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Treatments and drugs

By Mayo Clinic staff

Controlling Your Arthritis

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Arthritis treatment focuses on relieving symptoms and improving joint function. You may need to try several different treatments, or combinations of treatments, before you determine what works best for you.

Medications
The medications used to treat arthritis vary depending on the type of arthritis. Commonly used arthritis medications include:

  • Analgesics. These types of medications help reduce pain, but have no effect on inflammation. Examples include acetaminophen (Tylenol, others), tramadol (Ultram, Ryzolt, others) and narcotics containing oxycodone (Percocet, Oxycontin, others) or hydrocodone (Vicodin, Lortab, others).
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve). Some types of NSAIDs are available only by prescription. Oral NSAIDs can cause stomach irritation, and some may increase your risk of heart attack or stroke. Some NSAIDs are also available as creams or gels, which can be rubbed on joints.
  • Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin, the ingredient that makes hot peppers spicy. Rubbing these preparations on the skin over your aching joint may interfere with the transmission of pain signals from the joint itself.
  • Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid arthritis, DMARDs slow or stop your immune system from attacking your joints. Examples include methotrexate (Trexall) and hydroxychloroquine (Plaquenil).
  • Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are genetically engineered drugs that target various protein molecules that are involved in the immune response. Examples include etanercept (Enbrel) and infliximab (Remicade).
  • Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces inflammation and suppresses the immune system. Corticosteroids can be taken orally or be injected directly into the painful joint.

Therapy
Physical therapy can be helpful for some types of arthritis. Exercises can improve range of motion and strengthen the muscles surrounding joints. In some cases, splints or braces may be warranted.

Surgery
If conservative measures don't help, your doctor may suggest surgery, such as:

  • Joint replacement. This procedure removes your damaged joint and replaces it with an artificial one. Joints most commonly replaced are hips and knees.
  • Joint fusion. This procedure is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit.
Lifestyle and home remedies Tests and diagnosis
References
  1. Questions and answers about arthritis and rheumatic diseases. National Institute of Arthritis and Musculoskeletal Diseases. http://www.niams.nih.gov/Health_Info/Arthritis/arthritis_rheumatic_qa.asp. Accessed Nov. 6, 2012.
  2. Arthritis advice. National Institute on Aging. http://www.nia.nih.gov/health/publication/arthritis-advice. Accessed Nov. 6, 2012.
  3. Goldman L, et al. Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed Nov. 6, 2012.
  4. Arthritis: Frequently asked questions — General public. Centers for Disease Control and Prevention. http://www.cdc.gov/arthritis/basics/faqs.htm. Accessed Nov. 6, 2012.
  5. Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/208746819-6/0/1807/0.html. Accessed Nov. 6, 2012.
  6. Schur PH, et al. General principles of management of rheumatoid arthritis. http://uptodate.com/home/index. Accessed Nov. 6, 2012.
  7. Weissman BN, et al. Diagnostic imaging of joint pain. http://www.uptodate.com/home/index. Accessed Nov. 6, 2012.
  8. Chang-Miller A (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 26, 2012.
  9. Kalunian KC. Pharmacologic therapy of osteoarthritis. http://www.uptodate.com/home/index. Accessed Nov. 6, 2012.
  10. Kalunian KC. Nonpharmacologic therapy of osteoarthritis. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2010.
  11. Chronic pain and CAM: At a glance. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/pain/chronic.htm. Accessed Nov. 6, 2012.
  12. Sawitzke AD, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Annals of Rheumatic Diseases. 2010;69:1459.
DS01122 Jan. 22, 2013

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