Living with osteoarthritis (OA) often means navigating a daily balance between activity and comfort. For many, the condition manifests as stiff knees in the morning, aching hips after a walk, or swollen fingers that make gripping objects difficult. These symptoms can turn routine tasks like climbing stairs or opening a jar into painful challenges. It is a progressive condition, but having OA does not mean surrendering to a sedentary life.

Treatment is essential to manage pain, reduce stiffness, and maintain joint mobility. While OA cannot be reversed, effective management allows individuals to stay active and independent. The primary goal is to minimize discomfort and maximize function. Because OA affects everyone differently, ranging from mild annoyance to severe limitation, treatment plans are highly personalized. Choices depend on which joints are affected, the severity of the symptoms, and individual health history (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023).

Overview of treatment options for Osteoarthritis

The management of osteoarthritis typically follows a stepped approach. Treatment often begins with non-drug therapies, such as physical therapy, weight management, and low-impact exercise. However, when lifestyle changes alone are insufficient to control pain, medications play a crucial role.

The main goals of medication are to relieve pain and reduce inflammation during flare-ups. For mild cases, topical treatments or over-the-counter options are often enough. As symptoms progress, doctors may recommend prescription-strength drugs or injections directly into the joint. In severe cases where bone-on-bone friction causes debilitating pain and loss of function, surgical options like joint replacement may be considered, but medication remains the primary tool for delaying surgery and managing daily life.

Medications used for Osteoarthritis

For mild to moderate pain, oral analgesics are the standard first-line treatment. Acetaminophen is frequently used for pain relief that does not involve significant inflammation. However, for many OA patients, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are more effective. Common over-the-counter examples include ibuprofen and naproxen. For those who cannot take oral NSAIDs due to stomach issues, topical NSAIDs (gels or creams applied to the skin) are often recommended, particularly for knee or hand osteoarthritis.

When over-the-counter options fail, doctors may prescribe stronger NSAIDs or COX-2 inhibitors like celecoxib. These are designed to target inflammation with a lower risk of stomach bleeding compared to traditional NSAIDs.

For moderate to severe pain that resists oral medication, duloxetine, an antidepressant that also treats chronic pain is sometimes prescribed. Additionally, corticosteroid injections are a common second-line treatment. These are injected directly into the affected joint to provide rapid, short-term relief from severe inflammation. Hyaluronic acid injections (viscosupplementation) are another option, primarily for knees, acting as a lubricant (American College of Rheumatology, 2021).

How these medications work

NSAIDs work by blocking enzymes (COX-1 and COX-2) that produce prostaglandins, chemicals in the body that trigger pain and swelling. By reducing these chemicals, the medication lowers the inflammatory response within the joint capsule, easing the pressure and pain. Topical versions work similarly but penetrate the skin to reach the joint directly, keeping the drug concentration low in the rest of the body.

Corticosteroids are powerful anti-inflammatories that mimic the body’s natural hormones to shut down immune system inflammation rapidly at the injection site. Hyaluronic acid injections work mechanically rather than chemically; they aim to restore the thick, shock-absorbing fluid within the joint that tends to break down in OA patients, providing a cushion for the bones (Mayo Clinic, 2022).

Side effects and safety considerations

While effective, OA medications carry risks. Prolonged oral NSAID use risks stomach irritation, ulcers, bleeding, and increased cardiovascular risk. Older adults on regular NSAIDs need kidney monitoring. Acetaminophen is safe if the daily limit isn’t exceeded; otherwise, it can cause liver damage.

Corticosteroid injections can weaken cartilage if overused, so they are typically limited to 3-4 times yearly per joint. Topical NSAIDs have fewer systemic side effects but may irritate the skin. Patients should seek immediate care for signs of gastrointestinal bleeding (e.g., black or tarry stools, severe abdominal pain).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. American College of Rheumatology. https://www.rheumatology.org
2. Mayo Clinic. https://www.mayoclinic.org
3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov
4. Centers for Disease Control and Prevention. https://www.cdc.gov