, for example),
  • fever
  • anemia
  • fatigue
  • loss of appetite

For more details about these two different types of arthritis, please visit our Rheumatoid arthritis page and our Osteoarthritis page.

Contact Us/Make an Appointment by calling

  • Orthopaedics at 734-936-5780
  • Rheumatology Services at 888-229-3065

Selecting a health care provider is a very important decision. Because we are highly experienced in treating arthritis and joint inflammation, we would like to help you explore your options. Visit our Contact Us page to see a list of clinics and their contact information. Our staff will be glad to talk with you about how we can help.

Medication Choices for Osteoarthritis Pain

Start Osteoarthritis Pain Medications Slowly

If you get to a point where you need medication to manage the pain of osteoarthritis, you should always begin with drugs that have the fewest side effects and stay on the lowest dose that provides relief. Your doctor also might recommend sprays or creams that you can apply to your skin on or near the affected joint.

Options to try first, according to NIAMS:

Acetaminophen (Tylenol, Panadol). Generally, the first medication recommended for osteoarthritis treatment is acetaminophen. It relieves pain but does not reduce inflammation in the body. Acetaminophen is relatively safe, though taking more than the recommended dosage can damage your liver, according to the Food and Drug Administration (FDA). If you take acetaminophen regularly, you should also take care to avoid consuming more than two alcoholic drinks a day because the combination of acetaminophen and alcohol can increase your risk for liver damage.

Nonsteroidal anti-inflammatory drugs (NSAIDs). For people who don’t respond to acetaminophen, an NSAID is often prescribed at the lowest effective dose. Common over-the-counter NSAIDs include Advil and Motrin (ibuprofen) and Aleve (naproxen). NSAIDs relieve pain and reduce inflammation, but they can trigger more side effects than acetaminophen. NSAIDs may lead to stomach upset and, with prolonged use, stomach bleeding and kidney damage may occur, warns the FDA. In addition, NSAIDs other than aspirin can increase the risk for heart attack and stroke.

RELATED: 7 Top Antioxidant-Rich Foods for Osteoarthritis

In July 2015, the FDA strengthened the existing heart attack and stroke risk warnings associated with these drugs. Drug manufacturers now must change warning labels to reflect findings that these risks increase with the strength of the dose and the length of time you take NSAIDs. The risks also are higher for people who have heart disease or risk factors for heart disease when they start on an NSAID, but they can affect anyone.

Cyclooxygenase-2 inhibitors. COX-2 inhibitors like Celebrex are prescription-strength NSAIDs that have been designed to produce less stomach irritation. If you experience stomach irritation with other NSAIDs, acetaminophen doesn’t do enough to relieve your pain, and you have a low risk for heart disease, this may be your best option, according to recommendations published in BMC Medicine by the International NSAID Consensus Group in March 2015. However, although COX-2 inhibitors may lead to less stomach upset, they have the same risk of kidney damage. These medications must now carry the same warning of increased risk for heart attack and stroke as over-the-counter NSAIDs, according to the FDA. COX-2 inhibitors should be taken only at the lowest dose needed to relieve your pain.

Medications for Severe Osteoarthritis Pain

There are also many treatment options for pain that get more intense, as can be seen in more advanced stages of osteoarthritis. These include:

Opioid analgesics. If you’re experiencing severe pain, your doctor may recommend an opioid medication. These are medications that act like (or are made from) opium, a narcotic drug made from the opium poppy. They relieve pain by blocking pain receptors in the brain. Although opioids are powerful pain blockers, they also have many side effects and can be addictive, according to NIAMS. When opioids are taken as prescribed for pain relief, the drugs are usually safe, though drowsiness may occur, making it unsafe to drive or operate machinery while using them. It’s also important that you take them exactly as prescribed and not in excess, the FDA states. Misuse has become more common over the years; in 2013, the most recent year for results from the National Survey on Drug Use and Health, the number of Americans misusing painkillers was about 6.5 million in any given month.

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