7 Types of Medications for Joint Pain Relief

1. Tylenol (Acetaminophen)

Tylenol (acetaminophen) is an over-the-counter (OTC) non-opioid analgesic (pain relieving) and antipyretic (fever reducing) agent used for treating pain and fever. It relieves various kinds of mild to moderate body pains, such as symptoms of colds, sore throats, toothaches, menstrual cramps, and reactions to vaccinations.

It is also commonly used to relieve joint pain from osteoarthritis (arthritis caused by the breakdown of the cartilage within the joints). It works in the central nervous system to reduce pain and fever.

Acetaminophen is also available as a combination ingredient with many other drugs.

Common side effects may cause allergic reactions, including symptoms such as:

• Difficulty breathing or swallowing
• Hoarseness
• Itching
• Peeling or blistering skin
• Rash and hives
• Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

Acetaminophen can also cause liver damage when taken in amounts higher than the maximum daily dose, which is 4,000 milligrams (mg).

2. OTC NSAIDs

NSAIDs are the most commonly used medications for relieving pain from injuries, arthritis, and inflammation. They can also help reduce fever.

They work to reduce the production of prostaglandins, chemicals that cause pain and inflammation in the body. NSAIDs such as aspirin also prevent blood from clotting and help manage heart problems.

Most commonly used OTC, nonprescription NSAIDs are aspirin, ibuprofen, and naproxen.

Side effects of NSAIDs include:

• Allergic reactions or rashes
• Dizziness
• Fluid retention
• Gastrointestinal (GI) symptoms, such as indigestion, nausea, and gas
• GI ulcers or bleeding
• Increased risk of heart problems, such as heart attack or stroke
• Kidney problems
• Sodium (salt) retention

Pregnant and breastfeeding people should ask their healthcare provider before taking NSAIDs.

The Food and Drug Administration (FDA) warns to avoid using NSAIDs during the last three months of pregnancy. NSAIDs may cause problems in the fetus or complications during delivery.

3. Prescription-Strength NSAIDs

When OTC pain management options are not producing the required therapeutic effect, your healthcare provider will prescribe stronger pain relievers.

Prescription NSAIDs are more potent than OTC NSAIDs. Your healthcare provider may prescribe them if your joint pain is severe and cannot be managed by OTC medication.

NSAIDs block what are known as COX (cyclooxygenase) enzymes to inhibit the production of prostaglandins in the body. Prostaglandins are hormone-like chemicals that contribute to inflammation, pain, and fever.

Commonly prescribed NSAIDs include:

• Celebrex (celecoxib)
• Daypro (oxaprozin)
• Feldene (piroxicam)
• Indocin (indomethacin)
• Mobic (meloxicam)
• Ponstel (mefenamic acid)
• Toradol (ketorolac)
• Voltaren (diclofenac)

Although NSAIDs are widely used pain-management drugs, they may cause some side effects. These will generally be similar to OTC NSAIDs.

4. Corticosteroids

Corticosteroids are synthetic compounds designed to be similar to the natural steroid hormones produced by the adrenal gland.

Corticosteroids have immunosuppressive (tamps down the activity of the immune system), anti-inflammatory (reduces inflammation, including swelling and pain), and vasoconstrictive (causing a narrowing of the blood vessels) effects. They are injected into joints to reduce pain and relieve inflammation within the joint space. They are also used to treat many other inflammatory conditions.

Some commonly used drugs in this class include:

• Cortef (hydrocortisone)
• Depo-Medrol (methylprednisolone)
• Dexamethasone
• Intensol (betamethasone)
• Medrol (prednisolone)

Side effects can occur with high doses. These may include:

• Flushing
• Skin rash
• Stomach discomfort
• Swelling

While effective, long-term use of corticosteroids may lead to severe side effects.

Some potential side effects of long-term corticosteroid use are:

5. Disease-Modifying Antirheumatic Drugs

DMARDs are medicines used to treat joint pain caused by rheumatoid arthritis (RA). They are prescribed with other anti-inflammatory drugs.

DMARDs are immunosuppressive and immunomodulatory agents that work on the immune system to treat inflammation and pain. They reduce or prevent joint damage and bone weakening and improve joint function.

The different types of DMARDs are conventional, biological, and targeted synthetic. Conventionally used DMARDs include:

When conventional options do not work, your healthcare provider may prescribe biologic DMARDs to take along with methotrexate. They are given either under the skin or into a vein.

Different types of biologic agents include:

• Actemra (tocilizumab)
• Cimzia (certolizumab pegol)
• Enbrel (etanercept)
• Humira (adalimumab)
• Kevzara (sarilumab)
• Remicade (infliximab)
• Simponi (golimumab)

Some adverse effects of DMARDs include:

• Bloating
• Decreased appetite
• Infections from bacteria, viruses, and fungi
• Low white blood cell count
• Nausea or vomiting
• Skin cancer
• Skin reactions
• Mouth sores
• Worsened heart failure

DMARDs are second-line treatment agents after NSAIDs and corticosteroids. They are slow-acting and may take several weeks to months to show effects.

6. Opioids

Opioids are the most potent painkillers. They are natural or synthetic derivatives of natural substances found in the opium poppy plant.

Opioid drugs include pain medicine prescribed by a healthcare provider for:

• Coughing
• Diarrhea
• Joint pains due to different forms of arthritis
• Pain management in cancer
• Postsurgical pain
• Severe pain due to trauma or disease

Opioids work to achieve pain relief and relaxation by attaching to opioid receptor cells in the brain and spinal cord. Commonly prescribed opioids include:

• Codeine
• Conzip (tramadol)
• Fentanyl
• morphine
• Opana (oxymorphone)
• OxyContin (oxycodone)
• Vicodin (hydrocodone)

In the short term, the use of opioids can have side effects, including:

• Confusion
• Constipation
• Drowsiness
• Euphoria (feeling of intense happiness)
• Nausea
• Slowed breathing
• Vomiting

Long-term use or nonprescription use to get euphoria can lead to dependence or substance use disorder, also known as opioid use disorder (OUD).

7. Antidepressants

Antidepressants are also proven effective in improving the symptoms of joint pain (e.g., in the knee or hip), depression due to pain, and sleep quality in many people.

Antidepressant medicines work to change central pain‐producing mechanisms responsible for pain sensitivity and neuropathic pain.

Different classes of antidepressant drugs are used for orthopedic pain relief. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants.

Common antidepressant drugs used for pain relief may include:

• Amitriptyline
• Cymbalta (duloxetine)
• Effexor XR (venlafaxine)
• Pamelor (nortriptyline)
• Paxil (paroxetine)
• Prozac (fluoxetine)
• Zoloft (sertraline)

The most commonly observed side effects of antidepressants are:

• Cardiac conduction abnormalities (heart rhythm disturbances)
• Confusion
• Decreased sexual function
• Dizziness
• Drowsiness
• Dry mouth
• Increased appetite
• Insomnia (trouble sleeping)
• Nightmares
• Orthostatic hypotension (a sudden drop in blood pressure upon standing up)
• Reflex tachycardia (increased heart rate due to blood pressure decrease)
• Sedation
• Urinary retention
• Weight gain

Antidepressants may cause withdrawal effects, especially if the drug is stopped suddenly. Your healthcare provider will reduce the dose over some time before stopping it.

Antidepressants come with an FDA-issued boxed warning that a small number of children, teenagers, and young adults taking antidepressants may develop suicidal thoughts.

Other Options for Managing Joint Pain

Joint pain can be very uncomfortable and affect your quality of life. In addition to medications, some alternative therapies and lifestyle changes can also help improve symptoms.

• Acupuncture
• Diet and supplements
• Exercise
• Heat and cold therapy
• Massages
• Weight management

Summary

Joint pain is caused by inflammation of the joints, injuries, or autoimmune disorders. It may be linked to arthritis and muscle pain.

Although joint pain management has become easy and effective due to the availability of a wide range of medications, various drugs have different mechanisms of action to target pain, inflammation, swelling, and underlying medical problems.

While these medications are highly effective, they may have a few side effects that must be considered before taking them.

Consult your healthcare provider to combine medications and other natural remedies to treat the symptoms.