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The Best OTC Arthritis Meds
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.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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.
- 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.
Naproxen
Pain Meds That Do Not Contain Ibuprofen
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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.
- 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.
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.
- Aspirin is the oldest of the NSAIDs.
- 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.
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.
- Acetaminophen has been used for the treatment of pain related to arthritis.
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.
- Capsaicin, an extract of chile peppers, is available as an over-the-counter cream for arthritis and muscle pain relief.
- It also may stimulate fast sensory nerves which may over-ride chronic pain messages, similar to the effect of rubbing the skin after injury.
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.
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References
- CDC: Arthritis Statistics
- Mayo Clinic: Arthritis Topical Treatments
- Mayo Clinic: Arthritis Medications
- Van laar M, Pergolizzi JV, Mellinghoff HU, et al. Pain treatment in arthritis-related pain: beyond NSAIDs. Open Rheumatol J. 2012;6:320-30. doi:10.2174/1874312901206010320
- Walsh AM, Wechalekar MD, Guo Y, et al. Triple DMARD treatment in early rheumatoid arthritis modulates synovial T cell activation and plasmablast/plasma cell differentiation pathways. PLoS ONE. 2017;12(9):e0183928. doi:10.1371/journal.pone.0183928
- Curtis JR, Singh JA. Use of biologics in rheumatoid arthritis: current and emerging paradigms of care. Clin Ther. 2011;33(6):679-707. doi:10.1016/j.clinthera.2011.05.044
- Häuser W, Walitt B, Fitzcharles MA, Sommer C. Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Res Ther. 2014;16(1):201. doi:10.1186/ar4441
- Arthritis Foundation. What Is Fibromyalgia?
- Strand V, Mcintyre LF, Beach WR, Miller LE, Block JE. Safety and efficacy of US-approved viscosupplements for knee osteoarthritis: a systematic review and meta-analysis of randomized, saline-controlled trials. J Pain Res. 2015;8:217-28. doi:10.2147/JPR.S83076
- Chehade L, Jaafar ZA, El masri D, et al. Lifestyle Modification in Rheumatoid Arthritis: Dietary and Physical Activity Recommendations Based on Evidence. Curr Rheumatol Rev. 2019;15(3). doi:10.2174/1573397115666190121135940
- Yılmaz V, Umay E, Gündoğdu İ, Karaahmet ZÖ, Öztürk AE. Rheumatoid Arthritis: Are psychological factors effective in disease flare?. Eur J Rheumatol. 2017;4(2):127–132. doi:10.5152/eurjrheum.2017.16100
- National Center for Complementary and Integrative Medicine. Health.
- Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2004;141(12):901-10. doi:10.7326/0003-4819-141-12-200412210-00006
- Senftleber NK, Nielsen SM, Andersen JR, et al. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients. 2017;9(1):42. doi:10.3390/nu9010042
- Arthritis Foundation. Diagnosing Arthritis.
- Conditions and Treatments. Arthritis Foundation
- Osteoarthritis: In Depth. National Center for Complementary and Integrative Health.
- Rheumatoid Arthritis: In Depth. National Center for Complementary and Integrative Health.
- Questions About Arthritis and Rheumatic Diseases. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
- Senftleber NK, Nielsen SM, Andersen JR, et al. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients. 2017;9(1):42. Published 2017 Jan 6. doi:10.3390/nu9010042
Writer Bio
Melissa Lind holds a Bachelor of Science degree from the University of Texas College of Pharmacy. She has over 20 years experience as a health-care professional, including pharmacy practice as a registered pharmacist, and experience in clinical research management and community college instruction in pharmacology and health topics. Lind has been a freelance writer and independent content provider since 2006.