Painkillers like NSAIDs, paracetamol and corticoids are an essential tool in the fight against the joint pain caused by arthritis.
As with many other chronic illnesses arthritis is well-known for the pain and discomfort it causes. The acute, constant and often unrelenting joint pain has a significant impact on the individual’s quality of life. In the world of medicine, for pain to be considered chronic it must continue for a period of six months or more. For a lot of people with arthritis however, it is often a life-long complaint rather than a six month affliction.
Fortunately there are several painkillers (analgesics) currently available that have proven effective in helping alleviate the pain associated with arthritis. There are a variety of options out there, each one producing a different chemical response in the body. The indications (a valid reason to use it) and contraindications (a valid reason not to use it) for each medication will vary depending on the chemical reaction it triggers. Some can be bought over-the-counter while others cannot be purchased without a prescription. So, if you’re living with arthritis we’re certain you’ll be interested in finding out about the different pain relief options currently on offer:
-Paracetamol: Paracetamol is often the first point of call when treating arthritic pain. Paracetamol has an effect on the brain and does not reduce joint inflammation. It has fewer side effects than other painkillers and doesn’t cause dependency. It is competitively priced and can be bought over-the-counter, which has unfortunately led some people to take more than they should as they are unaware of the damage (i.e. severe liver damage) this can cause.
-Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs are the medications most commonly used to treat arthritis pain as they effectively reduce both pain and joint inflammation. NSAIDs work by reducing the body’s natural production of prostaglandins (the compounds responsible for the pain and inflammation associated with most types of arthritis).
Commonly used NSAIDs include acetylsalicylic acid (aspirin), ibuprofen and diclofenac. While these are freely available without a prescription you should use them with care as they can damage the lining of the stomach.
-Topical pain relief: These include creams, gels, sprays and ointments. Topical pain relief is applied directly to the affected joint. It is recommended when the arthritis is light to moderate and can be used in conjunction with oral painkillers in specific situations (after exercising for example).
Many contain capsaicin (an active component of chilli peppers) which is why they often cause a warm tingling or burning sensation when first applied (although this often disappears with continued use). You should notice an effect within a few weeks of use.
-Corticoids: Corticoids are synthetic hormones that help reduce the pain and inflammation associated with arthritis. They act directly on the cells, stopping them from releasing the substances that provoke the symptoms associated with inflammation (i.e. pain, heat, swelling and redness). They also stop new cells from accessing the injury site (which prolongs the inflammatory process).
Some corticoids (such as prednisone) are given orally, while others (such as cortisone) are injected. The injections are fast-acting but the effect is relatively short lived. Due to the side effects associated with corticoids (both oral and intravenous) you shouldn’t be given any more than three injections a year. While these side effects often disappear on suspension of the treatment most doctors use caution when prescribing them.
-Narcotics: Narcotics are medications that act on specific pain receptors in the nervous system. They include codeine and morphine – drugs that alter the individual’s consciousness and that produce a number of side effects. They are highly addictive and their tolerance levels build quickly - meaning you have to up your dose regularly if you want to get the same effect over the long-term. Because of this narcotics are generally only prescribed in extreme cases, when all other options have been exhausted.
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