What is the best prescription medication for osteoarthritis

Osteoarthritis (OA) is a degenerative condition that involves the gradual breakdown of cartilage. Lifestyle changes can improve a person’s quality of life, but doctors may also recommend prescription medications and over-the-counter (OTC) pain relievers.

OA is the most common type of arthritis. Although there is no cure, people can manage the condition by treating their symptoms.

Doctors commonly recommend OTC pain relievers such as ibuprofen, aspirin, and naproxen for people with OA. They may also prescribe steroids to help manage flare-ups.

Read more to learn about the different medications that are suitable for people with OA.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce and prevent OA-related pain and inflammation. Doctors frequently prescribe them as a first-line treatment for the condition.

Examples of NSAIDs include:

• ibuprofen (Advil)
• aspirin
• naproxen (Aleve)
• diclofenac epolamine (Flector)
• etoricoxib (Arcoxia)

A 2021 review examined 192 trials involving a total of 102,829 people and found that 60 milligrams (mg) of etoricoxib and 150 mg of diclofenac were the most effective oral NSAID treatments for improving function and reducing pain in people with OA.

The researchers note, however, that there is a risk of side effects with both NSAIDs. Topical diclofenac may be a safer option that doctors can consider as a first-line treatment for knee OA.

Although people can easily obtain these medications OTC, it is important to follow the dosage guidelines. It is possible to take too much, which can increase the risk of side effects such as:

• gastrointestinal problems
• heart complications
• bruising
• kidney problems

Drug interactions and allergic reactions are also possible, so people taking other medications or supplements should discuss potential interactions with a doctor.

Steroids are a good option for painful OA flare-ups because they effectively control inflammation.

However, because of the risks associated with long-term use, doctors generally only use corticosteroids as a short-term treatment for severe OA pain. Possible side effects include :

• adrenal insufficiency
• changes to blood sugar levels
• bone loss
• weight gain
• vision problems
• increased blood pressure
• increased risk of infection
• mood changes
• skin changes

People can take oral steroids or receive injections to the affected joint. Topical, IV, and intramuscular steroids are also available.

A 2019 study examined the effects of a 6-week treatment with 10 mg of oral prednisolone, which is a commonly used steroid. The study found that it effectively reduced pain and inflammation in people with OA of the hand.

Examples of other steroids that can help relieve the symptoms of OA include:

• cortisone
• prednisone
• methylprednisolone

As opioids have the potential to be habit-forming, there is some debate about whether they are a suitable option for treating OA-related pain.

Some researchers have concluded that the benefits of opioids for people with OA do not outweigh the potential downsides. However, some doctors may sometimes prescribe them to treat severe OA-related pain.

Topical medications come in the form of creams, gels, and ointments. People can apply them directly to the skin in an area where they are experiencing pain.

Topical NSAIDs may be a good option for people who:

• have pain in smaller joints, such as the fingers, hands, and ankles
• are over 65 years of age
• are sensitive to oral NSAIDs
• have risk factors that may increase oral NSAID complications

Another topical option is lidocaine patches. These create a numbing sensation that can help reduce pain. Topical products containing capsaicin, menthol, camphor, and cannabidiol (CBD) may also help block pain signals.

People should be mindful that skin irritation is possible when applying topical medications. Most manufacturers recommend doing a patch test to check for skin reactions before applying the product to a larger area.

Another medication that doctors sometimes prescribe for OA-related pain is duloxetine (Cymbalta). Doctors typically use it to treat depression, but the Food and Drug Administration (FDA) has also approved it to treat chronic musculoskeletal pain, including that resulting from OA.

Although there is no cure for OA, a doctor can help a person determine the best options for treating symptoms such as joint pain and swelling. A person should take note of any side effects they experience while taking medication and relay these to the doctor.

Anyone who experiences signs of a severe allergic reaction, also known as anaphylaxis, should seek medical attention immediately.

Osteoarthritis is a chronic, degenerative form of arthritis that can cause pain and swelling. Medications cannot cure the condition, but they may help reduce the symptoms and improve a person’s quality of life.

NSAIDs are the most common treatment because they target pain and swelling. People who cannot tolerate NSAIDs may find other drugs beneficial, such as steroids or topical medications.