The Drug I Most Often Prescribe for Arthritis Pain Relief

by Dr. Dana Hays

I often get asked what drug I prefer for osteoarthritis pain relief. Over the years it has changed based on the most current medical knowledge. As a doctor I am always looking for the best way to help each patient. This means looking at treatments that provide the greatest benefit with the least risk.

Because I also suffer from osteoarthritis I am very familiar with both the benefits and risks of the various treatment options. Unfortunately, most treatments with pharmaceutical drugs have what I consider excess side effects and risks.

The pain medication that doctors most often prescribed for arthritis pain is a class of drugs called Non Steroidal Anti Inflammatory Drugs or NSAIDs. These drugs work by reducing inflammation in the joint, which then reduces the pain and improves mobility.

NSAIDs includes such drugs as Aleve (Naproxen), Celebrex, Ibuprofen, etc. While drugs in this class help reduce joint inflammation and pain their most common side effect is an increased rate of stomach ulcers. This increase can be quite dramatic. For instance, 25.7 percent of the participants in the UCLA Medical School study developed stomach ulcers after twelve weeks of taking Naproxen.

In practice, I have seen patients develop bleeding ulcers after a few days using NSAIDs. This is a very frightening scenario when those patients come into the emergency room, with what can be a life-threatening bleed... it can be quite scary.

When Cox-2 Inhibitors (Vioxx, Celebrex, Bextra) where approved by the FDA they reduced the single largest risk that NSAIDs such as Naproxen had... stomach ulcers. At the time they were viewed by many as a very safe anti-inflammatory pain reliever.

Unfortunately as we found out... they were anything but safe. Now, due to the significantly increased risk of heart attacks and stroke, the only Cox-2 Inhibitor still on the market is Celebrex, but with stronger risk warnings on the label.

Before I tell you which drug I prescribe most for osteoarthritis I will tell you what I do for myself and recommend for many of my patients.

1. Low Impact Exercise. While the last thing you may want to do is exercise when you have joint pain, studies have shown that people who exercise regularly show a 25 percent improvement in arthritis symptoms. They have less pain, less stiffness and greater flexibility.

2. Weight Control. Maintaining a healthy weight alone can make a large difference for two reasons. First the added weight puts additional stress on your joints. When you walk the impact is about four times the weight. So an extra ten pounds creates impact on your knees, ankles, hips, and back of about 40 pounds with each step.

Second when you are overweight your body produces higher levels of pro-inflammatory compounds, increasing your body's systemic inflammation.

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