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Over-the-Counter Options for Osteoarthritis Pain. By Our September Student Pharmacist, MiKayla Matheny.


It is estimated that more than 45 million Americans, over 17%, have some form of arthritis.

The most common form of arthritis is osteoarthritis which results from ‘wear and tear’ on the joints. About a third of adults over age 65 have osteoarthritis. This type of arthritis is due to the breakdown of cartilage, which normally serves as a cushion and shock absorber between the bones in joints. As the cartilage gradually decays, joints can become stiff and painful to move.

Arthritis tends to get worse gradually over time and the pain and stiffness associated with arthritis can have very significant impacts on a person’s daily activities and their ability to do things they enjoy. However, there are treatment options available, many of which are over-the-counter (OTC) and available without a prescription. Let’s discuss a few of the most common oral OTC options to help with pain due to osteoarthritis:

Acetaminophen (Tylenol) – – Tylenol is a household name for a reason. Acetaminophen (sometimes abbreviated as APAP) is usually one of the first things recommended as an OTC option for pain. It is safe for most people when taken correctly and can be very effective.

Because of the way acetaminophen is metabolized by the liver, people with a history of liver problems should not take acetaminophen without talking with a doctor first. Taking too much acetaminophen can damage your liver, so you should never take more than the maximum dose indicated on the bottle (usually less than 4000 mg), unless your doctor specifically tells you to do so. Also, it is important to be aware that acetaminophen is contained in many combination OTC products, such as medicines for cough or cold, allergies, migraines, and sleep.

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Ibuprofen (Advil, Motrin) – – Ibuprofen can often be more effective than acetaminophen for arthritis pain because it has greater anti-inflammatory activity. However, ibuprofen has many more side effects and safety concerns. Ibuprofen is generally better for short term or occasional use. Long term use of ibuprofen can cause stomach ulcers or bleeding, can increase high blood pressure, and can cause kidney damage. Ibuprofen also interferes with the heart protective and clot prevention effects of daily low dose aspirin. This risk is minimized with only occasional ibuprofen use and single doses of ibuprofen are generally okay with aspirin. However, it is best to take ibuprofen at least eight hours before or two hours after a low dose aspirin. People on long-term low dose aspirin therapy should consult a doctor before using ibuprofen regularly or often. Never take more ibuprofen than the dose recommended on the bottle label unless told to do so by a doctor.

Naproxen (Aleve) – – Naproxen is in many ways similar to ibuprofen and has most of the same safety considerations because they are in the same class of medications. Some people prefer naproxen to ibuprofen, or vice versa, but there is no evidence that either is really more effective. The main differences between the two are that naproxen can be a little easier on the stomach and does not need to be taken as frequently as ibuprofen because it lasts longer in the body.


While these are the most common choices, there are many other options for arthritis pain available over the counter. There are several types of topical medications (which are applied to the skin rather than taken by mouth) which can also be very effective. Topicals can be more convenient or more effective for some people, but the choice of a topical medication is often very individualized. If you ever have questions about what OTC arthritis pain reliever would be best for you, ask your doctor or pharmacist to help you pick one out.

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