Medications

• Over-the-counter pain medicine:
  • Acetaminophen (such as Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), for example ibuprofen (such as Advil) and naproxen (for example, Aleve)
• Topical pain medicines (such as creams or patches) that are applied to the skin, for example, capsaicin, methyl salicylate, menthol, diclofenac
• Prescription pain medicine, such as:
  • Diclofenac and misoprostol (Arthrotec)—NSAID; may reduce the risk for gastrointestinal bleeding
  • Opiates and opiate-like medicines
• Antidepressants, such as duloxetine (Cymbalta)—may be prescribed to treat chronic pain from osteoarthritis
• Viscosupplementation—injection of a substance called hyaluronan into the joint, which helps lubricate the joint

Dietary Supplements

Glucosamine and chondroitin are two commonly used supplements. But, research has shown that these are not beneficial for most people with osteoarthritis. Talk with your doctor before taking any herbs or supplements.

Alternative Treatments

Some doctors report that acupuncture has been successful in reducing the pain of osteoarthritis. However, the evidence is not consistent.

While more studies are needed, balneotherapy (hot water therapy), relaxation therapy, exercise, yoga, and tai chi may be helpful.

Mechanical Aids

Shoes with shock-absorbing soles may provide some relief while you are doing daily activities or exercising. Splints or braces help to properly align joints and distribute weight. Knee and wrist joints may benefit from elastic supports. A neck brace or corset may relieve back pain. Also, a firm mattress may help chronic back pain. Canes, crutches, walkers, and orthopedic shoes can help with advanced osteoarthritis in the lower body.

Weight Reduction

Losing weight can lessen the stress on joints affected by osteoarthritis. Losing five pounds can eliminate at least 15 pounds of stressful impact for each step taken. The more weight lost, the greater the benefit.

Exercise and Physical Therapy

Strengthening the muscles supporting an arthritic joint (particularly the knee, lower back, and neck) may decrease pain and absorb energy around the joint. For example, if you have arthritis in the knee, exercise, including strength training, can also help improve knee function.

Swimming and water aerobics are good options. They do not put stress on the joint.

Another option is transcutaneous electrical nerve stimulation (TENS). With TENS, you are connected to a machine. The machine sends electrical signals through the skin to nerves. This type of therapy may decrease pain in some people.

Assistive Devices

If you are having difficulty getting around due to arthritis pain, your doctor might recommend that you install handrails and grips throughout your home. These are useful in the bathroom and shower. You may need elevated seats (including toilet seats) if you're having difficulty rising after sitting.

Heat and Ice

Applying heat (with hot water bottles or heating pads) helps joints and muscles move more easily. It can also lessen pain. Using ice packs after activity can also help.

Manual Therapy

If you have knee osteoarthritis, manual therapy (including massage therapy and manipulation) may be helpful.

Steroids

Corticosteroid injections to the inflamed joint may be given if other pain medicines do not work. However, repeated cortisone injections can be harmful to the cartilage. They are reserved for those with severe symptoms.

Surgery

Surgery can:

• Reposition bones to redistribute stress on the joint
• Replace joints
• Remove loose pieces of bone or cartilage from joints