Tramadol

Tramadol is an alternative treatment option for osteoarthritis (OA) of the knee and hip for people who have failed treatment with acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs) or cannot take these medications.

Salicylate

Salicylate topical preparations are an alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications.

Opioids

Opioids are second-line medications reserved for moderate to severe knee and hip osteoarthritis (OA) pain that does not respond to adequate trials of other therapies (acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), tramadol, duloxetine). Opioids trigger your body’s natural pain-relief mechanism. Tolerance to this medication develops rapidly and can lead to dependency or addiction in some people. Courses of opioids should be limited. . .

Non-Steroidal Anti-inflammatory Drugs (NSAIDs)

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) refers to a group of medications which are used for both inflammatory arthritis and osteoarthritis (OA). Some examples of NSAIDs are acetylsalicylic acid (ASA), celecoxib, diclofenac, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meloxicam, nabumetone, naproxen, piroxicam, and sulindac. NSAIDs can help relieve pain associated with many conditions and reduce inflammation. NSAIDs block enzymes that trigger inflammation to. . .

Duloxetine

Duloxetine is a first-line agent for fibromyalgia and a second-line agent for treatment of osteoarthritis (OA) of the knee that has not responded to acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). Duloxetine works by blocking neurotransmitters (serotonin and norepinephrine) that are involved in nerve pain. Stopping this medication requires monitoring by a healthcare provider as that may cause withdrawal side effects.

Celecoxib

Celecoxib is used for both inflammatory arthritis, such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS), and is a first-line treatment for osteoarthritis (OA). Celecoxib is an NSAID that blocks an enzyme called cyclooxygenase-2 (COX-2) which plays a role in inflammation. By blocking COX-2, celecoxib reduces pain and inflammation in the body. Celecoxib may cause stomach upset which can be. . .

Capsaicin

Capsaicin is a potential alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications.

Acetaminophen

Acetaminophen is a painkiller which can help with osteoarthritis and some inflammatory forms of arthritis. The mechanism of action is unclear, but it is thought to block cyclooxygenase enzymes (COX-1 and COX-2) which prevents your body from making prostaglandins which can cause pain and inflammation. Acetaminophen does not have many side effects but using more than the amount. . .

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