As a private rheumatologist and arthritis specialist, arthritis is one of the most common conditions I see in my London clinic. No surprise there. It has been estimated that nearly 19 million people throughout the UK suffer from musculoskeletal conditions causing pain and discomfort.
More than 400,000 suffer from rheumatoid arthritis. Another 220,000 suffer with ankylosing spondylitis while more than 8.75 million are regularly treated for osteoarthritis.
Painkillers are one of our best weapons against arthritis. Painkillers may or may not help improve the actual condition, depending on its type and cause. But even when painkillers does not address the root causes of arthritis pain, they still help alleviate the pain and allow patients to lead better lives.
In most cases, it is best to start with over-the-counter (OTC) analgesics to see if they work. Analgesics are medications that relieve pain. Some do so by blocking pain signals while others rely on reducing inflammation as a mechanism for reducing pain. Here in the UK, paracetamol is one of the most commonly recommended for arthritis. It is safe and simple to use, and it has proved effective for osteoarthritis.
Paracetamol is also known as acetaminophen. Patients for whom this particular drug is not appropriate are not necessarily left out in the cold. Other OTC analgesics include ibuprofen. Though they can be utilised without a prescription, it is still wise to consult a doctor before engaging in long-term use.
OTC and Prescription NSAIDS
An NSAID is a nonsteroidal anti-inflammatory drug. There are both OTC and prescription NSAIDs available for arthritis pain. For example, aspirin is an OTC NSAID. It reduces pain by reducing inflammation. NSAIDs are most effective at treating rheumatoid arthritis; they may not work so well with osteoarthritis due to the nature of the disease.
The pain of rheumatoid arthritis is linked largely to inflammation. Osteoarthritis pain is caused more by bones grinding on one another due to a lack of cushioning cartilage between them. There may be inflammation associated with osteoarthritis, but NSAIDs generally don’t help relieve bone-on-bone pain.
OTC NSAIDs include drugs like ibuprofen and neurofen. Examples of prescription NSAIDs include naproxen, meloxicam and arcoxia. Doctors generally do not like to go straight to prescription NSAIDs until OTC options have been tried first. Why? Because every prescription drug is controlled for a reason. Prescription drugs have side effects that always have to be considered.
Another class of prescription drugs we utilise to treat arthritis pain are known as disease modifying anti-rheumatic drugs (DMARDs). As the name suggests, these drugs are intended to modify the immune response of the disease being treated. In short, the drugs reduce the immune response.
DMARDs can be especially helpful for treating psoriatic arthritis, rheumatoid arthritis, and other forms of the disease linked to the body’s immune system. These drugs have to be used judiciously and with caution. Doctors tend to reserve them for patients for whom NSAIDs and analgesics don’t work.
Last but not least are corticosteroids. These are drugs usually given by injection directly into the site of pain. They both reduce inflammation and influence the body’s inflammatory response, preventing future inflammation for a set amount of time. They are effective for a number of different forms of arthritis.
If you are suffering from any sort of arthritis pain, rest assured there are medications that can help. I would be happy to discuss them with you at my London clinic. Contact my office today and make an appointment.