Finding the Best Joint Pain Relief for You: 24 Treatment Options
Here's your guide to finding the best joint pain relief. From traditional pain medication to natural remedies, there are many treatment options to fit your needs.
By Mary Anne Dunkin
Although the term arthritis technically means joint inflammation, most people with arthritis will tell you the most bothersome and debilitating symptom is pain. And arthritis pain comes in many forms: dull and aching pain, throbbing pain, or sharp pain that causes you to catch your breath when you put your weight on an affected knee or move your shoulder just so. Or pain that worsens after a day of activity, a poor night’s sleep or a time of stress.
Just as there are many types of pain, there are also many ways to treat arthritis pain. From traditional medications to natural remedies, pain relief is available in many forms.
Not every method works for everyone and one method that works for you one time won’t always work the next. You’ll likely need a combination of treatments for pain and you may need to stop some and add others over time. Having patience, using trial and error and working with your health care providers will help you find the best joint pain relief for you.
Here are 24 pain relief treatments to consider.
Oral, Injected and Topical Medications
1. Disease-modifying medications. If you have an inflammatory form of arthritis such as rheumatoid arthritis (RA) or psoriatic arthritis, an important route to relieving pain is controlling the underlying disease. Fortunately, a variety of medications — many developed in recent decades or years — make disease control possible. Drugs that can control the disease process include:
• Traditional disease-modifying antirheumatic drugs or DMARDs, such as methotrexate or leflunomide (Arava).
• Biological agents or biologics, which are drugs genetically engineered to inhibit or modify components of the immune system, including B cells, tumor necrosis factor (TNF) and interleukin (IL) 1.
• Janus kinase (JAK) inhibitors, a class of drugs that block signaling molecules called JAKs to curb cellular processes that lead to the progression of RA.
It is important to work with your doctor to find the right drug, or combination of drugs, to control your disease.
2. Oral pain-relieving medications. Some medications are designed to relieve pain and some developed for other reasons have been found to relieve pain. Some are available over-the-counter while others require a doctor’s prescription. They include:
• Acetaminophen (Tylenol). An over-the-counter (OTC) analgesic, acetaminophen may be sufficient for mild to moderate osteoarthritis pain. Prescription versions, which combine acetaminophen and a narcotic analgesic, may be used short term to relieve pain after joint surgery.
• Nonsteroidal anti-inflammatory drugs or NSAIDs. OTC doses of these drugs, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), may be useful for relieving pain. At higher prescription doses they may also relieve inflammation.
• Duloxetine (Cymbalta). Developed as an antidepressant, duloxetine is also approved for treating chronic pain related to osteoarthritis (OA).
• Tramadol (Ultram). Available only by prescription, tramadol is an opioid pain reliever prescribed for OA pain not relieved by other medication. Although the risk of addiction and abuse with tramadol is less than that of other opioids, its use is still tightly regulated.
3. Joint injections are used for acutely painful, inflamed joints.
• Corticosteroids injections — strong anti-inflammatory drugs similar to the cortisol made by our bodies — can quickly relieve both pain and inflammation.
• Hyaluronic acid injections can relieve painful osteoarthritis. Typically given in a series of injections, hyaluronic acid is a substance that gives joint fluid its natural viscosity. Hyaluronic acid injections are given a week apart in a series of three or four injections.
4. Topical Medications. Topical analgesics are drugs which are applied directly to the skin over the painful joint to relieve pain. They include sprays, creams, ointments and patches, and work by one or a combination of the following ingredients:
• Capsaicin, a chemical compound in hot chili peppers, which depletes the nerve cells of substance P, a chemical important for transmitting pain messages.
• Salicylates, the same ingredients that relieve pain in aspirin and aspirin-like drugs.
• Counterirritants, ingredients such as menthol and camphor, which create a burning and cooling sensation that distract your mind from your pain.
• Diclofenac, a prescription NSAID, which may act similarly to oral NSAIDs to relieve pain.
Diet and Natural Remedies
5. A healthy diet. A healthy diet may not directly affect your joint pain, but a diet rich in whole foods including fruits, vegetables, fish, nuts and beans, but low in processed foods and saturated fat, can be helpful for managing inflammatory arthritis. This in turn, can reduce pain. Some people say that eating certain foods causes pain to flare. If you suspect that a particular food is causing you pain, try eliminating solely that food from your diet. Eliminating multiple foods at once will make it difficult to determine if your suspected food is the culprit and eliminating too many foods or whole groups of foods could keep you from getting all of the nutrients you need.
6. Weight loss. If you are overweight, losing weight can be effective in easing arthritis pain, particularly for osteoarthritis of the knee. Even losing a small amount can help. But for those who are significantly overweight, losing a bit more is best. One study of 240 overweight or obese adults who lost 20% or more of their body weight had significantly lower levels of blood markers for inflammation and reported less pain and could walk farther in a six-minute test than those who lost less than 5% of their body weight.
A wide range of nutritional supplements have been purported to relieve joint pain and inflammation.
7. Fish oil. The polyunsaturated omega-3 fatty acids found in fish have potent inflammatory properties. Research has shown that in people with RA omega-3 supplements reduced joint pain, stiffness and swelling.
8. SAM-e. S-adenosyl-methionine (SAM-e) is a natural compound in the body that has anti-inflammatory, cartilage-protecting and pain-relieving effects. In some studies, it had a similar effective in relieving OA pain as NSAIDs.
9. Curcumin. Curcumin is the active compound in turmeric, a staple of Indian curries, which has been shown to have pain-and inflammation-relieving effects. In one study of patients with knee OA, a 1,500 mg daily dose of curcumin extract was as effective as 1,200 mg a day of ibuprofen.
10. Glucosamine and chondroitin sulfates. The most widely promoted and used supplements for osteoarthritis, glucosamine and chondroitin sulfates are components of natural cartilage. There is evidence the pair of supplements are effective pain relievers for some, but some studies show mixed or inconsistent results.
11. CBD. Cannabidiol, or CBD, is an active compound found in the cannabis plant. CBD is not intoxicating but may cause some drowsiness. Animal studies have suggested that CBD has pain-relieving and anti-inflammatory properties. These studies have not been validated in quality studies in humans, although some people report noticeable pain improvement with CBD and the Arthritis Foundation is urging the FDA to expedite the study and regulation of these products. If you decide to try CBD the Arthritis Foundation advises first speaking with your doctor, purchase from a reputable company, begin with a low dose and increase in small increments weekly if needed. It’s also important to have recommended follow-ups with your physician, as you would with any new treatment.
12. Medical marijuana. Also known as medical cannabis — although the two are not precisely the same — medical marijuana contains a number of active ingredients including CBD and tetrahydrocannabinol (THC), the substance that is primarily responsible for the drug’s “high.” Although the FDA has not approved the use of medical marijuana for any medical condition, some studies suggest it may be helpful for various types of pain. If you would like to try medical marijuana, speak with your doctor about a medicinal cannabis card that would allow you to buy and possess the drug. However, keep in mind that the long-term effects of the drug are unknown, it is still illegal in 13 states and even if you live in a state where medical marijuana is legal, carrying it across state lines is a crime.
Exercise, Physical Therapies and Devices
13. Physical Activity. Although joint pain may make activity difficult at first, you’ll likely find that once you try it, regular physical activity will actually ease your pain and help your body produce its own natural pain killers — endorphins. Physical activity also can increase your strength, stamina, flexibility and range of motion — all of which will help with everyday life. And if you are overweight, staying active can be an important part of a weight-loss plan. To avoid causing further pain, choose exercises that are gentle on joints such as walking, stationary cycling, swimming, water aerobics low-impact aerobics or yoga. A physical therapist (PT) or occupational therapist (OT) also can help you find and do physical activity that’s effective and safe for your specific condition and needs. They can help you adapt the way you move and move your joints — or the environment you live in — so you can safely complete daily tasks like getting in and out of bed, climbing stairs and more. To see safe and effective exercises approved by physical therapists, visit the Arthritis Foundation’s Your Exercise Solution.
14. Good Posture. Poor posture can put excessive stress on the joints of the spine, leading to neck and back pain, as well as pain in the extremities. Proper posture, if practiced consistently, can relieve those stresses and associated pain. Posture isn’t just a matter of standing up straight. A PT or OT can teach you how to use good posture while standing, sitting or moving and even comfortable positioning for relieving joint pain at night. A therapist can also help you with specific exercises designed to strengthen specific muscles that help you maintain good posture.
15. Rest. While it’s important to use joints to prevent stiffness, overusing your joints can cause or worsen pain, too. When using a particular joint be sure to take periodic rest breaks. Find the right balance between activity, rest and down time — that fits your needs — is key to optimizing your joint health and well-being.
16. Orthotics. Devices such as braces, splints and shoe inserts may be effective in relieving joint pain by shifting weight away from the damaged area of the joint, easing stress on a joint or relieving swelling by compression. A physical or occupational therapist can ensure you have the right orthotic and use it properly.
17. Assistive Devices. Devices are available to help you perform almost any task that causes or exacerbates joint pain, from buttoning blouses to sliding on shoes, to opening jars to reaching items on high shelves. An occupational therapist can help identify devices that would help you and teach you how to use them.
18. Hot and Cold Therapy. Apply heat to aching joints for temporary pain relief. Try a heating pad, hot water bottle, warm compresses, or soak in a hot tub or shower. For acutely inflamed and painful joints, try commercial ice packs or a bag of frozen peas or cut vegetables that mold to the shape of your joint and can be used and refrozen multiple times. Soaking smaller joints, like hands, feet and elbows, in paraffin wax can also help soothe those painful joints.
19. Acupuncture. This ancient practice, which involves inserting fine needles at specific points on the body, has been shown to reduce pain in people with some forms of arthritis who have moderate to severe pain despite taking anti-inflammatory or pain medications. However, it may take several weeks before you notice improvement.
20. Radiofrequency ablation (RFA). RFA is a procedure in which a doctor inserts a needle guided by X-ray into the painful area of an arthritic joint and then passes a current through the needles to ablate, or burn, the nerve ending to relieve pain. RFA is reserved for people for whom less invasive treatments have failed to relieve pain.
Mind-body therapies target interactions between the mind, body and behavior to distract the mind from painful stimuli. While many of these can be practiced on your own, if you need help getting started a psychotherapist can help.
21. Hypnosis. This practice can help you shift your attention away from pain by entering a trance-like state in which you have heightened concentration and focus. In a hypnotic state, you give control to your subconscious mind. Your overworked conscious mind takes a break, allowing you to reach a state of deep relaxation. Although you will likely need help from a professional to start, eventually you can learn and practice self-hypnosis to use whenever joint pain flares.
22. Biofeedback. Biofeedback is a technique that allows you to control some of your body’s functions, including its responses to pain triggers. During biofeedback, electrical sensors attached to your body transmit information to a machine that shows you how your thoughts and actions can affect your autonomic nervous system, which controls the heart, lungs, stomach and intestines, as well as the release of stress hormones. By learning how to control breathing and heart rate you can also control other physical reactions, such as pain.
23. Cognitive Behavioral Therapy (CBT). During CBT a psychotherapist helps you identify problematic behaviors and negative thoughts and feelings that can exacerbate pain and then trains you in pain coping skills, which enable you to have an active role in managing and controlling pain. CBT can increase your ability to control pain while acknowledging that there may be occasionally flares beyond your control.
24. Relaxation techniques. Relaxation techniques may relieve pain in a number of ways: by reducing stress, easing muscle tension, releasing endorphins and promoting restful sleep. You can experiment with relaxation techniques on your own or work with a psychotherapist who can teach you the techniques and get you started. Three techniques often used to relive pain are:
• Deep breathing. Similar to the Lamaze breathing women practice during labor, deep breathing exercises relax your body and allows you to focus on your breathing instead of your pain. To practice deep breathing, lie on your back in a comfortable positon. Place on one hand on your chest, the other on your belly. Breathe in slowly and deeply through your nose until you feel your belly feel with air and rise with your hand (your hand on your chest should not rise much). Breathe out through your nose. Repeat several times.
• Progressive muscle relaxation. This technique involves tensing and relaxing the major muscle groups, usually in a particular order. To use this technique, lie in comfortable position. As you breathe in, contract one muscle group, such as the feet/lower legs, for five to 10 seconds and relax. Repeat with your next muscle group, working all the way up to your facial muscles.
• Guided imagery. This relaxation technique involves visualizing in detail a positive, peaceful setting — “your happy place.” Think about a place you would like to be, then imagine the sights, sounds, smells as if you are actually there. Flooding your brain with positive sensations takes the focus off unpleasant ones — in this case, joint pain.
Learn more about the best arthritis treatment for you.
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