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Stronger painkillers for osteoarthritis

Back to What treatments are there for osteoarthritis?

Prescription painkillers for osteoarthritis

If you have severe pain and other medications aren’t giving enough relief, your doctor may recommend stronger painkillers (or opioids) such as tramadol, nefopam or meptazinol.

Stronger painkillers are more likely to have side-effects – especially nausea, dizziness and confusion – so you’ll need to see your doctor regularly and report any problems you have.

Some opioids (for example fentanyl) can be given as a plaster patch which you place on your skin – these can ease pain for a number of days.

Prescription non-steroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis

If joint inflammation is causing pain and stiffness, you may find a short course of non-steroidal anti-inflammatory drugs (NSAIDs), for example naproxen, useful.

Like all drugs, NSAIDs can sometimes have side-effects, but your doctor will take precautions to reduce the risk of these – for example, by prescribing the lowest effective dose for the shortest possible period of time.

NSAIDs can cause digestive problems (stomach upsets, indigestion, or damage to the stomach lining) so in most cases they’ll be prescribed along with a drug called a proton pump inhibitor (PPI), which will help to protect your stomach.

NSAIDs also carry an increased risk of heart attack or stroke. Although the increased risk is small, your doctor will be cautious about prescribing them if there are other factors that may increase your overall risk – for example, smoking, circulation problems, high blood pressure, high cholesterol or diabetes. NSAIDS can also reduce kidney function so you shouldn’t take them if you have known reduced kidney function or are on a water tablet (diuretic).

If you have trouble opening child-proof containers, your pharmacist will put your tablets in a more suitable container for you. You can order a special request card which you can hand to your pharmacist with your prescription.

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