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Medical Treatments for Osteoarthritis Pain 

Primary care doctors, physical therapists and orthopaedists can play an important role in treating osteoarthritis. Here’s the latest evidence on a growing range of options for treating OA pain, including topicals, pills, injectables, physical therapy, orthotic, brace care and more. 

1. Help From Experts
Doctors, therapists, pharmacists and other health professionals play a role in managing your OA. Here are several medical options for treating your pain. 
 
2. Self-Management Program

Self-management programs help you control your symptoms, better manage your arthritis, and lead a fuller life. On-line and in-person programs can be located through The Self-Management Resource Center.
3. Physical Therapy
A physical therapist can create an exercise program just for you. Working with a PT can improve your balance, strength and joint alignment; increase your overall function; and reduce pain. 
 
4. Oral NSAIDs
Over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) are the drug of choice for OA. You can get ibuprofen and naproxen sodium without a prescription. Others, like diclofenac or celecoxib, need a prescription. You should take the smallest dose that gives you relief for the shortest time possible.
 
5. Topical NSAIDs
When used on the knee, these rub-on products like Voltaren gel work as well as NSAID pills but pose fewer stomach risks. They may not be as useful when used on the hip due to the depth of the joint or the hands due to frequent hand washing.
 
6. Acetaminophen
Acetaminophen can treat mild-to-moderate OA pain, but studies show it doesn’t work as well as NSAIDs do. If you can’t take NSAIDs, acetaminophen may be used as needed for pain.
 
7. Duloxetine (Cymbalta)
This antidepressant has been shown to ease chronic pain, including pain from OA. It can be used alone or combined with NSAIDs. 
 
8. Steroid Injections
Injecting corticosteroids directly into joints with OA can decrease pain. Relief typically wears off after a few weeks. You may need repeat injections. If the doctor is injecting your hip, they may use ultrasound to make sure the needle is in the correct spot
 
9. Surgery
Although you will try other pain-relief methods first, surgery  is very effective and improves function. Different surgical options are available depending on the joint.
 
10. Cognitive Behavioral Therapy
This type of talk therapy helps you recognize negative thinking and behaviors so you can respond to challenges more effectively. It has been shown to improve pain, health-related quality of life, mood, fatigue, and function.
 
11. Acupuncture
This ancient practice of inserting fine needles along energy pathways may reduce OA pain. Evidence of its usefulness is not strong, but the risks are low.
12. Radiofrequency Ablation
In this procedure, a needle is inserted next to a nerve near your painful joint. High-frequency energy is passed through the needle, damaging the nerve. Pain relief can last up to a year, or until the nerves regenerate.
 
13. Tramadol
If you are not able to take NSAIDs, have found no other therapies effective, or have no surgical option, the opioid tramadol may be considered. Talk with your doctor about side effects and risk of addiction.
 
14. Medical Care With Self-Care
These medicines and therapies conducted by health professionals should help you start to feel better. But you won’t get their full benefits unless you combine them with self-care treatments.

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