Osteoarthritis Treatment Over Counter Medication

Nonprescription, or over-the-counter (OTC), drugs used to treat osteoarthritis include traditional painkillers, such as ibuprofen and acetaminophen, and supplements such as glucosamine and chondroitin. Some treatment claims have yet to be substantiated by medical research, and others are completely ineffective.

Most of the OTC osteoarthritis treatments are NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs offer pain relief by reducing arthritic inflammation. Some of the commonly known OTC NSAIDs are ibuprofen (Advil®, Motrin®), naproxen (Aleve®) and aspirin.

FDA Issues New Warning

On April 7, 2005 the Food and Drug Administration asked the manufacturers of prescription and OTC NSAIDs, such as ibuprofen and naproxen, to include a boxed warning indicating the potential increased risk of cardiovascular events and gastrointestinal bleeding associated with NSAID use.

Acetaminophen (Tylenol®), a non-aspirin pain reliever, is also commonly used in arthritis treatment. Its effectiveness on osteoarthritis of the knee is comparable to ibuprofen, when given at sufficient doses. Acetaminophen must be taken in relatively high doses to offer effective arthritis pain relief, and large amounts can cause liver damage. Even an over-the-counter drug, like acetaminophen which is generally considered as “safe,” should be discussed with your doctor before being used to treat arthritis.

Glucosamine and Chondroitin

The manufacturers of glucosamine sulfate and chondroitin sulfate supplements claim they can provide pain relief. Glucosamine sulfate also reportedly promotes cartilage creation and repair. Clinical studies are lending credence to the use of both glucosamine and chondroitin to treat mild to moderate osteoarthritis. Research has indicated that glucosamine and chondroitin are as effective at arthritis pain relief as over-the-counter NSAIDs.

Although their names suggest a relationship, glucosamine sulfate and chondroitin sulfate are two different compounds. Glucosamine is an amino sugar that occurs naturally in the body. Chondroitin is an essential part of a protein molecule that keeps cartilage elastic and flexible.

Both glucosamine and chondroitin appear to be safe for long-term use, although clinical trials continue to investigate both compounds. Neither should be taken while pregnant, not because of any proven problems, but simply because further research into their effect on fetal development is required. People with diabetes should consult their doctors before using glucosamine-it is, after all, a sugar. Finally, if you’re allergic to shellfish, remember that the main source of chondroitin sulfate is chitin, which is harvested from shellfish shells.

Capsaicin: A Topical Option

Capsaicin comes from a tropical pepper plant, and is used as a topical pain reliever. The capsaicin cream is applied to the skin covering the joint several times a day and must be used consistently to experience any effects. Pain relief may take one to two weeks.

Generally considered safe, capsaicin may cause a stinging sensation when applied to the skin. Care must be taken not to apply it to broken skin, and contact with the eyes should be avoided. People with pepper allergies should not use capsaicin without first consulting a health professional.

The MSM Supplement Controversy

MSM supplement manufacturers have been claiming that MSM, or methylsulfonylmethane, a naturally occurring sulfur present in plant and animal tissue, has osteoarthritis-fighting properties. While MSM does have pain-relieving properties, claims that an MSM supplement can repair damaged cartilage or halt osteoarthritis are not backed by scientific evidence. Any evidence of these abilities is purely anecdotal.

On the positive side, MSM seems to be very safe with the only common side effects being diarrhea, upset stomach or mild cramps, and these are typically seen only at high doses. How MSM’s pain-fighting abilities compare to traditional over-the-counter NSAIDs has yet to be determined. Most researchers doubt claims that it “halts” osteoarthritis. Indeed, some manufacturers present MSM as curing so many different disorders that healthy skepticism seems advisable.

Resources

Arthritis and Glucosamine Resource Center. (2004). The truth about MSM: Is it really essential for osteoarthritis sufferers?

Arthritis Foundation. (2002). Glucosamine and chondroitin sulfate.

Food and Drug Administration (FDA). (2005, April 7). FDA announces series of changes to the class of marketed non-steroidal anti-inflammatory drugs (NSAIDs). FDA News.

National Library of Medicine. (1998). Capsaicin (Topical). MedlinePlus Medical Encyclopedia.

Rogers, J.R. (2001). What exactly is glucosamine? Active America Inc.

Supplement Watch Inc. (2004). MSM.