There are no medications yet that treat the underlying disease process. Instead, the goal of medical treatment for osteoarthritis (OA) is to reduce pain and stiffness and make it easier to remain active.

The most commonly used medications for osteoarthritis are:

Analgesics are drugs that relieve pain. These medicines do not reduce inflammation or swelling. But if pain relief is your main concern, these drugs tend to have fewer side effects than drugs that reduce inflammation.

The most commonly used analgesic is acetaminophen, which the American College of Rheumatology recommends for the treatment of mild or moderate pain caused by osteoarthritis. Acetaminophen is available over the counter as generic and store brands or the name brand Tylenol, Anacin (aspirin-free), Excedrin caplets and Panadol. Acetaminophen can be taken in doses of 325 to 1,000 mg every four to six hours, but no more than 4,000 mg should be taken per day. This drug can interact with alcohol. Check with your doctor before using acetaminophen if you consume more than three alcoholic drinks per day.

If you have severe pain, your doctor may prescribe a stronger analgesic. Examples include propoxyphene hydrochloride (Darvon, PC-Cap and Wygesic), acetaminophen with codeine and tramadol (Ultram). Often, these drugs are used only for short periods because the carry the risk of dependence.

Topical analgesics – These are creams, rubs and salves that are applied directly to the painful area.  One of them, Voltaren Gel, is a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, and is available only by prescription. The rest are available over the counter. Their effects come from one or more of a variety of active ingredients. The most common ingredients are:

Capsaicin – A highly purified natural ingredient found in cayenne peppers, capsaicin works by depleting the amount of a neurotransmitter called substance P that is believed to send pain messages to the brain. For the first couple of weeks of use, the ingredient may cause burning or stinging. Capsaicin is available under the product names Zostrix, Zostrix HP, Capzasin-P and others. Menthacin includes both capsaicin and counterirritants.

Counterirritants – Like stepping on your toe to take your mind off a headache, counter-irritants stimulate or irritate the nerve endings to distract the brain’s attention from musculoskeletal pain. Counterirritants encompass such substances as menthol, oil of wintergreen, camphor, eucalyptus oil, turpentine oil, dihydrochloride and methlnicotinate and are found in products such as ArthriCare, Eucalyptamint, Icy Hot and Therapeutic Mineral Ice.

Salicylates – Like the salicylates found in many oral pain relievers, these compounds may work by inhibiting prostaglandins. They primarily work topically as counterirritants, themselves stimulating or irritating nerve endings. Brand name examples of topical analgesics containing salicylates include Aspercreme, Ben-Gay, Flexall, Mobisyl and Sportscreme.