A number of tablets and creams can help osteoarthritis symptoms. Because they work in different ways you can combine different treatments if you need to. Your pharmacist can advise you and supply paracetamol, and some low-dose tablets and creams without a prescription.
Over-the-counter painkillers for osteoarthritis
Painkillers (analgesics) often help with pain and stiffness, although they don’t affect the arthritis itself and won’t repair damage to your joint. They’re best used occasionally when the pain is very bad or when you’re likely to be exercising.
Paracetamol is usually the best and safest painkiller to try first, but make sure you take the right dose as most people take too little. You should try taking 1 g (usually two tablets) three or four times a day. It’s best to take them before the pain becomes very bad but you shouldn’t take them more often than every four hours.
Combined analgesics (for example co-codamol) contain paracetamol and a second codeine-like drug, and they may be helpful for more severe pain. They’re stronger than paracetamol and are therefore more likely to cause side-effects such as constipation or dizziness.
Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) for osteoarthritis
Over-the counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also help. You can use these for a course of about 5–10 days, but if they’ve not helped within this time then they’re unlikely to. If the pain returns when you stop taking the tablets, try another short course.
If you’re already taking NSAID tablets, speak to your doctor about non-NSAID creams (for example capsaicin cream) to avoid taking too much of one type of drug.
You shouldn’t take ibuprofen or aspirin if you’re pregnant, or if you have asthma, indigestion or a stomach (gastrointestinal) ulcer, until you’ve spoken with your doctor or pharmacist.
If you know you’re going to be more active than usual, try taking a painkiller before you start to avoid increased pain later.
Anti-inflammatory creams and gels for osteoarthritis
You can apply anti-inflammatory creams and gels directly onto painful joints three times a day. There’s no need to rub them in – they absorb through your skin on their own. They’re especially helpful for osteoarthritis of the knee or hand but not for deep joints such as the hip.
Anti-inflammatory creams and gels are extremely well tolerated as very little is absorbed into your bloodstream. They’re a good option if you have trouble taking tablets. You can decide if they help your pain within the first few days of trying them.