Arthritis Foundation Logo
Español ES
Your Local Area
Sign In
Popular Search
arthritis gout home ja
Suggested Content
Article
Rx for Access
Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
Article
Do I Have Arthritis?
Think you may have arthritis? Learn about the four most common warning signs.
Article
Gout
Gout is an inflammatory type of arthritis that can come and go.
Arthritis Foundation Logo
  • About Arthritis
    Common Topics
    woman holding her wristWhat Is Arthritis?

    Arthritis is not one disease. Learn about the different types of arthritis, how they differ and why it’s important.

    microbesInflammation and the Immune System

    Body-wide inflammation is at the root of most chronic diseases — and you may have more control over it than you think.

    Patient talking with nurseNewly Diagnosed With Arthritis

    A new arthritis diagnosis can be overwhelming. These tips can help.

    • Understanding Arthritis
    • Arthritis Types
    • More About Arthritis
    • Where it Hurts
    • Related Conditions
  • Treatments
    Common Topics
    Woman holding shoulderWebinar: Touch Therapies for Pain Management

    Learn the evidence behind popular touch therapies for arthritis, including what to try and what to avoid, for how long and when.

    Managing Arthritis Care Costs

    Learn the basics about health care costs and financial tools available to you.

    Man with head in hands on bedWebinar: Arthritis Fatigue Causes and Solutions

    Learn the various causes of arthritis-related fatigue and strategies to combat weariness.

    • Treatment Plan
    • Drug Guide
    • Joint Surgery
    • Complementary Therapies
    • Insurance Management
  • Healthy Living
    Common Topics
    Woman with upset stomachMicrobiome, Gut Health & Arthritis

    Microbiome, microbes, microorganisms – these terms may be confusing, but the types of bacteria living in and on our bodies can impact arthritis. Learn what helps or harms the microbiome and the health of your gut and discover dietary changes that can make a difference. This episode was originally released on January 19, 2021.

    man exercisingStairs Workout Demo

    Strengthen your leg muscles and improve your stability to make going up and down stairs safer and easier.

    woman consoling anotherArthritis and Mental Health

    Learn about the connection between arthritis, depression and anxiety and how these conditions can make your arthritis worse.

    • Ease of Use Products
    • Managing Pain
    • Recipes & Nutrition
    • Physical Activity
    • Emotional Well-being
    • Daily Living
    • Family & Relationships
  • Juvenile Arthritis
    Common Topics
    2023 JA Family Summit

    Learn about the National Juvenile Arthritis Conference, a place for families to connect, share and learn.

    JA Camps

    The Arthritis Foundation’s JA camp programs give kids with arthritis and related childhood rheumatic diseases the chance to make lasting memories.

    Juvenile Arthritis Volunteer

    • About Juvenile Arthritis
    • Treatment
    • Managing Pain
    • Medical Decisions
    • Nutrition
    • Emotional Well-being
  • Professionals
    Common Topics
    Transforming Clinical Interactions

    The Live Yes! Arthritis community connects patients with others online and in-person for support and education, and encourages patients to play an active role in their health care.

    Partners 4 Patients with Arthritis

    The Arthritis Foundation recently launched an initiative to build stronger relationships and increase recognition of our most engaged practices. 

    Fellowships

    See how we're aiming to address the growing shortage of arthritis specialists, especially in under-served parts of the country.

    • Better Living Toolkits
    • Our Issue Briefs
  • Science
    Common Topics
    OACS Forum Series

    The Osteoarthritis Clinical Studies Forum Series features OA thought leaders from across the globe discussing the future of how the disease can be treated to improve patient outcomes.

    man bandaging boy's kneeConquering Childhood Arthritis

    The Arthritis Foundation is mobilizing patients and their families to engage in studies comparing the effectiveness of treatments for juvenile arthritis and funding research for more options.

    Focus

    • Awards
    • Funding Opportunities
    • OACS Forum Series
    • Osteoarthritis Focus
    • Participate in Clinical Trials
    • Partnerships
    • Publications
  • Get Involved
    Common Topics
    Capital hillAction Center

    Take action today - use the resources here to learn who your elected officials are, what opportunities we have to advocate from the comfort of your own home, federal and state legislation, and more!

    LiveYes! Insights thumbnailLive Yes! INSIGHTS

    Share your experience in a 10-minute assessment to be among those changing the future of arthritis.

    woman listening to podcastLive Yes! Podcast

    You may have arthritis, but it doesn't have you. The Arthritis Foundation’s one-of-a-kind podcast. Hosted by patients, for patients.

    • Advocacy
    • Ways to Give
    • Fundraising
    • Volunteer
    • Partnership
    • Live Yes! Arthritis Community
Donate
Back

Fight Arthritis Pain Without Pills 

 These pain relief methods include creams, exercise, CAM therapies, footwear, nerve treatments and injections. 

According to the National Center for Health Statistics, 76.2 million, or 26% of Americans, suffer from chronic pain – and more than half of those have some form of arthritis or related condition. The question that plagues many of us is this: Can’t something be done for arthritis pain besides pills? 

While over-the-counter and prescription pain medicines can be effective if used properly, there are possible risks whenever you take a pill. So many people want to explore alternative pain relief therapies. There’s an array of options – from electrical stimulation to meditation, topical creams to shoes. 

Experts recommend these options. 

1. Topical Medications

What they are: Gels, creams and patches that are applied to the skin supply sodium channel blockers, such as lidocaine or prilocaine. Prescription NSAIDs that come in drops, gels, sprays or patches are also becoming popular. Popular OTC creams for pain relief include ingredients like capsaicin, menthol or camphor.

How they work: Sodium channel blockers work by numbing nerve endings close to the skin. Topical NSAIDs work by reaching the joint fluid and decreasing inflammatory proteins like prostaglandins, says David N. Maine, MD, director of the Center for Interventional Pain Medicine at Mercy Medical Center in Baltimore. “They have a direct anti-inflammatory effect.” Capsaicin produces a mild tingling, burning sensation and works by blocking pain signals to your nerves. Topicals with menthol or camphor are called counterirritants. They don’t affect pain signals or inflammation, but rather work by producing a cooling sensation to distract from the pain.

Pain they work well for: Sodium channel blockers work best for nerve disorders like diabetic neuropathy or neuropathic pain. Topical NSAIDs help relieve the pain and inflammation common in arthritis. Capsaicin is recommended for nerve pain as well as joint pain.

Risks: Physicians believe NSAID topicals may pose fewer cardiovascular and gastrointestinal risks than oral NSAIDs because the topicals are absorbed locally rather than throughout the body. Says Dr. Maine: “GI side effects are rare compared to oral nonsteroidals.” About 10% to 15% of patients have some reaction, usually skin related, including rashes, irritation or itching.   

 

2. The Right Shoes

What they are: According to a  study on 31 people with osteoarthritis by Rush University Medical Center researchers, flat, flexible shoes like flip-flops and sneakers (Puma H-Street shoes were used in the study) reduced the force exerted on knee joints by 11% to 15% compared with clogs and special walking shoes. 

How they work: “Higher [force] on the knee joints is associated with pain,” says lead author and rheumatologist Najia Shakoor, MD. “So, if you exert less [force], you should have less pain.” 

Pain they work well for: Wearing flexible shoes may best relieve pain from osteoarthritis (OA) of the knee and perhaps the hip. 

Risks: Despite the study findings, Dr. Shakoor hastens to say that flip-flops can cause other problems like plantar fasciitis, inflammation of the connective tissue along the bottom of the foot. And they can put people with osteoarthritis at greater risk for falls. “Flat, flexible, closed shoes with arch support are a good choice,” she adds. 

 

3. Steroid Injection

What it is: Corticosteroids, such as cortisone, hydrocortisone and prednisone, are synthetic versions of the hormone cortisol, which reduces inflammation. 

How it works: A doctor injects a steroid directly into a joint to calm inflammation, says Allen D. Boyd Jr., MD, chief of Adult Reconstructive Surgery and Total Joint Replacement at the University of Rochester Medical Center in New York. 

Pain it works well for: “A steroid injection will make almost anyone [with inflammatory joint pain] feel better for days or months or longer,” says Dr. Boyd. “It’s good for anyone with inflammatory arthritis and can be used across the board, including for juvenile arthritis (JA).” 

Risks: You can repeat a steroid shot two to three times a year, Dr. Boyd says. More than that may make the ligaments and tendons more fragile, and they can rupture. And there is some small risk of infection with any injection.   

 

4. Exercise/Physical Therapy

What it is: Physical therapy is a treatment that uses exercises designed to improve posture, strength, function, range of motion and to reduce pain. It boosts energy and mood as well. 

How it works: A patient who is new to exercise might begin a program of strengthening, stretching and aerobics by seeing a physical therapist twice a week for 12 weeks. “We ask patients to work toward exercising two to three times a week for 30 to 40 minutes each time,” says Padmanabhan. 

Pain it works well for: Exercise works for any kind of arthritis, including OA, rheumatoid arthritis (RA) and ankylosing spondylitis. 

Risks: Overdoing exercise is always a risk. Don’t exercise through pain. High-impact activities like running and jumping may worsen joint health and increase your risk of injury, so be sure to check with your doctor or physical therapist before trying them. You may be better to stick with low-impact sports like swimming, water aerobics and cycling. 

 

5.Heat/Cold

What it is: You can apply heat with heating pads, warm compresses, heat patches, warm baths or even hot wax. Cold therapy can arrive in a cold pack, ice pack or frozen vegetable packs. 

How it works: “Muscle spasms can cause basic constriction of blood flow,” says Padmanabhan. “Heat works by increasing the blood flow to the [painful] area. It also relaxes the muscles.” Cold sensations travel along large nerve fibers, superseding pain sensations that travel along smaller fibers. Cold also reduces swelling and inflammation by constricting the blood vessels. 

Pain it works well for: “Heat works better [than cold] for osteoarthritis pain,” say Padmanabhan. Apply heat two or three times a day for 15 minutes at a time. Heated paraffin wax baths can be helpful for patients with RA, especially their hands – if they’re not having a flare. Cold works best for inflammation caused by injuries like sprains, strains and pulled muscles and ligaments. Apply cold packs two to four times a day for 15 minutes at a time until pain and swelling lessen. 

Risks: Heat can aggravate an acute injury like a muscle sprain or strain, making the swelling and inflammation worse. And overdoing either heat or cold can cause burns; never apply to bare skin.   

 

6. Trigger Point Injection

What it is: A physician injects anesthesia such as lidocaine, or anesthesia plus a corticosteroid, into muscle. 

How it works: “Trigger points are bundles of muscle that are painful,” says Mehul J. Desai, MD, director of Pain Medicine and Non-Operative Spine Services at The George Washington University Hospital in Washington, D.C. “Putting a needle into the trigger point allows the muscle tissue to go back to its normal structure. An injection can [relieve pain] for weeks or months.” Stretching and exercising the muscle afterward helps the injection’s effect last longer. 

Pain it works well for: It can work for any kind of muscle pain caused by arthritis but not for fibromyalgia, says Dr. Desai. 

Risks: You shouldn’t have the injections more than three to four times a year. Too many create scar tissue, which can change the muscle’s ability to contract, ultimately causing more pain. 

 

7. Meditation

What it is: Meditation is the practice of developing a deep concentration or focus. Tanya Edwards, MD, director of the Center for Integrative Medicine, Wellness Institute at the Cleveland Clinic, defines meditation as an array of mind-body and relaxation techniques – meditation, breath work, progressive relaxation, guided imagery – that help to lessen pain. 

How it works: According to Dr. Edwards, stress produces chemicals in the body that increase inflammation. “With relaxation techniques, you have stress reduction and therefore decreased inflammation and less pain,” she says. Meditation also relaxes muscles that tense up with pain. Dr. Edwards suggests meditating for 20 minutes once or twice a day. For moments of acute pain, she also recommends “meditation minutes.” For example, take four to five deep breaths, counting to 10 with each inhalation and exhalation. “Just doing that four to five times a day can decrease depression and improve outlook,” she says. 

Pain it works well for: “It works on any kind of pain,” Dr. Edwards says. Numerous studies have found that regular meditation practice reduces the brain’s response to pain. 

Risks: None. 

 

8. Nerve Block

What it is: A doctor injects a local anesthetic, or a mixture of local anesthetic plus a steroid, into a nerve. Nerve blocks are used to block pain and to help physicians pinpoint where certain pain is coming from. 

How it works: “The anesthetic stops the conduction [of signals] along the nerve, and the steroids help [calm] the inflammatory tissue,” Dr. Desai says. 

Pain it works well for: “A block is most commonly used when pain is in the spine and going down into the arm or leg,” says Dr. Desai. 

Risks: Infection and bleeding are possibilities. And it’s possible that a physician could target a wrong nerve, which could lead to problems with movement or feeling in areas affected by that nerve.  

 

9. Acupuncture

What it is: Acupuncture is an ancient Chinese therapy that involves placing tiny needles along meridians in the body to release trapped energy, or chi. 

How it works: “Placing the needles increases the production of endorphins, morphine-like substances that are natural pain relievers,” says Dr. Edwards. “It also may increase the blood flow to the area, which helps get rid of by-products like lactic acid that cause pain.”  Afraid of needles? Try acupressure - it involves using the fingers, knuckles and palms to apply pressure instead. 

Pain it works well for: “It’s appropriate for any kind of arthritis pain – almost any kind of pain,” Dr. Edwards says. 

Risks: If you are on blood thinners, there’s an increased risk of bleeding, and if you are getting chemotherapy, you may have an increased risk of infection. 

 

10. Facet Joint Denervation

What it is: A physician uses radiofrequency heat energy to destroy painful nerves that supply the facet joints, or the paired joints at the back of the spine. 

How it works: The doctor delivers radio waves through a needle inserted next to the nerve. The injury to the nerve interrupts pain signals. “The nerve typically comes back in three to 12 months,” Dr. Desai says. “If you have arthritis, it’s likely you would have pain again.” 

Pain it works well for: According to Dr. Desai, this therapy is very useful for patients with OA in the facet joints. “The therapy can be used for multiple kinds of arthritis. It’s typically used for back pain,” he adds. 

Risks: In rare instances, you can have numbness, infection, bleeding or a temporary increase in pain. Or the procedure may not work at all. 

 

11. Peripheral Nerve Stimulation

What it is: A physician implants a trial electrode just under the skin along a painful peripheral nerve (any nerve outside the brain and spinal cord) that receives electrical signals from a small battery-operated generator. If your pain is relieved after a week-long trial, the electrode as well as a small generator are permanently placed. 

How it works: The therapy works much the way TENS does. “An electrical current stimulates large fast fibers [whose messages] get to the spinal cord before [those] from the thin fibers that carry pain,” says Dr. Desai. 

Pain it works well for: “Although it’s most commonly used for nerve injuries, it’s also used for low back pain [such as that] caused by osteoarthritis,” Dr. Desai says. “The relief can last perpetually.” 

Risks: It’s possible to have infection and further nerve injury, says Dr. Desai, “but it’s a low-risk procedure.” 

 

12. Pain Pump

What it is: After a short trial, a doctor implants a small pump programmed to deliver varying amounts of pain medication, such as morphine or baclofen (a muscle relaxant), through a catheter threaded into a space around the spinal cord. 

How it works: The pump delivers narcotic medication directly to a painful area so that a patient has fewer systemwide side effects than she would with oral narcotics, says Dr. Desai. 

Pain it works well for: “It’s used increasingly for low-back pain that could be caused by osteoarthritis or spinal arthritis,” says Dr. Desai. 

Risks: As with any surgery, there are risks of infection and bleeding. And it’s possible that the catheter could get blocked, although that’s rare. The battery also must be replaced every five to seven years. In some whose pumps have delivered medication to a joint, such as a shoulder joint, patients have developed chondrolysis, a rare condition in which cartilage dies.   

Managing Pain
View All Articles
Quiz to Help Manage Pain
This eye-opening quiz may be just what you need to help you take control of arthritis pain.
Take the Quiz
Give & Get Your Best
Your gift does amazing things for the Live Yes! Arthritis Community. Help yourself and help others.
Donate
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.

 
Get Involved
  • Live Yes! Arthritis Community
  • Live Yes! Connect Groups
  • Live Yes! Online Community
  • Local Office
  • Fundraising
  • Webinars
  • Volunteer Portal
  • Store
About
  • About Us
  • Annual Report
  • Careers
  • Code Of Ethics
  • Financials
  • News and Stories
  • Privacy Notice
  • Terms of Use
  • Español
Join Us
  • Jingle Bell Run
  • JA Camps
  • Pathways Conference
  • Walk to Cure Arthritis
  • Fundraise Your Way
  • JA Family Summit
Home Office
  • 1355 Peachtree St NE Suite 600
  • Atlanta, GA 30309
  • Helpline: 1-800-283-7800
  • Contact Us
Ashburn, VA
63° Arthritis Index At Extreme Risk
See More Details
Arthritis Foundation is a qualified 501(c)(3) EIN 58-1341679
I Want to Contribute
I Need Help
  • Donate

    Donate

    Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life.

  • Volunteer

    Volunteer

    Join us and become a Champion of Yes. There are many volunteer opportunities available.

  • Live Yes! INSIGHTS

    Live Yes! INSIGHTS

    Take part to be among those changing lives today and changing the future of arthritis.

  • Partner

    Partner

    Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.

Donate


Ways to Give

Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.

Make a Donation

Help millions of people live with less pain and fund groundbreaking research to discover a cure for this devastating disease. Please, make your urgently-needed donation to the Arthritis Foundation now!

Become a Member

Become an Arthritis Foundation member today for just $20 and you'll receive access to helpful tools..... and more. 

Make a Honor or Memorial Gift

Honor a loved one with a meaningful donation to the Arthritis Foundation. We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift.

Gift Planning

I want information on ways to remember the AF in my will, trust or other financial planning vehicles.
 

Other Ways to Give

  • Match Gift
  • Donate a Car
  • Donor-Advised Funds

Volunteer


Volunteer Opportunities

The Arthritis Foundation is focused on finding a cure and championing the fight against arthritis with life-changing information, advocacy, science and community. We can only achieve these goals with your help. Strong, outspoken and engaged volunteers will help us conquer arthritis. By getting involved, you become a leader in our organization and help make a difference in the lives of millions. Join us and become a Champion of Yes.

Become a Volunteer

More About Volunteering

  • Walk to Cure
  • Jingle Bell Run
  • Do it Yourself Fundraising
  • JA Camp
  • Start a Live Yes! Connect Group
  • Be an Online Community Moderator
  • Local Leadership Board

Live Yes! INSIGHTS


Give Just 10 Minutes.

Tell us what matters most to you. Change the future of arthritis.

By taking part in the Live Yes! INSIGHTS assessment, you’ll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. And all it takes is just 10 minutes.

Your shared experiences will help:

- Lead to more effective treatments and outcomes
- Develop programs to meet the needs of you and your community
- Shape a powerful agenda that fights for you

Now is the time to make your voice count, for yourself and the entire arthritis community. 

Currently this program is for the adult arthritis community.  Since the needs of the juvenile arthritis (JA) community are unique, we are currently working with experts to develop a customized experience for JA families. 

How are you changing the future?

By sharing your experience, you’re showing decision-makers the realities of living with arthritis, paving the way for change. You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own.

Get Started

Partner


Meet Our Partners

As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Join us today and help lead the way as a Champion of Yes.

Trailblazer

Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. They contribute $2,000,000 to $2,749,000

Visionary

Our Visionary partners help us plan for a future that includes a cure for arthritis. These inspired and inventive champions have contributed $1,500,00 to $1,999,999.

Pioneer

Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. They contribute $1,000,000 to $1,499,999.

Pacesetter

Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. They contribute $500,000 to $999,000.

Signature

Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. They contribute $250,000 to $499,999.

Supporting

Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. They contribute $100,000 to $249,999.

More About Partnerships

  • Partner with Us
  • Ease Of Use Commendation
  • Let's Get a Grip On Arthritis
  • Promotions that Give Back