Effective Medications for Joint Pain Relief

Here’s how you can decide which OTC pain reliever is right for your joint pain:

• Talk to your doctor. Ask if there are any medical reasons you shouldn’t take an over-the-counter drug. For example, if you take blood thinners, research in the European Heart Journal indicates that the risk of internal bleeding is higher if you take NSAIDs. Likewise, doctors suggest you avoid taking NSAIDs if you have chronic kidney disease, as these drugs are processed through your kidneys. You might also want to avoid NSAIDs if you have uncontrolled high blood pressure or diabetes, liver disease, stomach ulcers or inflammatory bowel disease.
• Pay attention to side effects. NSAIDs can harm your stomach lining, contributing to GI issues from upset stomach to bleeding. This is especially true if you take them over an extended period. If you’ve taken these medications multiple times a day for more than a week at a time, talk to your doctor to make sure it’s safe, Calcei says.
• Consider dosage. If you regularly take pain relief medication multiple times a day and your pain gets worse before the next dose, a longer-acting OTC may be a better option. Or talk to your doctor about a prescription-strength medication.

3. Prescription pain relievers come in a few forms

If you have joint swelling, a joint feels like it’s “catching” or “locking,” or you worry that your knee will give out, you may be in a good position to start a prescription medication, Hartwell says.

First, he advises seeing your doctor to get imaging, like an X-ray or MRI, to identify a possible injury, so they can treat it. At that point, your doctor may recommend:

• Continuing with an over-the-counter pain med
• Moving to a prescription anti-inflammatory like celecoxib (Celebrex), meloxicam or fenoprofen (Nalfon), which are stronger
• Using oral corticosteroids like prednisone, which are prescribed with caution. “Steroids have side effects that are often significant. We do not prescribe them for long-term use,” Calcei says. Side effects include mood changes, headaches, dizziness, vision problems and weight gain, among many others.

Oral corticosteroids may be recommended if you have an inflammatory joint disease like rheumatoid arthritis, as these drugs are used as a temporary therapy while waiting for other, more powerful immunosuppressant drugs like DMARDs or biologics to kick in.

• Starting joint injections, which relieve pain and improve joint function. Corticosteroid injections and hyaluronic acid injections are two common joint pain treatments.

“Steroid injections can be helpful to control pain for a long period of time,” Hartwell says. Research suggests that an injection into the shoulder or hip joint, for example, provides relief for as long as eight or 12 weeks, respectively.

Hyaluronic acid injections into the joint are another option and have been found to relieve pain and improve function in knee osteoarthritis.

4. Opioids are used sparingly for joint pain

Opioid overuse is considered a public health crisis, with misuse and abuse of these drugs causing dizziness, constipation, depression and death.

“We really try to stay away from these except in post-op pain or acute injury,” Calcei says. “In that instance, we focus on using a much shorter course, with nothing taken longer term.”

Work with your doctor to identify an alternative to opioids. Other medications include acetaminophen, NSAIDs, antidepressants and joint injections, but you also can consider nonmedication treatments like physical therapy, exercise and TENS (transcutaneous electrical nerve stimulation) devices, which use low-voltage electrical currents to relieve pain.

5. Medications used for other conditions can also target joint pain

Some medications that you may not associate with pain relief, such as prescription antidepressants or anti-seizure medications, may be entirely appropriate.

Duloxetine (Cymbalta) is one example of an SNRI, a class of drugs typically used to treat depression and anxiety, that is also effective in relieving chronic nerve pain, one of the causes of joint pain. It can also improve mood and sleep, two things that can make pain worse.

Gabapentin and pregabalin, which are used to manage and treat seizures, also target chronic nerve pain by quieting pain receptors.

Regarding these and similar medications, Hartwell stresses how important it is that your doctor identify the correct source of your pain.

“In many scenarios, there is not a musculoskeletal or anatomic reason for the pain. The pain may be coming from heightened pain sensitivity, nerve-type pain or chronic pain that makes a nerve medication a better option,” he says.

6. Inflammatory arthritis requires more powerful medications

Although osteoarthritis (“wear and tear” arthritis) is the most common form of arthritis, autoimmune diseases that attack the joints, like rheumatoid arthritis, also cause joint pain and inflammation. DMARDs — such as tumor necrosis factor inhibitors (Enbrel, Remicade, Humira) and methotrexate — act on inflammatory and immune pathways to slow disease progression and improve symptoms.

Managing chronic pain is extremely complex and you shouldn’t go at it on your own; work with your doctor to come up with a well-rounded plan that controls your pain but also improves your quality of life.