Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) taken at the recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs are available by prescription. Misuse of NSAIDs can cause stomach upset, cardiovascular problems, bleeding problems, and liver and kidney damage. Examples are:
• Acetaminophen (Tylenol, others) has been shown to help some people with osteoarthritis who have mild to moderate pain. Taking more than the recommended dose of acetaminophen can cause liver damage.
• Ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), taken at the recommended doses, typically relieve osteoarthritis pain. Stronger NSAIDs are available by prescription.
• NSAIDs as gels, applied to the skin over the affected joint, have fewer side effects and may relieve pain just as well.
• Duloxetine (Cymbalta). Normally used as an antidepressant. This medication is also approved to treat chronic pain, including osteoarthritis pain.
Opioids are not recommended as a first-line treatment for osteoarthritis (OA) pain. While opioids can help with pain, they have many potential risks and side effects, and their long-term safety and effectiveness are unknown: