Analgesics can relieve arthritis pain when used safely.

Analgesics are a class of medications designed specifically to relieve pain.  They include acetaminophen (Tylenol), which is available over the counter (OTC) or by prescription when combined with another drug, and opioids (narcotics), which are only available by prescription. There are two types of opioids: conventional or atypical. They work differently in the body. 

Some medicines combine acetaminophen with an opioid for added pain relief.  But two opioids should never be taken together.  

The use of opioids for chronic, non-cancer pain is controversial. But the drugs are an important treatment option for people with uncontrolled arthritis pain, particularly if they cannot take nonsteroidal anti-inflammatory drugs (NSAIDs). Because of potential for side effects and accidental overdoses, opioids are tightly regulated. 

Benefits and Risks

Analgesics can be life-changing for people with arthritis, relieving pain and making it possible to work, do daily activities and maintain a level of activity needed for good health.  But they also carry risks, particularly if not used carefully. Here’s what you need to know about both types of analgesics.
Benefits and Risks


Acetaminophen is the active ingredient in more than 500 OTC and prescription medications. These include products for cold, allergy, headache and sleep. 

Benefits: For many people, acetaminophen provides pain relief without the stomach upset and other common side effects of NSAIDs. For that reason, it’s often the first pain treatment of choice, particularly for pain not related to inflammation and for people who can’t take NSAIDs. When taken according to instructions on the label, it is generally safe.

Risks: Because acetaminophen is a common ingredient in many products, it’s possible to get too much if you are already taking it for pain and are not diligent about reading ingredient labels. When taken in too-high doses or along with alcohol, it can cause severe liver damage, which can be fatal.


Conventional opioids are drugs that are chemically similar to, but more powerful than, the body’s natural pain relievers (endorphins). They work by binding to receptors on cells mainly in the brain, spinal cord and gastrointestinal system. Atypical opioids were developed to relieve pain with less risk than conventional opioids. They work in different ways, but their effects on pain are similar to conventional opioids.

Benefits:  Like your body’s natural endorphins, opioids dull pain perception and promote feelings of pleasure and well-being, mainly when used short term. This makes them particularly beneficial for acute pain, such as the pain from surgery, a broken bone or an acute flare of arthritis. 

Risks: Over time, your body develops a tolerance for opioids. That means it takes larger doses of the drugs to achieve the same results. In some cases, the pleasurable feelings that  the drugs promote lead to addiction – a craving for the drug’s effects despite negative consequences. By acting on pain receptors in the brain, opioids slow breathing. Taking too high of a dose, or taking them with other drugs that slow breathing, can be fatal. 
Like all drugs, analgesics are associated with side effects. While some may improve on their own in a few days, others may require some attention from you or a call to your doctor. Here are some of the more common side effects and what to do if you experience them.
Side Effects and Solutions


Solution: Drink more liquids (except alcohol or sugary drinks) throughout the day and eat plenty of foods high in fiber such as oatmeal, whole grains, fruits and vegetables. 


Solution: Drowsiness is worst the first 72 hours of beginning an opioid, so avoid driving or doing anything that requires close attention until you know how your body reacts. If drowsiness persists, speak with your doctor about lowering the dose or investigating other causes of your drowsiness. 


Solution: Like drowsiness, nausea usually subsides within 72 hours of a new prescription. In the meantime, avoid spicy foods and strong odors, sip cold water and lie down with a cool towel on your head and neck. If nausea persists more than a few days, ask your doctor about a medication to treat nausea.

Skin Itching

Solution: Apply cool compresses or moisturizers to itchy skin. Ask your doctor about using an antihistamine. 

Dry Mouth

Solution: Sip on water and other fluids (except alcohol or sugary drinks) throughout the day to keep your mouth moist and suck on sugar-free candies to promote saliva flow. Avoid mouth washes containing alcohol.  Ask your doctor if you need to lower your medication dosage or use an artificial saliva substitute. 
Safe use

Acetaminophen Safety

• Take no more than 4,000 mg daily. (If you take acetaminophen regularly and/or have health problems, your limit should be 3,000 mg daily.) Always read product labels to ensure you are not taking more than the daily limit if you use other OTC medicines. 

• Limit alcohol intake to no more than two drinks a day.

Opioid Safety

•  Never take more than your prescribed dose for the shortest time possible. 

•  If you take opioids regularly, see your doctor frequently for monitoring.

•  Use a single provider for opioid prescriptions and a single pharmacy to fill them.

•  Let all your doctors know you are taking an opioid, particularly before they prescribe a new medication. 

•  Avoid alcohol if you are taking an opioid. 

•  Don’t stop taking an opioid abruptly. Your doctor will need to slowly taper the dose to help you avoid withdrawal symptoms.  
Taking more than the recommended dose of acetaminophen can lead to liver damage and death. 
Taking opioid analgesics at higher doses than your doctor prescribes or combining them with other drugs – including alcohol – that affect the central nervous system can potentially lead to fatal overdoses. 

Using opioid analgesics carries a risk of addiction and/or overdose. Your doctor may order regular urine tests to check for treatment compliance.

Stay in the Know. Live in the Yes.

Get involved with the arthritis community. Tell us a little about yourself and, based on your interests, you’ll receive emails packed with the latest information and resources to live your best life and connect with others.