Medications to Treat Pain
As outlined in the Understanding Pain section, arthritis pain can be caused by inflammation, damage to joint tissues or nerves, or an abnormality in pain processing in the nerves and the brain. Medications to treat pain can target sources of the pain or a part of the nervous system processing the pain. Just as there are differences in how individuals respond to pain, effects from medication can also differ depending on how the medicine is absorbed and removed by the body.
Medications you take by mouth, rub on the skin over the joint or have injected into a joint include the following:
- Acetaminophen is an over-the-counter (OTC) analgesic that helps to relieve pain and reduce fever.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter and by prescription. OTC NSAIDs relieve pain and reduce fever. Prescription-strength NSAIDs can both relieve pain and reduce the inflammation that causes pain.
- Topical pain relievers may contain combinations of NSAIDs, salicylates, skin irritants and local anesthetics that temporarily relieve pain. Salicylates make it harder for nerve endings in the skin to sense pain. Irritants stimulate nerve endings to cause feelings of cold, warmth or itching, which distract attention from the actual pain. Some topical pain relievers contain capsaicin (the chemical that makes chili peppers taste hot), which blocks pain messages to the brain.
- Sedatives and sleep medications can help you get more restorative sleep, helping to break that part of the pain chain.
- Anti-seizure medications can be used to treat neuropathic pain and centralized pain through their effects on the central nervous system.
- Antidepressants are used to interrupt pain signals in the central nervous system.
- Opioid pain relievers work on receptors located in the nerve pathways that start in the brain and move to the joints and other tissues.
- Corticosteroids are medications that mimic the effects of the hormone cortisol, which is produced naturally by the adrenal glands. Taken orally, given by infusion or injected directly into inflamed joints, they can quickly bring down inflammation and ease pain.
- Viscosupplementation involves injecting the lubricating substance hyaluronic acid into the knee to ease movement of the joint and relieve pain.