Osteoarthritis medications & treatments

Medically reviewed by  Jamie Winn, PharmD

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Osteoarthritis is the most common type of arthritis, affecting an estimated 32.5 million people in the United States and 240 million people worldwide. It is the leading cause of chronic disability in older Americans, costing more than $185 billion annually to treat. Approximately 4 out of 5 adults aged 55 years and older have evidence of osteoarthritis on X-ray. Although commonly seen in older people, it can affect younger people as well. For them, it is usually the result of a joint injury, an abnormal joint structure, or a genetic defect in joint cartilage.

What is osteoarthritis?

Osteoarthritis is a degenerative joint disease, which causes the protective cartilage in your joint to break down and lose its elasticity. As it wears away, it causes tendons and ligaments to stretch resulting in pain, swelling, and stiffness. Osteoarthritis can cause damage to any joint, but the most commonly affected joints are your hands, knees, hips, and spine (neck or lower back). While osteoarthritis symptoms can be successfully managed, the damage to your joints cannot be reversed.

Osteoarthritis causes

While osteoarthritis is typically thought of as a “wear and condition”, there are other risk factors that contribute to the development of OA, including:

• Age. Your risk of OA increases as you age, especially after age 50 according to the Arthritis Foundation.
• Gender. Women have higher rates of OA than men.
• Family history. Having parents or siblings with OA increases your risk.
• Obesity. Extra body weight adds more stress to your weight-bearing joints which can increase the risk of OA in those joints.
• Joint injury or overuse. Injury or repetitive stress on your joints can increase your risk.
• Joint abnormalities. If you were born with a joint abnormality such as scoliosis, it increases your risk of OA developing in that joint. 

How is osteoarthritis diagnosed?

To properly diagnose osteoarthritis, your doctor or healthcare provider may look at your symptoms, review your medical history, perform a physical examination, and run some lab and imaging tests.

Osteoarthritis symptoms

Some common symptoms of osteoarthritis include:

• Joint pain during or following activity
• Joint stiffness, usually when you first wake up or after inactivity
• Reduced range of motion and flexibility
• Swelling around the joint
• Grating, cracking, or popping sounds when you move your joints
• Tenderness around the joint
• Bone spurs (bony growths at the edge of the joint)

Your doctor may use the following test to help confirm a diagnosis of osteoarthritis:

• X-ray. X-rays can show joint or bone damage as well as bone spurs. Early joint damage does not typically show up on x-rays.
• Magnetic resonance imaging (MRI). An MRI is not typically used for diagnosis but may be recommended when a tear in the cartilage or surrounding ligament is suspected.
• Blood tests. No blood test can confirm OA but your doctor may order this to rule out other causes of your joint pain, such as rheumatoid arthritis.
• Joint aspiration. Your doctor may draw joint fluid to rule out other forms of arthritis or medical conditions such as gout or infection.

What are some osteoarthritis treatment options?

There is no cure for OA, but there are treatments used to minimize pain, continue physical activities, maintain a good quality of life and prevent disease progression.

Medications

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs). These commonly used medications treat pain and inflammation. Over-the-counter options include Aspirin, Advil/Motrin (ibuprofen), and Aleve (naproxen).
• Oral Analgesics. These pain relievers include OTC Tylenol (acetaminophen) and prescription opioids such as Ultram (tramadol). Tylenol can be used for mild to moderate arthritis pain, while opioids are typically used for severe arthritis pain.
• Topical analgesics. These alternatives to oral and injectable medications come in creams, gels, ointments, and patches. Some examples include Zostrix (capsaicin) and Voltaren gel (diclofenac).
• Corticosteroids. Steroids are typically used short-term for OA flare-ups. They can be given orally or injected directly into the affected joint. Oral examples include Decadron (dexamethasone) while cortisone injectables include Depo-Medrol (methylprednisolone) and Kenalog (triamcinolone).
• Cymbalta (duloxetine). This medication is typically used to treat depression but is used off-label to treat chronic musculoskeletal pain.
• Hyaluronic acid. This lubricating injection is similar to a component normally found in your joint fluid and may add some cushioning to help relieve pain.

Surgery

Severe osteoarthritis that hasn’t responded to therapy or has extensive joint damage may require surgery. Surgery can help relieve pain and restore the function of the joint. Joint replacement surgery replaces damaged joints to restore mobility and relieve pain. Hip and knee replacement are the most common joint replacement surgeries. If your doctor thinks you are a good candidate for surgery, they will refer you to an orthopedic surgeon.

Other therapies

A physical therapist can help you to use exercise and other methods to increase muscle strength around your joints, increase your flexibility, and reduce pain. You should only perform gentle, low-impact exercises and stop if you experience new or increased pain.

You may also benefit from assistive devices such as canes or crutches to help relieve some of the stress on your weight-bearing joints.

Some other complementary therapies such as massage or acupuncture may help with pain relief. Talk to your doctor to see if any of these are a good option for you.

What is the best medication for osteoarthritis?

The best medication for the treatment of osteoarthritis will depend on the individual’s specific medical osteoarthritis, medical history, medications that the individual is already taking that may potentially interact with osteoarthritis medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best medication for you. The table below includes a list of the most prescribed or over-the-counter osteoarthritis medications approved by the Food and Drug Administration (FDA).

Best medications for osteoarthritis

Your healthcare provider will determine the right dosage based on your response to the treatment, medical osteoarthritis, weight, and age. Other possible side effects may exist; this is not a complete list.

What are the most common side effects of osteoarthritis medications?

As with all medicines, those used for osteoarthritis will have some side effects, depending on the class you are taking.

Oral medications such as NSAIDs commonly cause stomach pain, headache, indigestion, nausea, diarrhea, and constipation.

Topical medications such as Voltaren Gel (diclofenac) can cause application site redness, dry skin, rash, itching, and pain.

Injectable medications such as Kenalog (triamcinolone acetonide) can cause injection site reactions, joint swelling, bruising, nervousness, and itching.

What are some home remedies for osteoarthritis?

There are several lifestyle changes and self-management strategies you can use to help manage arthritis and its symptoms.

Osteoarthritis prevention

• Regular exercise. Regular physical activity can strengthen the muscles around your joints and make them more stable. Try walking, bicycling or water aerobics, or other low-impact exercise programs.
• Balance exercises. Yoga and tai chi can help strengthen the small muscles around your knee joints and ankles which can help prevent falls.
• Lose weight. Extra weight can worsen your osteoarthritis pain. Weight loss can help reduce the stress on your joints, especially if you are overweight or obese.
• Use heat and cold. Heat and cold therapies can reduce inflammation and pain in your joints. Heat therapy helps increase blood flow which can help reduce pain. Cold therapy can numb the sore area and reduce pain and inflammation.
• Use braces or shoe inserts. Inserts and braces can help support your joint to help take pressure off of it when you stand or walk.
• Use assistive devices. Using canes or walkers can help you safely move around while relieving pressure on your joints. If you have arthritis in your hands, there are devices to help you perform daily tasks that require gripping.

Frequently asked questions about osteoarthritis

Is osteoarthritis fatal?

OA is not a fatal condition. It can have some physical complications such as weight gain, poor sleep, and fractures that can lead to other serious conditions.

How do I know if I have osteoarthritis?

Everyone seems to have their own unique aches and pains. Some signs that your pain might be due to OA include:

• Joint pain during or following activity
• Joint stiffness, usually when you first wake up or after rest
• Reduced range of motion and flexibility
• Swelling around the joint
• Grating, cracking, or popping sounds when you move your joints
• Tenderness around the joint
• Bone spurs (osteophytes)

What joints are most affected by osteoarthritis?

Although it can affect any joint, it most commonly affects the joints of the hands, fingers, knees, hips, and spine.

What foods should I avoid with osteoarthritis?

Foods that promote inflammation in your body should be avoided. These include:

• Refined grain products such as wheat pasta.
• Fried foods
• Red meat
• Salt
• Refined sugar
• Alcohol

What foods are the best to eat for osteoarthritis?

Certain foods can help reduce inflammation and help with your OA symptoms, including:

• Oily fish such as sardines, salmon, and tuna, which are high in omega-3 fatty acids
• Oils such as extra virgin olive oil and sunflower oil
• Calcium and vitamin D-rich foods like leafy green vegetables
• Broccoli, which contains sulforaphane, a compound that researchers think can slow the progression of OA
• Green tea, which is full of polyphenols (antioxidants) that may reduce inflammation and slow cartilage breakdown
• Garlic, which contains diallyl disulfide that may inhibit enzymes in the body that damage cartilage

Related resources for osteoarthritis

• Juvenile idiopathic awareness month. ANRF
• Osteoarthritis overview. MayoClinic
• Overview of osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases
• What is osteoarthritis? Centers for Disease Control and Prevention
• Osteoarthritis. Arthritis.org
• Osteoarthritis symptoms and causes. Cleveland Clinic
• Everything you need to know about osteoarthritis. Healthline
• Osteoarthritis practice essentials. Medscape