- BACK and NECK CONDITIONS
- ELBOW CONDITIONS
- FOOT and ANKLE CONDITIONS
- HIP CONDITIONS
- KNEE CONDITIONS
- SHOULDER CONDITIONS
- WRIST and HAND CONDITIONS
Medication, Supplements & Injections
The painkillers listed below can be used before you do any activity that usually causes pain (such as when you go out walking) so that you can perform that activity with less discomfort. They can also be used before bed, or throughout the night if you are suffering from any sleep disturbance due to your symptoms.
Non-steroidal anti-inflammatory drugs (NSAID) creams:
Such as Ibuprofen or diclofenac.
These can be rubbed into the skin over the knee to provide you with periods of pain relief that can last for several hours at a time. They have fewer side-effects and are safer than NSAID tablets, and therefore should always be tried first. They can also be used alongside NSAID tablets, which may allow you to take less tablets if you supplement these with the creams and gels. You can buy these in pharmacies, but can get a stronger dose on prescription from your GP.
Non-steroidal anti-inflammatory drugs (NSAID) tablets:
Such as Ibuprofen, or stronger versions like Naproxen which you can get on prescription from your GP.
Some people are intolerant to anti-inflammatory tablets due to other health conditions, so if you are in doubt then make sure to discuss this with your GP. They also can cause side-effects and should be taken at the lowest dose that works for you, for the shortest possible time, and usually with other tablets to protect the stomach which your GP can prescribe. The longer you take them and the higher the dose, the greater the risk of side effects, such as kidney damage, bleeding from the stomach, heart attacks and strokes. If you already have kidney or heart problems, your risk is higher.
This is a cream which you rub into your skin over the knee where you feel pain. It contains an ingredient from chilli peppers so burns a bit when you put it on, but research has shown that it is effective at reducing arthritic knee pain for a few hours at a time. You need to use it 3-4 times a day for several weeks to get the benefit, so don’t give up on it before you’ve given it a chance! You can only get this on prescription from your GP.
Weak Opioids (such as Codeine):
You should only take these if you are intolerant of NSAIDs.. Opioids can cause side effects and addiction, so you should take the lowest dose possible for the shortest time possible.
Paracetamol is not recommended for use in osteoarthritis as research has not demonstrated that it is particularly useful for managing osteoarthritic pain.
There is no convincing evidence that any supplements are effective at stopping or delaying the development of osteoarthritis, nor that they significantly improve symptoms. They therefore are not recommended in any current treatment guidelines.
The theoretical principles behind some more popular supplements are discussed below for your information, however:
Glucosamine and Chondroitin
Glucosamine and Chondroitin are components of joint cartilage and have historically been prescribed as supplements to help improve cartilage health, however the most recent guidelines suggest that these are no more beneficial than placebo medications, and their use therefore is no longer recommended.
Fish oil supplements (particularly Omega-3 fatty acids – or the vegan equivalent from algae-based supplements) have potent anti-inflammatory properties, and have been shown to reduce joint pain, stiffness and swelling in rheumatoid arthritis more than osteoarthritis. They also have the added benefit of protecting against heart disease and dementia. High dose fish oil supplements can thin the blood and may interact wth anticoagulant medicines such as warfarin, so it’s always best to discuss these with your GP before taking them if you are in any doubt.
Turmeric (or curcumin) is a natural anti-inflammatory, and has been shown to be as effective as simple anti-inflammatories like Ibuprofen in recent research. Some people report finding these very useful in helping to manage their arthritic symptoms. Research into the risks and rewards of Turmeric supplements is still relatively new however, so we can’t be certain of their long-term risks and benefits as yet, and you should discuss this with your GP before deciding to take them if you are taking blood thinning or anti-convulsant medication or have a clotting disorder.
Several vitamin supplements have been studied for their effects on arthritis, including the anti-oxidant vitamins A, C, and E, and vitamins D & K. So far there is no evidence that taking antioxident vitamins improves arthritis symptoms, although vitamin D & K are both important for bone health and vitamin K is also involved in cartilage structure, so supplementing these two nutrients may be helpful if you’re deficient in them. Since Vitamin A, D, E and K are fat soluble (rather than water soluble, where any excess can be flushed out in urine), it is possible that levels can build up in your body to a harmful level if you take too much. Therefore it is advisable that you check with your doctor about safe amounts to take to avoid building up an excess.
Before taking any supplements, it is best to consult with your GP or pharmacist, to ensure that it is safe and appropriate for you to take and that they will not interact with any of your existing medications or underlying medical conditions.
We can inject corticosteroids into your knee joint, which have a strong anti-inflammatory effect. These can help to reduce the inflammation that may be contributing to your joint pain, and typically help to relieve symptoms by 60-100% for several weeks or months at a time.
The effects of these are generally short-term, and therefore are most beneficial when they are used to settle down a “flare up” of pain, where your joint has become acutely painful and swollen, and has not settled with the usual use of anti-inflammatories and modification of activity levels. In this situation, an injection can really help to settle things down to allow you to gradually increase your activity levels again, and strengthen your joint back up again to get you back on track.
However, it is worth remembering that steroid injections have risks associated with them, including:
- Arthritis progression – some research suggests that repeated steroid injections can actually have a negative impact on the health of the joint cartilage, and can contribute to worsening arthritis with repeated use.
- Infection – Infection in your joint following an injection is rare, with rates recorded as one in 40,000. However, joint infections can be serious, so if this did occur it would need emergency treatment with antibiotics.
- Immune system suppression – steroid injections have been shown to reduce the function of your immune system for a period of 3 weeks following injection. This means that if you were to come in to contact with the coronavirus during this period of time (or if you were incubating the virus before you had the injection) you could have a more severe reaction to the virus as your immune system would find it harder to attack the virus. The risk of this is reduced if you have already had both vaccines however, and is considered a very low risk if you are in the “low risk” category for coronavirus infection generally.
A full list of risks and benefits for steroid injections can be accessed here on our website.
Other types of injections:
There is no good evidence that Injections with Hyaluronic acid, platelet rich plasma, or stem cell therapy help with Osteoarthritis.