Managing arthritis pain can become a full time job. Pain and stiffness caused by joint inflammation can make even small chores such as dressing difficult. It is no wonder, then, that pharmaceutical companies devote significant amounts of time and money to researching new arthritis drugs. Commonly used arthritis medications include non-steroidal anti-inflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs), biologic response modifiers (BRMs), and corticosteroids. In addition to these medications, which actually treat the diseases, topical and oral analgesics help relieve the symptoms.
Corticosteroids such as prednisone and cortisone were the forerunners of modern arthritis medications. Taken orally or injected directly into painful, inflamed joints, they work by reducing the inflammation that causes the pain and damage. They also suppress the overactive immune system, which is the root cause of arthritis and all autoimmune diseases. Although they have been around for years, corticosteroids are still used in conjunction with newer arthritis medications.
NSAIDs are available over the counter in the form of aspirin, ibuprofen and naproxen sodium. Prescription NSAIDs include Celebrex®, Motrin®, Anaprox®, Feldene® and Clinoril®. These medications reduce inflammation and pain by blocking certain enzymes and proteins produced by the body. Unfortunately, they can cause skin rashes and stomach problems such as heartburn and ulcers.
Though NSAIDs are the first-line arthritis treatment, they do not always halt the joint destruction and deformity brought about by aggressive diseases such as rheumatoid arthritis. In these instances, doctors may prescribe DMARDs such as Trexall™ and Plaquenil®. These arthritis medications work to stop the immune system’s attack on the joints. While they are slow acting and may take months to become effective, these arthritis drugs can bring about remission of the disease.
BRMs are frequently used in conjunction with other DMARDs. They are tumor necrosis factor (TNF) blockers that begin to bring relief within a week or two after treatment begins, which is well before the standard DMARDs kick in. Evidence indicates that the biologics also help stop the progress of the diseases for which they are prescribed. Enbrel®, Remicade® and Humira® are BRMs often prescribed for use with other arthritis medications.
Oral and topical analgesics help manage arthritis pain, though they do nothing to reduce inflammation. Tylenol® and prescription Ultram®, Percocet® and Vicodin® are oral pain relievers used by arthritis sufferers. Over the counter topical creams or gels, such as those that contain menthol or capsaicin, can interrupt pain signals from inflamed joints and bring about a temporary respite.
It is unlikely that successful arthritis treatment will consist of only one type of medication. Typically, it takes a combination of drugs managed by a doctor who can adjust the combinations and dosages as needed. Sometimes real relief comes only through trial and error to find a complement of medications that not only ease pain but treat its cause as well.