Pain Relievers

Q. I am in my 50s and have mild arthritic pain in my knees and left hip. I would like to take a pain reliever on a daily basis, but worry whether it is OK to do so long term. If I can take something daily, which type of over-the-counter pain reliever is the most effective for mild arthritic pain: ibuprofen, acetaminophen, or NSAIDS (Non-steroidal anti-inflammatory drugs)?

A. Arthritis simply means inflammation of a joint. There are more than 100 documented forms of arthritis and it ranks as one of the most common diseases in the world. The weight-bearing joints of the lower extremity are often the first to show signs and symptoms of arthritic change.

There are several effective over-the-counter oral medications that can help alleviate much of the pain and swelling. Before taking any new medication, it is a good idea to talk with your doctor about the possible undesirable side effects, contraindications, or drug interactions.

Acetaminophen (Tylenol®) can safely ease much of the pain experienced with mild arthritis; typically start with two tablets every four to six hours, as needed. Many NSAID’s (non-steroidal anti-inflammatory drugs) are also available without a prescription; these medications typically act to decrease the inflammation of the joint, as well as ease the pain. Two of the most common options are ibuprofen (Motrin®) and naproxen (Naprosyn® and Aleve®), both of which can be taken safely at the recommended daily dosage shown on the insert. Most NSAID’s become more effective after a short build-up period of two to three weeks, when the drug reaches an effective steady state in your system.

There are also several newer nonsteroidal medications, classified as COX-2 inhibitors, which are aimed at providing similar relief with a reduced effect on the gastrointestinal system. These medications are a good choice for any individual with a history of reflux or peptic ulcer disease, but they do require a prescription from your doctor.

Most importantly, as with any medical issue, please consult your trusted primary care physician or orthopaedist if your arthritis symptoms persist.

Chad C. Smalley, M.D.

General Orthopaedics & Sports Medicine

Center for Sports Medicine & Orthopaedics

7480 Ziegler Rd.

Chattanooga, TN 37421