American Medical Association Family Medical Guide - American Medical Association [700]
Heat is usually used to relax muscles and warm them up before exercising. Heat up your sore joints with a heating pad or hot pack or by sitting in a hot tub or heated pool. Many people who have osteoarthritis find that a hot shower in the morning is all they need to loosen their stiff joints.
Applying cold can be helpful for short-term pain relief. Cooling a sore joint reduces pain by numbing the area. Never apply ice or cold packs directly to your skin—wrap them in a towel first. Use cold treatments carefully; the lack of feeling may cause you to overuse the sore joint.
Medication
Because of the potential side effects of many drugs that are used for treating osteoarthritis, medication is usually recommended only after other treatments such as weight loss and exercise have been tried and have not been effective. Arthritis medications generally are used to reduce pain and tenderness in the joints. No drugs are available that can stop the progression of the disease or cure it.
Many medications that are used to relieve osteoarthritis pain are available over the counter; some of the stronger ones are available only by prescription. All drugs used to treat osteoarthritis can cause side effects. If you are taking a medication for arthritis, tell your doctor immediately if you have any unusual symptoms. You may not have any problems until after you have been taking the medication regularly for a long time.
Topical medications
Creams, rubs, or sprays can be applied to the skin over a sore muscle or joint to temporarily relieve pain. Creams containing capsaicin (a substance found in hot peppers) reduce pain by blocking the ability of the nerve endings around the joint to send pain messages to the brain. Many of these medications are available over the counter. (Do not touch your eyes, nose, or genitals after applying capsaicin cream.)
Pain relievers
Drugs containing acetaminophen are usually prescribed for osteoarthritis because they don’t cause stomach irritation like some other pain relievers such as aspirin. Acetaminophen is most effective when it is used regularly. However, acetaminophen does not relieve inflammation, and you should not take it regularly if you consume three or more alcoholic beverages a day because the combination can damage the liver.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen, and ketoprofen are often used to relieve the pain and inflammation of osteoarthritis. Many NSAIDs are available over the counter, but stronger ones require a doctor’s prescription. NSAIDs such as celecoxib and rofecoxib may cause less stomach irritation than some of the older medications and are very effective for many people.
Corticosteroids
Corticosteroids are sometimes given in injections to reduce the inflammation and pain of severe osteoarthritis. A doctor injects the corticosteroid directly into the affected joint. Because corticosteroids can cause serious side effects, such as damage to bones and cartilage, the injections are given no more than a few times a year.
Glucosamine and chondroitin
A combination of the over-the-counter supplements glucosamine and chondroitin may help relieve osteoarthritis pain and increase mobility. These supplements seem to work together to strengthen cartilage.
Viscosupplementation
Viscosupplementation is a nonsurgical procedure that is usually recommended for people with osteoarthritis who do not yet need surgery. In viscosupplementation, a doctor injects a sterile mixture of a synovial fluid substitute and saline solution into a joint (usually the knee joint) three times