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Harvard Health Blog
Is there a “best” pain reliever for osteoarthritis?
- By Robert R. Edwards, Ph.D., Contributing Editor
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
I was recently diagnosed with osteoarthritis of my hands for which the rheumatologist prescribed plaquenil. Has anyone else been prescribed this for oa, I am wondering if that is a typical treatment?
I have bone to bone left knee and nearly same right knee. Hips hurt too. Now 70, but find whilst walking hurts cycling is better. Would appreciate any advice
Does anyone have any experience with NSAID topical solution called diclofenac sodium 2% ? Pennsaid is one of the brand names. It is advertised for osteoarthritis knee pain. Expensive stuff. A friend used it for muscle tendonitis because he could not use oral NSAIDs due to GI issues, and for him, a little bit helped relieve the pain when it flared.
I use diclofenac patches along with diclofenac pills and they help some what.
My wife with KOA and before knee replacement surgery was prescribed paracetamol and tramadol combination drug with which she was not comfortable and the drug had to be withdrawn
By the way I am 218 lbs female.
Meant to be posted under reply to another post, sorry folks.
Has any one heard about the new studies being look at, using the rooster comb to replace loss cartilage?
I, at 82, have OA, mostly in the fingers and meta carpals bilaterally, with marked 65% limitation of movement, but especially in the middle finger proximal joints. That on the right was more painful, and did not respond to medication with Voltarin. X-ray showed fragmentation of the bone around the joint. So I decided to have surgery. The joint was replaced with a much lauded plastic joint, followed by physical therapy. It is 8 months now. I am assiduous in keeping up with the exercises. The pain is much less, and is responsive to transcutaneous analgesics and anti-inflammatories, but the motion is still markedly impaired, and is about the same as the other hand. No cure, but I won’t knock the procedure.
yes i recently got the “chicken” shot from an ortho doc for my knee! it took down the swelling & reduced the pain significantly! unfortunately i still have osteo arthritis in the knee so i live with that. Opiods help greatly & the constipation is handled with syllium supplements. i would recommend the shot although i noticed an irristible urge to crow @ sunrise!!
I have bone to bone left knee and nearly same right knee. Hips hurt too. Now 70, but find whilst walking hurts cycling is better. Would appreciate any advice, vic
Water arobics works for me
It might be worth trying glucoseamine + chondroitine + curcumine.
You all write too much but biased.why no mention how bedt homeopathy help pain of any sorts to human being devoid of any side effect…
hi — I am a 70 year old male retired construction worker — have OA in most of my joints — had left knee arthroscopic surgery (not successful) and right knee is close to bone on bone — have had cortisone shots in both knees and both shoulders(right shoulder is bone on bone) and the series of filler shots in right knee — both ankles are also very painful plus left hip joint and both hands have a lot of pain – also carpal tunnel ops both hands and some neck pain — aside from the shots I have used many types of prescribed narcotic meds over the last 15 years — as I have aged they seem to work less and have more bad side effects — have had many mri,s and cat scans and x rays also ,plus I suffer from coronary artery disease (have a few stents) –the onset of damp weather seems to make the OA worse — have recently started taking OSTEO BI FLEX , an over the counter medicine with very, very good results(was recommended by my family doctor) — a large reduction in knee and hip pain — I also take up to 4 Tylenol pills a day plus about 5 different meds related to the heart problems –the OSTEO BI FLEX doesn’t seem to help every joint , but the knees and hip pain reduction is amazing — the cortisone shots have also helped both shoulders , and its been over a year since those shots
It’s amazing that so many of us suffering from OA have fought so long and gone through so much just to live a less painful life, especially taking all the medication we are forced to swallow. It gets old waking up in pain – at times so severe that I just wanted to stay under the warm covers and not come out until a real cure for osteoarthritis was on the horizon. But…we all know the truth about that one, it’s not in sight! Going on doxycycline has helped my hands, which had become so deformed at the knuckles. Even the cartilage on my right thumb was completely eaten away before the physical therapist noticed my thumb could bend in ways that reminded you of a horror movie! Sad truth is, there is NOTHING out there except compression gloves, to help arthritis or deforming and/or clenching fingers. I spent three years experimenting with every glove on the market and finally made my own only because I was scared to death of loosing my independence – one finger at a time. So…if anyone is interested I’d be glad to share with you what Straight Fingers has done for me and also let you know when we are hoping to offer them to the millions of arthritic hands around the world ~ to help you keep your independence one finger at a time ~ that would be so awesome!
I would love to hear more about straight fingers.
Please tell me about your device “straight fingers”. What it is made of? How and where can I get them?
I would love to hear about them devise Steve Collins was referring to. I just had a knee replacement and I will do what ever can be do to save my other knee.
My finger joints were getting very sore and swelling. Tying shoe laces and even using knife and fork hurt, as well as keyboarding – I was working as a computer engineer and that’s a problem. The arthritis doctor diagnosed Heberden’s Nodes and recommended NSAIDS. He said they were not a cure just helped alleviate pain.
Just at the same time – that was 20 years ago – glucosamine was being touted. Works for me. Hurting stopped. Joints stopped swelling and over time even a bit less. I’m 81. Carpentry, gardening, mechanical work no problem anymore. Well, of course don’t over do it. No NSAIDS.
Reportedly glucosamine lubricates the insides of the joints so long as there is still cartilage there. It is not for bone on bone.
Opiates lost their effectiveness for my wife’s severe chronic back pain. After slowly being weaned down from the opiates, she was placed on generic Suboxone. This is a medication approved for addicts. However, it had been observed by some pain management doctors that some addicts who also had chronic pain received pain relief from this drug. Within a brief time my wife experienced quite amazing pain relief. This drug was very effective for many years until her death.
I am a 70 year old female with degenerative osteoarthritis, have suffered because of this since my late 30’s, have undergone four back surgeries involving fusion of most of my spine. I’m on the verge of undergoing a fifth of the same type surgery. It scares me to undergo this again at my age, but have run out of options, including many, many steroid injections. The only problem I have with the 60mg of Oxcodone and 10mg of Oxycontin at bedtime which I take daily is the coñstant sleepiness. I would welcome another solution, but nothing else has come even close to helping at all. I can’t keep up with my housework or anything else because of the sleepiness which takes away my quality of life to the point of terrible depression.
According to my husband, a pain management Doctor based in Kentucky, a pain pump would be the best option for you.
Dear Readers & Doctors,
For over 30 years, I have suffered with OA and now some of my joints are afflicted with inflammatory OA. I have lost a substantial amount of weight; had both knees replaced, one hip replaced, and now face replacement of my other hip and a reverse shoulder replacement – all due to osteoarthritis., not rheumatoid arthritis. My fingers are so swollen that I can no longer wear rings; have difficulty opening packages and, even typing.
I exercise for 60 minutes per day, at 67 still work, and am still able to garden, shop, and enjoy many forms of recreation – all mildly, but at least I can still find some enjoyment in them.
I have tried every drug in the medical books, worked with numerous PT people, rheumatologists, GPs, dietitians and nutritionists, in hopes that the next best cure would work. And, I have been responsible and cooperative with the medical practitioners. I don’t smoke, drink or take any recreational drugs – no combinations of anything not prescribed by my doctor.
The only regime that has allowed me to continue enjoying any quality of life, for the past 20 years, has been the use of tramadol and ibuprofen on a regular basis. Now, with tramadol being categorized as a controlled substance my doctor has reduced my dosage, and expects me to feel as well as I did. Instead, my quality of life has been reduced because it hurts more to move even though I really try to “suck” it up and not complain.
However, I, and many, many others are seriously affected in a negative way by those who take these drugs to get high, and politicians responding to a societal problem of drug abuse.
I cannot change society’s complex drug abuse issues; however, I feel equally victimized because I am now categorized as an addict, when in reality the only effect I have ever received from taking my tramadol /ibuprofen mix has been a reduction of pain and some inflammation – no highs, no alterations in thinking.
I respect everyone’s opinion on this subject, but believe that people such as myself, who truly are chronic pain sufferers have been abandoned by medical practitioners who have not tried walking in the shoes of one of their
chronic pain patients and are more concerned about losing their licenses than treating their patients.
I am tired of hearing about taking NSAIDS for severe OA. I cannot take enough to relieve my pain. I will continue to try every new form of treatment and hope that it helps, but I will guarantee to everyone reading my comments that my arthritis will continue to progress, and I will continue to feel worse, until I just can’t stand moving at all. I would prefer to have continual constipation than to die from the effects of NSAIDS and arthritis.
In the meantime, while I am still able to write, I plan on pushing back on politicians who have forgotten the persuasive power of the baby boomer generation – many of whom are my peers in pain. Please let’s continue to push back for responsible pain management and make politicians realize that there is another side to this story of the war on opioids – there are other victims who are being denigrated by the harsh words, overly-strict government regulations and accusations of uncaring doctors and politicians. Sincerely,
A Peer in Pain
Perhaps you can find a different doctor who will prescribe what you need, especially since you have experimented with the lower dose. Seems ridiculous that your own doctor won’t do it. I could understand that he/she might want to write the scrip for a lower total quantity (given the recent increase in abuse) but leave your daily dosage as it was. Good Luck
I’m based in Phoenix, AZ and I was referred to your article this morning. I don’t want to be crass and use this response to advertise a device we are manufacturing in the US that will deal effectively with OA and other chronic ailments (drug-free). My e-mail address is provided (to you) if you are interested to know more. Dr. Joe Shurman, Chairman at Scripps Pain Clinic in San Diego has joined our team because of his emphatic belief in the efficacy of our device. We have a “launch” press release issuing this coming Wednesday (6th April) and I would be happy to include you in the recipient list.
Sounds interesting. Have suffered from OA of left knee for years. Low grade and still play tennis with a stand-off brace.(doubles only)
Walking for distance becoming more difficult. Please include me in your mailings
Please include me in your list.
This request is to take advantage for info regarding drugs and treatment for osteoarthritis. Trust it will reach the intended recipient and that info will come to me. Thanks for the offer.
Mr. Collins, Please include me in your mailings.
Please put me on your mailing list. I would welcome any non drug prescription information. It appears that anything I take for my OA has unwanted side effects.
I would very much appreciate it if you would include me in your list.
Please include me in your mailings.
Please include me on your list for the launch email. Thanks.
Please put me on your mailing list.
Please add me to your list
Please include me
Please include me in your mailing list for the “launch” press release, thank you.
Please include me in your email list. Thanks
I also have low back pain as well as my total right leg.
3 yrs ago Achilles tendon snapped also problems with ankle.
Please place me on recipient list.
Please add me to your mailing list
Please include me in your mailing list. Thanks.
Thank you, I would like to be included in the email information.
Where is your email address? Don’t see it here. My knee is so much better after over a year of practicing Tai Chi and Qi Gong. These disciplines require that we stand with knees slightly bent, and also do a fair amount of squatting. My thigh muscles have become so much stronger that my knee no longer hurts and I’m planning to skip my Synvisc shot this summer! Hooray for oriental methods of healing! But I have terrible issues with my lumbar spine. I have foraminal stenosis which can’t be operated on because of scoliosis, disc degeneration, arthritis, etc. So I am in almost constant pain in that part of my body. Is your new ‘invention’ something that can be used for back pain? Thanks…
I am 60 years old, practice horseback riding, jogging and long walks almost every day.
I find that ω3 helps a lot in osteoarthritis related pains, a daily dose of 2000 mg. has helped me a lot. I do not need to take any pain killers.
What do u mean by w3?
Let’s see: Opiates, the greatest pain killer known to man have side effects of nausea and constipation. NSAID’s cause kidney damage, stomach ulcers, liver damage (not mentioned in the article) and death, especially when ingested with a sufficient amount of alcohol. I have yet to find a patient with chronic pain who prefers death over constipation. It is true that long term use of opiates also depresses testosterone and often leads to gynecomastia, an unpleasant side effect among men, albeit preferable to liver destruction and death – caused by heavy, long-term use of NSAID’s (in particular Acetaminophen). If God hadn’t wanted men to take opiates He wouldn’t have put opiate receptors in our brains. This war on opiates for chronic pain is not based on medicine; it’s based on politics. Shameful.
Your comment deserves a round of applause for clarifying the advantages of opioids vs NSAIDs and delivering to those who demonize the use of opioids for chronic pain a much needed dose of reality. My husband, who has anaphylactic allergies to NSAIDs and aspirin, suffered greatly from several severe pain conditions and while treated by a “pain management” doctor, and was coerced into agreeing to years of damaging steroid injections in turn for opioid prescriptions. We finally found a doctor who refused to play God and assume he knew what levels of opioids would relieve the pain. Although shrewd, (he had us in his office once a week for a year before relaxing to monthly check ups), his willingness to get to know and listen to my husband gave us five additional years of running our business. Now that my husband has advanced cancer, it’s becoming increasingly difficult to get his class 2 Rx’s filled. Everyone is afraid of losing their licenses due to the witch hunts by overly zealous regulators spurred on by Politicians who demonize this medicine. They truly make me sick – I wish for all of them years of untreatable severe chronic pain and I’m not proud of feeling so angry about this. We’re dreading the day when the politicians completely ban this class of medicine from the market – and they will soon unless more people like Dr. Price speak out.
If god wanted wanted men to use opiates????
What century are you living in?
Assuming that there is a caring god, obviously he would want us to take advantage of any effective pain-reliever that is developed.
And, what about PRP (Platelet Rich Plasma) and Stem Cell Therapy for painful arthritic joints??
On March 23, 2016, the Mayo Clinic presented a Webinar entitled,
“Stem Cell Therapy and Growth Factors for Osteoarthritis: Hope or Hype,” and the Mayo Clinic is now scheduling appointments. . . . I will not attempt to post a link, but if you search for “Mayo Clinic Connect,” it will appear in your search engine with 6 subheadings. One of the subheadings is “Webinars.” So, you can find the free webinar from there and view it for yourselves.
Why are glucosamine and chondroitin with or without MSM not mentioned, for the knee at least?
I don’t need any double blind studies after having treated tens [and probably over a few hundreds of patients over the many years with these compounds and also heard the results of many patients which bought them self these compounds.
I validate these data far more than any computer search .
The only problem is that the treatment is an ongoing one and most people get problems again after stopping these supplements for a while, even a week or so [we know this in Israel as many religious people stop these supplements during Pesach which is not strictly necessary according to Jewish law]
An answer form Harvard would be appreciated.
Because, Harold, it is no help when there is no more cartilege left to lubricate. I am over 60 now and have had to use opiates for migraine, RLS, and, now, ruined joints. It is the only thing that helps without making me ill, and, I have NEVER found myself in danger of becoming addicted! That, above all, is what worries me about all these antsy politicians and their unthinking Mandatory ideas for ‘fixing’ things. They have ruined many lives and now…our Doctors?
I started having achy joints when I was in my 30’s and by 45 was taking diclofenac sodium/misoprostol because aspirin upset my stomach. I had major lower back surgery at 59 with rods and pins and another back surgery at 62. I went through months of PT but was still in a great deal of pain. I was actually considering suicide when I was sent to a pain clinic a year later. They put me on Morphine Sulfate 20 mg, twice daily and after 10 years of treatment I am now taking 30 mgs twice daily. I am still far from pain free, but I can at least garden and keep my house clean. I don’t know what I would have done without the wonderful Doctors and nurses at the pain clinic.
Yes, Turmeric is wonderful for so many things. I take 6 capsules when I wake up. I used to put it in my 4 gallons of Green Tea with Ginger and other herbs. I had to cut down to only 6 capsules so it does not interfere with Iron absorption. This is not an issue for many, but I was anemic and my doctor told me to take iron. She said that taking turmeric in the morning was fine.
I would like to know about cannabis (pot) for treating the pain.
please let me know what replies you get. I am considering moving to a different state, because of the side effects of the various meds.
I have av410,lb friend sears by it. So years ago I got a state issued card and then there were no compassion centers to get the stuff so I never tried it. He is in another state than me. Let me know your responses results as well. I understand you get no high when you do it medicinally.
I have found that taking Turmeric capsules and or drinking Turmeric tea help tremendously. It totally keeps me from having to take medication. Also, going to the gym helps.
I’ve had osteoarthritis most of my adult life, and have had two related surgeries. I too have found turmeric capsules very helpful. On the evidence of what happens when I run out and am too busy for a couple of days to re-stock, I’d say they give me about 30% pain relief, just like the costlier, kidney-damaging drugs discussed in this article. I also agree that a regular gym habit helps a lot: thanks to the 2nd of my surgeries this winter I can again judge its helpfulness by contrast to what happened when I had to stop, 3 months ago: ouch! But while many people don’t have time for a regular habit of working out (including me, often), everyone has time to take a turmeric capsule with meals.
The use of fresh Tumeric and Finger roots works for me . I also use a Tumeric powder mixed with A combination of Green and Rooibos tea. Black Pepper added , helps the resorption.
Paracetemol does not work , best painkillers for me are Optoids. But use a lot less , after started with my Tumeric about a year ago.
As a Retired Dentist , I suffer from Neck , lower back and knee problems. But then I Walk 60 min a day , swim 4 times a week . For 66 , I am resonabally fit.
Conclusion, I believe that the use of the Turmeric and Ginger have improved my mobility , and I use a lot less painkillers .
Yes, I started taking turmeric capsules because I really didn’t want to take NSAIDs regularly, as they can have significant longterm effects.
There are, I believe, studies of curcumin, the essential ingredient of turmeric, which are confirming its benefits. I take one 500 mg. capsule each day, and the effect on achiness in my hands is very noticeable.
And, I also walk a lot – good for my arthritic knees, and do hand exercises. Less – if at all possible – is more!
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