Arthritis Pain Relief

Arthritis pain relief covers more ground than the over-the-counter aisle suggests. Between topical creams, oral pain relievers, and heat wraps, it’s easy to assume that’s the extent of what’s available. But arthritis pain has treatment paths that go well beyond what you can pick up without a prescription, including targeted medications and injections that address inflammation at the source. Which path makes sense depends on the type of arthritis involved, how severe the pain is, and what’s already been tried. Let’s talk about what those clinical options are and when it’s time to bring in a specialist.

At-Home Relief vs. When to See a Specialist

Mild, occasional arthritis pain often responds well to at-home care: over-the-counter pain relievers, heat or ice, gentle movement, and rest during flare-ups. These are reasonable first steps and work for a lot of people, especially early on or with mild osteoarthritis.

The signal to move past home care is when pain persists despite consistent OTC use, when it’s limiting movement or daily activities, when swelling or stiffness doesn’t improve with rest, or when one joint is clearly worse than the rest. At that point, a specialist can identify what type of arthritis is involved and build a plan around it.

Medications That Help With Arthritis Pain

Although drug treatments carry some risk of side effects, the benefits generally outweigh the risks for most patients. Arthritis pain relief options include the following categories.

Painkillers

• Simple analgesics like acetaminophen
• More complex analgesics chemically related to morphine, sometimes combined with acetaminophen in combination products
• Tramadol, oxycodone, slow-release morphine, or patches containing fentanyl or buprenorphine

NSAIDs

• Aspirin or ibuprofen, available over the counter without a prescription
• Diclofenac, naproxen, or indomethacin, available by prescription
• Gels or creams applied directly to the painful joint, such as ibuprofen or diclofenac
• A newer type of NSAID commonly called “coxibs” (for example, Celecoxib), designed to control pain and inflammation

Coxibs are less likely to cause the indigestion and stomach ulcers sometimes linked with older NSAIDs. According to Mayo Clinic, NSAIDs can cause stomach upset, cardiovascular problems, and kidney or liver issues with extended use, so they’re generally used at the lowest effective dose.

Steroids

• Steroid tablets, usually prednisolone, often prescribed when other treatments haven’t worked, as with polymyalgia rheumatica (PMR)
• Steroid injections, either into the joint itself or into the soft tissue around the joint

The Mayo Clinic notes that steroid injections are typically limited to three or four times a year in the same joint, since repeated use can worsen joint damage over time.

Chronic Nerve Pain Medications

Drugs for nerve pain and chronic pain syndromes can include:

• Tricyclic antidepressants, such as amitriptyline. Prescribed to be taken at night, these work partly by improving sleep and partly by helping the brain control sensations coming from the upper body and limbs.
• Neuromodulatory drugs, such as gabapentin, carbamazepine, and pregabalin, act on the nervous system. They can help control some types of pain, especially when it’s caused by nerve damage.

Nerve Blocks and Other Injection Techniques for Pain

Injections that block pain by acting directly on a nerve or spinal nerve root are becoming more widely available. They usually combine a local anesthetic with a steroid. They’re not suitable for all types of pain, but they’re sometimes helpful for:

• Arthritis back pain relief involving the small facet joints between the bones of the spine
• Compression of nerves in the lower spine

A lumbar epidural steroid injection is one example of this kind of targeted injection, used when inflammation around the spinal nerves is contributing to pain. Special scans, such as MRI or CT, are usually needed to determine the exact injection site. The specialist can then place the needle accurately by following an X-ray image displayed on a screen.

Knee arthritis pain relief sometimes involves a related option, hyaluronic acid injections, which add cushioning fluid to the joint. The Mayo Clinic notes the evidence here is mixed, with some research suggesting these injections offer no more relief than a placebo for certain patients.

Other Pain-Relief Treatments for Arthritis

Beyond medications, there are other ways to relieve arthritis pain.

Home Remedies

• Heating pad, heated rice pad, or a hot water bottle
• Ice pack or a cold-water compress
• Rest and good quality sleep. Disturbed or unrefreshing sleep can increase pain, so mention to your doctor if this is a recurring problem.

These techniques are often helpful after an injury and for sudden flare-ups of arthritis or back pain.

Manual Techniques

Physical therapists, osteopathic providers, and chiropractors may use a variety of manual techniques, including:

• Manipulation and stretching
• Massage, with or without creams that create a sense of warmth
• Technologies such as ultrasound, laser, or interferential treatment
• Exercise programs to strengthen muscles and improve general fitness

Transcutaneous Electrical Nerve Stimulation (TENS)

TENS uses small electrical pulses to create a tingling sensation. It aims to disrupt pain signals by reducing the sensitivity of the nerve endings in the spinal cord. Some people find it very effective, especially when the pain is due to nerve damage. It’s best to get guidance from a physical therapist on pad placement and on the frequency, strength, and length of treatment.

Acupuncture

Doctors and other practitioners use acupuncture, often with good results. Very fine needles are inserted into specific points in the body. It’s thought to work by diverting or changing painful sensations sent to the brain and by stimulating the body’s own pain-relieving hormones, endorphins and enkephalins.

Psychological Techniques and Relaxation

Pain management clinics often use psychological techniques. Pain is never a purely physical experience, and learning to think differently about it and adjusting behavior around it can help, especially with chronic pain. For some conditions, including back pain, the Alexander technique may help. The Alexander technique teaches awareness of posture and relaxation to reduce muscle tension.