Osteoarthritis is the most common type of arthritis. It primarily affects women over forty. It was once referred to as degenerative joint disease because it is a form of arthritis that manifests from years of wear and tear. Factors that increase the strain on joints, such as obesity and working in a job that involves repetitive motion can increase the risk of osteoarthritis. Hormone changes after menopause also can contribute to the onset of joint deterioration.
This disease is characterized by pain, stiffness, and joint swelling. Cracking sounds are possible with movement, and there may be a decreased range of motion as tissue deteriorates. As the disease worsens joints may become deformed. Medications for osteoarthritis are intended to reduce the symptoms of the disease. This involves pain management, anti-inflammatories, and efforts to decrease bone loss. The best osteoarthritis medications may vary from individual to individual, depending on the severity of the symptoms and the state of the cartilage, joints, and bone. Many conventional drugs do come with negative side effects, so sometimes the best treatment is using the most effective medications to ensure quality of life in the smallest doses possible, while at the same time eating a healthy diet and getting moderate physical activity.
Without a Prescription
The first line of defense for relieving pain and stiffness is an over-the-counter medication. They are effective in mild to moderate cases. Although there are side effects with long-term use, such as possible gastrointestinal problems and the risk of kidney and liver damage, they are the mildest medications available aside from natural remedies.
Acetaminophen is available without a prescription. It has analgesic properties, acting to reduce pain, but it does not reduce inflammation. Found in drugs such as Tylenol, acetaminophen is the best medication for mild pain. As it can affect other medications always talk to your doctor if you are choosing to take acetaminophen. Also, as it can cause liver damage this may not be an ideal choice if you are consuming alcohol regularly.
Ibuprofen and naproxen, which are found in Advil, Motrin, and Aleve, are non-steroidal anti-inflammatory medications. They relieve pain and inflammation. Again, this option is ideal for mild pain and swelling. Long term use can cause kidney and liver damage and have an adverse affect on cardiovascular health.
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.
Biophosphates are a newer class of medication for osteoarthritis. They act by preserving bone density during menopause, when hormone levels are dropping and a women is at a higher risk for developing osteoarthritis. Boniva, Fosamax, Actonel, and Reclast are all brand names for biophosphate drugs. Are there side effects of this medication or is it an ideal treatment option? Heartburn and an upset stomach are short-term side effects that can be avoided by taking the drugs on an empty stomach and to not lie down after taking. In rare cases long-term use has been linked to thigh fractures and deterioration of the jawbone.
The Best Solution
While there are many different drugs available, the best osteoarthritis medications are what you and your doctor decide is right for your specific case, combined with healthy lifestyle choices. All conventional options come with negative side effects. It is important to weigh the risks
involved and decipher what is the minimal amount of drugs that are necessary for well-being. Biophosphates may offer something other than relief from pain and inflammation — a decrease in the rate of bone deterioration. Eating a diet rich in nutrients, especially calcium, magnesium, silica, vitamin K, and vitamin D, and getting regular exercise will also improve bone health.
Balch, Phyllis A. "Prescription for Nutritional Healing." Fourth Edition (Penguin Books, 2006).
photo by Brittany Culver
photo by Hobvias Sudoneighm