The best medicines for joint pain

It is widely believed that joint pain affects only people of advanced age. And often, when you hear a characteristic crunch in the joints, you can hear a joke like "you're already falling apart like an old man." However, joint pain, swelling, and stiffness can manifest themselves at any age. Modern medicine offers a number of medications that effectively eliminate pain and inflammation. The first thing doctors recommend is non-steroidal anti-inflammatory drugs. What other over-the-counter and prescription medications can be used for joint pain to help you move comfortably and live a full life?

First-line medications: freedom of movement

Osteoarthritis damages cartilage and tissue, leading to pain, stiffness, and loss of joint function. Experts from the AF Arthritis Foundation recommend that patients with these symptoms take non-steroidal anti-inflammatory drugs (NSAIDs) because they block enzymes that cause pain and swelling.

• Medications such as ibuprofen and naproxen are available as patches, topical gels, prescription liquids, and tablets.

In a2019scientific review, researchers noted that oral NSAIDs provide effective pain relief and help reduce inflammation in people with rheumatoid arthritis.

At the same time, doctors warn that long-term use of NSAIDs can damage the gastric mucosa and cause gastrointestinal bleeding. These medications can also increase the risk of heart attack, stroke, and heart failure, so they should be taken only for a short period of time. If NSAIDs are not recommended for the patient, some experts recommend taking acetaminophen to reduce pain. However, according to several AF studies, acetaminophen is ineffective in relieving osteoarthritis pain. However, it may help many patients.

Over-the-counter medications: pain relief, reduction of inflammation

For severe joint pain, doctors usually prescribe two over-the-counter medications: NSAIDs and acetaminophen.

Ibuprofen (Advil, Motrin ) is a type of NSAID that blocks enzymes, reducing pain and inflammation. Experts recommend ibuprofen as a first-line treatment for joint pain. The drug is available in several forms in doses of 200-800 mg. The daily dose varies from 400 to 800 mg up to three times a day.

• Side effects: ringing in the ears, dizziness, constipation or diarrhea, bloating.

Naproxen (Aleve) is another NSAID that has the same effect as ibuprofen: it blocks the cyclooxygenase enzymes COX-1 and COX-2, reducing fever, pain, and inflammation. The drug is available in tablet, capsule, and oral solution form. Doctors prescribe 220-550 mg of Naproxen every 12 hours for mild to moderate pain. The drug should not be taken for more than 6 months.

• Side effects: irritable bowel syndrome, constipation, dry mouth, thirst, headache, insomnia, hearing problems.

Diclofenac , an anti-inflammatory drug for topical use in the form of gel, liquid and patches, helps to effectively relieve pain in the affected joint when applied directly to the skin. Topical NSAIDs can be prescribed either in combination with other anti-inflammatory drugs or for people who have too severe side effects from other medications.

Acetaminophen (Tylenol ) is often recommended for patients who have severe side effects from NSAIDs. The drug reduces mild to moderate pain by blocking COX-3 activity. It is often used for arthritis because it does not damage the heart and stomach as NSAIDs do.

• Doses for adults are 325-500 mg in tablets, for children - 80-160 mg.
• Side effects: in large doses, it can cause liver damage, rashes, nausea.

Prescription drugs: effective for severe pain

Tramadol (ConZip, Ultram ) is an atypical opioid that helps block pain receptors in the brain. Unlike other opioids, in acceptable, analgesic doses, it does not cause dependence and does not affect vital functions. However, many doctors still group it with other opioids.

• Experts recommend using tramadol only for certain people: those who are intolerant to NSAIDs; have surgery contraindicated; or do not respond to other treatments.
• Side effects: drowsiness, nervousness, muscle tension, mood changes.

Corticosteroid injections

Corticosteroid injections can help reduce inflammation and pain. The drug is injected in combination with an anesthetic directly into the affected joint. In some cases, the doctor may drain excess fluid from the damaged joint before the injection.

Experts often recommend corticosteroid injections for rheumatoid arthritis more than for osteoarthritis. Injections are effective for patients who have severe pain, as well as those who do not respond to other painkillers.

Usually, a person needs 3-4 injections per year. The medication can provide relief for several months, but after the first dose, the medication may not be as effective or take effect as quickly. The advantage of injectable steroids is that people rarely experience side effects due to the low doses.

Injections, physiotherapy, massages

In addition to injections of corticosteroids, doctors may also use injections of the following substances for arthritis therapy

• hyaluronic acid
• sugar solution - prolotherapy;
• platelet-rich plasma;
• autologous conditioned serum;
• stem cells.

In addition to the use of drugs, experts advise to additionally engage in special therapeutic gymnastics (yoga, Chinese Tai Chi practice) and take courses of special procedures:

• acupuncture
• massage
• physiotherapy;
• electrical stimulation;
• heat and cold therapy.

Biological drugs for RA

Many patients with rheumatoid arthritis benefit from biologic drugs. They are more difficult to produce than conventional synthetic DMARDs, so they are more expensive. Some of these medications are administered as an injection or intravenous infusion. There are several types of biologics. Each of them acts in its own way, stopping or slowing down inflammatory processes:

• Anti-TNFs are TNF inhibitors that block tumor necrosis factor, an inflammatory protein or cytokine.
• Interleukin inhibitors are drugs that block interleukins, a type of cytokine involved in the activation of the immune system.
• B-cell inhibitors can be used to treat rheumatoid arthritis when other treatments fail.
• Selective costimulation modulators bind to certain cells, suppressing the inflammatory process. Like B-cell inhibitors, they are usually used only when TNF inhibitors are not effective.

Drug therapy for arthritis depends on the level of pain, inflammation, and individual patient characteristics. Over-the-counter nonsteroidal anti-inflammatory drugs can help at the first signs of the disease. Prescription drugs are used when more intensive treatment is required. All drugs can cause side effects, which are best known in advance. For the prevention and comprehensive treatment of joint diseases, experts advise doing therapeutic exercises, undergoing massage, heat and cold therapy.