For more severe symptoms your doctor may recommend a prescription medication for the pain and/or inflammation. Tramadol for example is the best choice for treating acute flare-ups. It has no anti-inflammatory properties but it does provide strong pain relief as needed. Other prescription pain pills, such as codeine are available but they are intended for relieving serious pain. Because of the side effects and the risk of dependence they are not ideal for long-term use.
There are also stronger non-steroidal anti-inflammatory medications (NSAIDs) that are available with a prescription. They block the production of chemicals in the body that cause inflammation, known as prostaglandins. Some of the more popular drugs, by brand name, include Celebrex, Daypro, Feldene, Lodine, and Relafen. As with all analgesic and anti-inflammatory drugs listed so far, there are negative side effects that come with the use of these medications — the longer the use and higher the doses, the greater the risk for side effects. Prescription NSAIDs can cause stomach ulcers, high blood pressure, liver and kidney damage, heartburn, headaches, dizziness, and ringing in the ears. There is also an increased risk of heart attack, stroke, and stomach bleeding with use.
A third option is to have cortisone shots. Corticosteroids can relieve joint pain by reducing inflammation in tendons and ligaments, but they can also cause joint damage. They are used only when analgesic and NSAIDs are not enough. Cortisone shots only bring relief for several weeks or months.