Table of ContentsView AllTable of ContentsComparison of Pain RelieversTylenol (Acetaminophen)OTC NSAIDsPrescription NSAIDsCorticosteroidsDMARDsOpioidsAntidepressantsOther Options
Table of ContentsView All
View All
Table of Contents
Comparison of Pain Relievers
Tylenol (Acetaminophen)
OTC NSAIDs
Prescription NSAIDs
Corticosteroids
DMARDs
Opioids
Antidepressants
Other Options
There is a wide availability of medications forjoint pain, ranging from the first-line approach of over-the-counter (OTC) medications to second-line prescription drugs such as corticosteroids and disease-modifying antirheumatic drugs (DMARDs). Prescription medications are used when OTC options are not alleviating the symptoms.
1. Tylenol (Acetaminophen)
Tylenol (acetaminophen)is an over-the-counter (OTC) non-opioid analgesic (pain relieving) and antipyretic (fever reducing) agent used for treating pain and fever. It relieves various kinds of mild to moderate body pains, such as symptoms of colds, sore throats, toothaches, menstrual cramps, and reactions to vaccinations.
Acetaminophen is also available as a combination ingredient with many other drugs.
Common side effects may cause allergic reactions, including symptoms such as:
Acetaminophen can also cause liver damagewhen taken in amounts higher than the maximum daily dose, which is 4,000 milligrams (mg).
2. OTC NSAIDs
NSAIDs are the most commonly used medications for relieving pain from injuries, arthritis, and inflammation. They can also help reduce fever.
They work to reduce the production ofprostaglandins, chemicals that cause pain and inflammation in the body. NSAIDs such as aspirin also prevent blood from clotting and help manage heart problems.
Most commonly used OTC, nonprescription NSAIDs are aspirin,ibuprofen, and naproxen.
Side effects of NSAIDs include:
Pregnant and breastfeeding people should ask their healthcare provider before taking NSAIDs.
The Food and Drug Administration (FDA) warns to avoid using NSAIDs during the last three months of pregnancy. NSAIDs may cause problems in the fetus or complications during delivery.
3. Prescription-Strength NSAIDs
When OTC pain management options are not producing the required therapeutic effect, your healthcare provider will prescribe stronger pain relievers.
NSAIDs block what are known asCOX (cyclooxygenase) enzymesto inhibit the production of prostaglandins in the body. Prostaglandins are hormone-like chemicals that contribute to inflammation, pain, and fever.
Commonly prescribed NSAIDs include:
Although NSAIDs are widely used pain-management drugs, they may cause some side effects. These will generally be similar to OTC NSAIDs.
4. Corticosteroids
Corticosteroids have immunosuppressive (tamps down the activity of the immune system), anti-inflammatory (reduces inflammation, including swelling and pain), and vasoconstrictive (causing a narrowing of the blood vessels) effects.They are injected into joints toreduce pain and relieve inflammationwithin the joint space. They are also used to treat many other inflammatory conditions.
Some commonly used drugs in this class include:
Side effects can occur with high doses. These may include:
While effective, long-term use of corticosteroids may lead to severe side effects.
Some potential side effects of long-term corticosteroid use are:
5. Disease-Modifying Antirheumatic Drugs
DMARDs are immunosuppressive and immunomodulatory agents that work on the immune system to treat inflammation and pain. They reduce or prevent joint damage and bone weakening and improve joint function.
The different types of DMARDs are conventional, biological, and targeted synthetic. Conventionally used DMARDs include:
When conventional options do not work, your healthcare provider may prescribebiologicDMARDs to take along with methotrexate.They are given either under the skin or into a vein.
Different types of biologic agents include:
Some adverse effects of DMARDs include:
DMARDs are second-line treatment agents after NSAIDs and corticosteroids. They are slow-acting and may take several weeks to months to show effects.
6. Opioids
Opioidsare the most potent painkillers. They are natural or synthetic derivatives of natural substances found in the opium poppy plant.
In the short term, the use of opioids can have side effects, including:
Long-term use or nonprescription use to get euphoria can lead to dependence or substance use disorder, also known asopioid use disorder (OUD).
7. Antidepressants
Antidepressants are also proven effective in improving the symptoms of joint pain (e.g., in the knee or hip), depression due to pain, and sleep quality in many people.
Antidepressant medicines work to change central pain‐producing mechanisms responsible for pain sensitivity and neuropathic pain.
Different classes of antidepressant drugs are used for orthopedic pain relief. These includeselective serotonin reuptake inhibitors (SSRIs),serotonin-norepinephrine reuptake inhibitors(SNRIs) and tricyclic antidepressants.
Common antidepressant drugs used for pain relief may include:
The most commonly observed side effects of antidepressants are:
Antidepressants may causewithdrawal effects, especially if the drug is stopped suddenly. Your healthcare provider will reduce the dose over some time before stopping it.
Antidepressants come with an FDA-issued boxed warning that a small number of children, teenagers, and young adults taking antidepressants may develop suicidal thoughts.
Other Options for Managing Joint Pain
Joint pain can be very uncomfortable and affect your quality of life. In addition to medications, some alternative therapies and lifestyle changes can also help improve symptoms.
Summary
Although joint pain management has become easy and effective due to the availability of a wide range of medications, various drugs have different mechanisms of action to target pain, inflammation, swelling, and underlying medical problems.
While these medications are highly effective, they may have a few side effects that must be considered before taking them.
Consult your healthcare provider to combine medications and other natural remedies to treat the symptoms.
24 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Arthritis basics.
MedlinePlus.Acetaminophen.
Ohashi N, Kohno T.Analgesic effect of acetaminophen: a review of known and novel mechanisms of action.Front Pharmacol.2020;11:580289. doi:10.3389/fphar.2020.580289
DailyMed.Label: Tylenol Regular Strength- acetaminophen tablet, film coated.
American Academy of Orthopaedic Surgeons.What are NSAIDs?
US Food and Drug Administration.Non-steroidal anti-inflammatory drugs (NSAIDs).
Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J.A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly.Aging Dis. 2018 Feb 1;9(1):143-150. doi:10.14336/AD.2017.0306
Bindu S, Mazumder S, Bandyopadhyay U.Non-steroidal anti-inflammatory drugs (Nsaids) and organ damage: A current perspective.Biochem Pharmacol. 2020;180:114147. doi:10.1016/j.bcp.2020.114147
MedlinePlus.Ibuprofen.
US Food and Drug Administration.Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Drug Safety Communication - Avoid Use of NSAIDs in Pregnancy at 20 Weeks or Later.
Crofford LJ.Use of NSAIDs in treating patients with arthritis.Arthritis Res Ther.2013;15(Suppl 3):S2. doi:10.1186/ar4174
Food and Drug Administration.COX-2 selective (includes Bextra, Celebrex, and Vioxx) and non-selective non-steroidal anti-inflammatory drugs (NSAIDs).
MedlinePlus.Corticosteroids overdose.
Min KH, Rhee CK, Jung JY, Suh MW.Characteristics of adverse effects when using high dose short term steroid regimen.Korean J Audiol. 2012;16(2):65-70. doi:10.7874/kja.2012.16.2.65
Rice JB, White AG, Scarpati LM, et al.Long-term systemic corticosteroid exposure: a systematic literature review.Clin Ther. 2017;39(11):2216-2229. doi:10.1016/j.clinthera.2017.09.011.
MedlinePlus.Rheumatoid arthritis.
Rein P, Mueller RB.Treatment with biologicals in rheumatoid arthritis: an overview.Rheumatol Ther.2017;4(2):247-261. doi:10.1007/s40744-017-0073-3
UpToDate.Patient education: disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (beyond the basics).
MedlinePlus.Opioid and opioids use disorder (OUD).
National Institute on Drug Abuse.Prescription opioids drug facts.
Leaney AA, Lyttle JR, Segan J, et al.Antidepressants for hip and knee osteoarthritis.Cochrane Database Syst Rev. 2022;2022(10):CD012157. doi:10.1002/14651858.CD012157.pub2
MedlinePlus.Antidepressants
Majnik J, Császár-Nagy N, Böcskei G, et al.Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis.Front Med (Lausanne). 2022;9:991677. doi: 10.3389/fmed.2022.991677
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.Cookies SettingsAccept All Cookies
By clicking “Accept All Cookies”, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts.
Cookies SettingsAccept All Cookies
