Medicines, injections, and supplements for arthritis
Arthritis - medications; Arthritis - steroid injections; Arthritis - supplements; Arthritis - hyaluronic acid
Over-the-Counter Pain Relievers
Over-the-counter pain relievers can help with your arthritis symptoms. "Over-the-counter" means you can buy these medicines without a prescription.
Most doctors recommend acetaminophen (such as Tylenol) first. It has fewer side effects than other drugs. Do not take more than 3 grams (3,000 mg) a day. If you have liver problems, talk to your doctor first about how much acetaminophen is right for you.
If your pain continues, your doctor may suggest non-steroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include aspirin, ibuprofen, and naproxen.
Taking acetaminophen or another pain pill before exercising is OK. But do not overdo the exercise because you have taken medicine.
Both NSAIDs and acetaminophen in high doses, or taken for a long time, can cause serious side effects. If you are taking pain relievers on most days, tell your provider. You may need to be watched for side effects. Your provider may want to monitor you with certain blood tests.
Capsaicin (Zostrix) is a skin cream that may help relieve pain. You may feel a warm, stinging sensation when you first apply the cream. This sensation goes away after a few days of use. Pain relief usually begins within 1 to 2 weeks.
NSAIDs in the form of skin cream are available over-the-counter or by prescription. Ask your provider if these might be right for you.
Steroid Shots for Arthritis
Medicine called corticosteroids can be injected into the joint to help with swelling and pain. Relief can last for months. More than 2 or 3 shots a year may be harmful. These shots are usually done at your doctor's office.
When the pain seems to go away after these injections, it may be tempting to go back to activities that may have caused your pain. When you receive these injections, ask your doctor or physical therapist to give you exercises and stretches that will decrease the chance of your pain returning.
Other Shots for Knee Arthritis
Hyaluronic acid is a substance already in the fluid of your knee. It helps lubricate the joint. When you have arthritis, the hyaluronic acid in your joint becomes thinner and less effective.
- Your doctor can inject a form of hyaluronic acid into your joint to help lubricate and protect it. This is sometimes called artificial joint fluid, or viscosupplementation.
- These injections cannot help everyone and fewer health plans cover these injections.
Platelet rich plasma or PRP injection is a fairly new treatment. The results have shown it to be safe and perhaps helpful for people with early arthritis. Talk to your provider before having the injection.
There are other injections such as stem cells or amniotic cells. These treatments are quite new and mostly experimental. Please talk with your provider first before having them.
Supplements
The body naturally makes both glucosamine and chondroitin sulfate. They are important for healthy cartilage in your joints. These two substances come in supplement form and can be bought over-the-counter.
Glucosamine and chondroitin sulfate supplements may help control pain. But they do not seem to help the joint grow new cartilage or keep arthritis from getting worse. Some doctors recommend a trial period of 3 months to see whether glucosamine and chondroitin help.
S-adenosylmethionine (SAMe, pronounced "sammy") is a man-made form of a natural chemical in the body. Claims that SAMe can help arthritis are not well proven.
References
Block JA. Clinical features of osteoarthritis. In: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 181.
Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465-474. PMID: 22563589
Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2020;72(2):149-162. PMID: 31908149
Louis ML, Dumonceau RG, Jouve E, et al. Intra-articular injection of autologous microfat and platelet-rich plasma in the treatment of knee osteoarthritis: a double-blind randomized comparative study. Arthroscopy. 2021;37(10):3125-3137. PMID: 33887408
Version Info
Last reviewed on: 7/28/2021
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
