How Arthritis Is Treated

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Arthritis cannot be cured, but an effective arthritis treatment plan can help you manage the disease. The goals of arthritis treatment are to control pain and other symptoms, minimize joint damage and deformities, slow the progression of the disease, and preserve physical functioning.

There are several types of arthritis, and there are specific treatments for each type. Arthritis treatment options include medication, lifestyle changes, joint injections, surgeries, and more. You will likely need a combination of treatments, and your regimen may need to change over time.

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Over-the-Counter (OTC) Therapies

Pain relief is one of the primary goals of arthritis treatment, and most healthcare providers recommend starting with OTC options.

Commonly recommended treatments include:

Tylenol (acetaminophen) has fewer side effects than some of the other OTC medications, but it doesn't help reduce inflammation. You must be careful not to take more than 4,000 milligrams (mg) per day; there isn't much leeway between a therapeutic dose and a toxic one that can permanently damage your liver.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as Bayer (aspirin), Motrin (ibuprofen), and Aleve (naproxen) can also be used for pain relief. If you are taking large amounts of these or using them for a long period of time, you should talk to your healthcare provider and be monitored for side effects.

In addition to monitoring how often you reach for an OTC drug for arthritis pain relief, check any other medications you are taking to ensure they don't also contain the same active ingredient (e.g., acetaminophen or ibuprofen) so you won't go over the maximum daily dosage.

Adult dosing:

  • Acetaminophen: 4,000 mg
  • Aspirin: 4,000 mg
  • Ibuprofen: 3,200 mg
  • Naproxen sodium: 1,650 mg

Topical skin creams are another option. Some creams contain NSAIDs. Zostrix (capsaicin/menthol) skin cream contains capsaicin, the natural ingredient that makes peppers hot.

Transcutaneous electrical nerve stimulation (TENS) may also help with pain relief. While some units are available OTC, others may require a prescription to obtain them and/or to have them covered by insurance.

Prescriptions

Depending on the severity of your arthritis symptoms when you first consult with your healthcare provider, you might be prescribed one or more prescription medications.

Drug classes used to treat arthritis include the following.

NSAIDs/COX-2 Inhibitors

Prescription-strength NSAIDs are among the most commonly-prescribed and widely-used arthritis drugs. They work to relieve inflammation and pain. The three types include salicylates, NSAIDs, and COX-2 selective inhibitors.

NSAIDs work by blocking the activity of the enzyme cyclooxygenase, also known as COX. COX-1 is involved in maintaining healthy tissue, while COX-2 is involved in the inflammation pathway. NSAIDs affect both forms. Celebrex (celecoxib) is a selective inhibitor and is the only one currently available in the United States.

NSAIDs can have side effects such as indigestion, nausea, and ulcers. With the exception of aspirin, NSAIDs and COX-2 selective inhibitors can also significantly increase the risk of heart attack and stroke. Many of the COX-2 selective inhibitors were removed from the marketplace due to this concern.

Common prescription NSAIDs used to treat arthritis symptoms:

  • Feldene (piroxicam)
  • Indocin (indomethacin)
  • Mobic (meloxicam)
  • Clinoril (sulindac)
  • Dolobid (diflunisal)
  • Relafen (nabumetone)

Analgesics (Pain Medications)

Analgesics are pain-relieving drugs that do not relieve inflammation. Acetaminophen is the most commonly used analgesic, and it may be found in some prescription medications.

Narcotic analgesic drugs may also be prescribed for more severe pain. They can cause drowsiness, nausea, constipation, abnormally shallow breathing, and euphoria. Older adults are more prone to these effects. There is also a risk of drug tolerance, dependence, addiction, and withdrawal.

Narcotics include Tylenol #3 (acetaminophen/codeine), OxyContin (oxycodone), Percodan (oxycodone/aspirin), Vicodin (hydrocodone/acetaminophen), and several others.

Corticosteroids

Corticosteroids reduce swelling and inflammation quickly. They are commonly prescribed for inflammatory types of arthritis such as rheumatoid arthritis, lupuspolymyalgia rheumatica, and vasculitis. They have the potential for serious side effects when taken at high doses or over a long period. Healthcare providers may prescribe short-term, high-dose intravenous steroids in some situations.

Examples of corticosteroids used for treating inflammatory arthritis include Deltasone (prednisone), Cortef (hydrocortisone), and Decadron (dexamethasone).

Local steroid injections can be used for managing inflammation in a specific, painful joint. Three steroid injections per year into a joint is the maximum allowed by some healthcare providers.

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

DMARDs are slow-acting anti-rheumatic drugs that help stop disease progression and joint damage in certain forms of arthritis. They often take weeks or months to work. DMARDs are used for treating rheumatoid arthritispsoriatic arthritis, and ankylosing spondylitis.

Common DMARDs include methotrexate and Plaquenil (hydroxychloroquine). Xeljanz (tofacitinib citrate), may be used if you have an inadequate response to methotrexate. Xeljanz is the first in a class of arthritis drugs known as JAK (Janus kinase) inhibitors.

Biologic Response Modifiers (Biologics)

Biologics stimulate or restore the ability of the immune system to fight disease or infection. They are derived from living sources rather than being synthesized. Biologics are most often used to treat rheumatoid arthritis when DMARDs have not given a satisfactory response. They are given by injection.

TNF blockers are one class of biologics that interfere with inflammatory activity. They include Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab), Cimzia (certolizumab pegol), and Simponi (golimumab).

Another type is Orencia (abatacept), a T-cell co-stimulation modulator. Rituxan (rituximab) is used in combination with methotrexate to treat rheumatoid arthritis, targeting one type of immune cell. Actemra (tocilizumab) is a monoclonal antibody that inhibits the interleukin-6 (IL-6) receptor. Two major concerns with these drugs include the risk of serious infection or lymphoma.

Krystexxa (pegloticase) is a biologic drug that works by breaking down uric acid and is used in treating gout.

Other Drugs

In addition to analgesics and anti-inflammatory medications, gout may be treated with drugs that manage uric acid levels to prevent crystal formation. These include Zyloprim (allopurinol) and Uloric (febuxostat). Colchicine is a drug with a specific effect in helping prevent gout attacks. It is considered an additive treatment.

Cymbalta (duloxetine HCl), a drug originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of fibromyalgia, is also approved for the treatment of chronic musculoskeletal pain stemming from osteoarthritis and other causes.


According to the Arthritis Foundation, 20% to 30% of people with rheumatoid arthritis also develop fibromyalgia. In these situations, Cymbalta or another fibromyalgia drug—like Lyrica (pregabalin) and Savella (milnacipran HCl)—may be prescribed along with your arthritis medication.

Surgeries and Specialist-Driven Procedures

Viscosupplementation is a procedure that involves the injection of gel-like substances (hyaluronates) into a joint (currently approved for knee) to supplement the viscous properties of synovial fluid.

Joint surgery can be considered when severe joint damage and pain interfere with daily activities.

Surgical options include:

  • Arthrodesis (fusion)
  • Arthroplasty
  • Osteotomy
  • Joint replacement
  • Revision joint replacement
  • Resection
  • Synovectomy
  • Partial knee replacement

Home Remedies and Lifestyle

Regular exercise can reduce pain and improve physical function, muscle strength, and quality of life for people with arthritis, and it is strongly recommended for people who have arthritis. While it can be difficult to be motivated to exercise when you are having symptoms such as pain or fatigue, choosing the right exercise that you also enjoy can make a big difference in your quality of life.

Eating a nutritious diet is important for maintaining ideal weight and for bone health. There is no known diet that can cure arthritis, so you can start by following the basics of healthy eating; you may also benefit from incorporating anti-inflammatory foods.

Reducing stress may also help calm the pain and stiffness associated with arthritis. Being under stress can heighten your pain perception. A study also found that psychological stress was associated with flares and relapse in people with rheumatoid arthritis.

Home remedies to manage pain and stiffness can help you keep it from interfering with daily living. You can try tactics such as cryotherapy (cold packs), heat therapy or warm water therapy (especially for stiffness), or self-massage. Beware of folk remedies.

Assistive devices can help protect your joints and make it easier for you to go about your day. Look into canes, walkers, raised toilet seats, grabbers, and other helpful devices.

Complementary and Alternative Medicine (CAM)

If you prefer a natural approach to treating arthritis, or would like to explore complementary options, it's imperative that you tell your healthcare provider what you want to try (or are already using). There are many alternative treatment options that, while popular, are not verified for effectiveness and safety.

The National Center for Complementary and Integrative Medicine, a division of the National Institutes of Health (NIH), reports on the effectiveness of some CAM treatments for arthritis:

  • Acupuncture and acupressure: Studies have not shown clear evidence of a beneficial effect for rheumatoid arthritis. But as practiced in the U.S., it may help some patients with knee osteoarthritis manage their pain.
  • Biofeedback and relaxation techniques: Some small studies have been promising for rheumatoid arthritis.
  • Magnets: Static magnets have not been shown to have any effect on osteoarthritis. Electromagnetic field therapy is still being explored.
  • Massage therapy: Only a few studies have been done assessing the effects of massage, so it isn't possible to give a definitive recommendation. The therapist needs to take care not to stress the joints.
  • Meditation: Four studies have found mindfulness meditation to be helpful in managing symptoms of pain and in helping patients cope with their condition.
  • Tai chi: Studies have found tai chi to be beneficial for well-being in osteoarthritis patients and rheumatoid arthritis patients.
  • Yoga: Yoga should be a beneficial form of exercise for people with arthritis, but modifications may be needed to minimize joint stress.
  • Omega-3 fatty acids (fish oil): A 2017 review of studies found some favorable effects on pain for patients with rheumatoid arthritis.
  • Glucosamine and chondroitin: After much study, it appears chondroitin doesn't help osteoarthritis pain, and it's unclear as to whether glucosamine has any effect.

Be wary of dietary supplements or herbal treatments sold for arthritis relief. You could experience dangerous side effects or drug interactions and the U.S. Food and Drug Administration (FDA) warns that many are tainted with prescription drugs.

Can diet help treat arthritis?

Research suggests that following an anti-inflammatory diet can reduce osteoarthritis and rheumatoid arthritis symptoms. A healthy diet can also lead to weight loss, which reduces stress and strain on joints. Gout, a form of metabolic arthritis, can be relieved by avoiding purines (such as alcohol and seafood) that can trigger gout flares.

A Word From Verywell

The Arthritis Foundation recommends seeing a healthcare provider if you have joint pain, stiffness, or swelling persisting for two or more weeks, whether or not your symptoms began suddenly or gradually. Only a healthcare provider can diagnose arthritis. An accurate diagnosis is needed so that appropriate treatment can begin. A rheumatologist (arthritis specialist) will help you understand all of your options—their benefits and their risks.

Frequently Asked Questions

  • How do you treat arthritis?

    The treatment varies based on the severity of your symptoms and the type of arthritis you have. Options include rest, exercise, weight loss, cold/hot therapy, over-the-counter and prescription pain relievers, oral and injected steroids, disease-modifying anti-rheumatic drugs (DMARDs), and surgery.

  • Can arthritis be cured?

    Most forms of arthritis are chronic and can be managed but not cured. Some forms of septic arthritis will resolve once the infection is treated and cleared. Around half of all cases of juvenile idiopathic arthritis resolve before adulthood.

  • What over-the-counter drugs help relieve arthritis?

    Options for helping manage pain include Tylenol (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen). Topical NSAIDs and medicated ointments containing camphor, capsaicin, or menthol may provide temporary relief of mild arthritis pain.

  • What prescription drugs are used to treat arthritis?

    For moderate to severe osteoarthritis, options include COX-2 inhibitors like Celebrex (celecoxib) and oral opioids like Ultram (tramadol). For rheumatoid arthritis, disease-modifying antirheumatic drugs (DMARDs) like methotrexate, oral corticosteroids like prednisone, or biologics like Rituxan (rituximab) may be prescribed.

  • When are DMARDs used to treat arthritis?

    Disease-modifying antirheumatic drugs (DMARDs) are used to treat rheumatoid arthritis and other forms of autoimmune arthritis. DMARDs are started early in the disease and can achieve disease remission in roughly 50% of cases. Conventional DMARDs include:

    • Methotrexate
    • Azulfidine (sulfasalazine)
    • Arava (leflunomide)
    • Plaquenil (hydroxychloroquine)
  • When are biologics used to treat arthritis?

    Biologics, also known as biological DMARDS, are typically started when methotrexate or other conventional DMARDs don't provide relief after three months.

    Options include:

  • When is surgery needed for arthritis?

    If pain or loss of joint mobility is diminishing your ability to function, surgery may be considered. Options include arthroscopy, synovectomy (removal of the lining of the joint), osteotomy (the cutting and reshaping of the joint bone), and total joint replacement.

  • What natural therapies are effective in treating arthritis?

    According to the National Center for Complementary and Integrative Medicine, acupuncture and massage therapy may relieve the pain of osteoarthritis. Omega-3 fatty acids, gamma-linolenic acid (GLA), and the herb thunder god vine (Tripterygium wilfordii) are potentially useful in relieving rheumatoid arthritis symptoms.

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