Arthritis pain medication options
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
There are multiple drug options available for the pain control of arthritis.
Analgesics are drugs that help relieve pain, but not inflammation. Acetaminophen is one example of an analgesic that gives mild relief of arthritis pain, but does not reduce swelling. It is available without a prescription. Tramadol (Ultram) is another analgesic pain medicine. Narcotic pain relievers are sometimes used for patients with severe arthritis pain when all other therapies have failed.
Non-steroidal anti-inflammatory drugs (NSAIDs) help reduce joint pain, stiffness and swelling. NSAIDs cut down on the production of prostaglandins, which are substances that promote inflammation. Examples of over-the-counter NSAIDs include aspirin, ibuprofen and naproxen sodium. Other NSAIDs are available by prescription. NSAIDs are associated with side effects related to both the gastrointestinal tract (ulcers, gastrointestinal bleeding) as well as the cardiovascular system (heart attack and stroke).
Glucocorticoids ("cortisone")are drugs chemically related related to a natural hormone called cortisol. Scientists have developed synthetic forms of cortisone that can be administered via pill form or injected directly into joints or other tissues. These drugs help relieve pain by reducing inflammation. Glucocorticoid injections must be monitored carefully; side effects can occur injections are given too frequently.
Disease-modifying anti-rheumatic drugs (DMARDs) often are used to slow down inflammatory conditions such as rheumatoid arthritis. While their main function is to reduce inflammation, and suppress the immune system, these drugs also help relieve pain. The drugs may take several weeks or months to begin working. Examples of DMARDs include methotrexate, hydroxychloroquine, azathioprine, azulfidine and lefunomide.
Biologic agents, are used to suppress arthritis inflammation. These include Enbrel, Humira, Kineret, Cimzia, Simponi, Remicade, Actemra, Orencia, and Rituxan.
Antidepressants, in addition to relieving depression, also can help relieve chronic pain. They are typically prescribed for the chronic pain of fibromyalgia. However, one, Cymbalta has also been FDA approved to treat osteoarthritis and low back pain. These drugs work by blocking pain messengers in the brain. These drugs also can help improve sleep quality, which in turn may help reduce pain. Three major groups are the tricyclics,the selective serotonin reuptake inhibitors and the selective nor-epinephrine and serotonin reuptake inhibitors.
GABA stimulators are also being used for chronic pain. These include drugs such as Neurontin and Lyrica.
Topical pain relievers can temporarily relieve the pain of arthritis. They include creams, rubs and sprays that are applied to the skin over a painful muscle or joint. Some topical pain relievers may contain combinations of salicylates, skin irritants and local anesthetics that relieve pain in one area.
Other over-the-counter topical creams containing capsaicin (the chemical that makes chili peppers taste "hot") work by decreasing "substance P," a neurotransmitter, which sends pain signals to the brain.
Muscle relaxants, such as cyclobenzaprine or carisoprodol, may relieve pain by decreasing muscle spasms that often trigger pain signals.
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