According to the CDC, over 20 percent of the adults in the United States are afflicted with arthritis, including up to half of those over 65 years of age 1. Though some patients will require treatment with prescription medication for arthritis, those with mild to moderate arthritis may benefit from use of over-the-counter (OTC) arthritis meds.

Ibuprofen

Ibuprofen is a member of the non-steroidal anti-inflammatory drugs (NSAIDs) category of pain medication. NSAIDs work to relieve mild to moderate pain by interfering with inflammatory chemicals. The most common side effect from this medication is stomach upset or nausea. Ibuprofen is the most commonly used OTC arthritis medication and is available in non-prescription strength, including tablets and fast release capsules, which may last four to six hours.

Naproxen

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Naproxen sodium is available non-prescription strength as an over-the-counter remedy for arthritis. It carries similar side effects to ibuprofen; most commonly stomach upset, which may be reduced by taking it with food. It is available in tablet and fast release capsule form and may last eight to twelve hours.

Aspirin

Aspirin is the oldest of the NSAIDs. Aspirin is also known as acetyl salicylic acid (ASA), a salicylate type anti-inflammatory drug that has been in use for many years to treat mild to moderate pain. Aspirin has a significant side effect profile including stomach upset, ringing of the ears and irreversible platelet aggregation inhibition which may cause difficulty with clotting mechanisms, particularly if taken in high doses. Aspirin should not be taken by those with a fever or infection, particularly children as it may lead to a serious condition known as Reye's syndrome which may be fatal. It also should not be taken during pregnancy as it may cause birth defects. Several formulations and strengths of aspirin are available as over-the-counter medications for the treatment of mild to moderate arthritis 3.

Acetaminophen

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Acetaminophen has been used for the treatment of pain related to arthritis. Acetaminophen, also known as N-Acetyl-p-Aminophenol (APAP), works differently to relieve pain than any of the NSAIDs. It acts only to relieve pain by acting on the brain and will not decrease inflammation in peripheral tissues such as the joints. It is available in several strengths and formulations for the treatment of arthritis pain.

Capsaicin Cream

Capsaicin, an extract of chile peppers, is available as an over-the-counter cream for arthritis and muscle pain relief. It works by reducing levels of substance P, an inflammatory chemical responsible for transmitting pain messages to the brain. It also may stimulate fast sensory nerves which may over-ride chronic pain messages, similar to the effect of rubbing the skin after injury. Side effects of capsaicin topical treatment may include localized irritation and burning of the skin. In severe cases, blisters may develop requiring discontinuation. Care should be taken to avoid getting capsaicin in the eyes or on mucous membranes, as it may cause severe burning and irritation.

Salicylate Creams

Several types of over-the-counter topical treatments for arthritis pain include one of the salicylate-type anti-inflammatory medications, most commonly methylsalicylate 23. The salicylate may be absorbed through the skin and into the joint to reduce inflammation similar to the way aspirin works, but in a topical formation. Some topical salicylate creams may contain warming agents such as menthol to also warm the joint and provide the sensation of comfort and relief.

Cold, Hot Topical Treatments

Some topical treatments often marketed to reduce muscle inflammation may also help to reduce arthritis pain 2. Initially, the skin may be chilled followed by a warming sensation which helps to reduce arthritis pain by distracting nerve cells from transmitting pain signals. These creams or gels may also cause local irritation and some are bothered by a heavy sports odor, but many find them effective for mild to moderate pain.