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Get a grip on arthritis
Arthritic pain can be a debilitating condition. It's certainly not uncommon -- between 20 and 50 million Americans suffer from some form of arthritis, which means there are lots of products to help remedy the condition. Arthritis comes in many types, but the three most common are osteoarthritis, rheumatoid arthritis, and gout.
Don't confuse arthritis with muscular or ligament strain -- arthritis is centered in the joints. It makes joints painful, stiff, and swollen. Remember to look for medications that reduce inflammation. Gels or heat-rubs may relieve the pain and stiffness, but they don't reduce swelling.
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Classifying Your Condition
Understand your arthritis. While all ages can be affected, the incidence of arthritis increases with age. In fact, arthritis symptoms strike 80% of people over age 65. The three main types of arthritis have different causes, so treatments may differ.
- Osteoarthritis: the most frequently diagnosed form of arthritis is considered one of the "ailments" of old age caused by normal wear and tear on joints. It affects both men and women equally and usually involves symptoms of stiffness and joint pain. Joints which are weight-bearing or under frequent strain are the most frequently affected, and include the knees, hips, spine, and hands.
- Rheumatoid arthritis: an inflammation and swelling of joint membranes caused by the body's autoimmune response. This form of arthritis usually begins in middle age and affects women more frequently than men.
- Gout: severe, sudden inflammation of one joint at a time caused by the buildup of uric acid; usually affects the feet, ankles, or knees.
Acetaminophen or NSAIDs or Salicylates?
There is no hard-and-fast rule in deciding what medication to take to relieve your pain. Factors include your current health status, liver function, and allergies (to name a few). For prolonged use of medication (more than 10 days), remember to talk to your physician about the best strategy for you.
Several over-the-counter drugs exist to combat the sometimes-debilitating effects of this long-term disease. Many pain relievers combine analgesic and antirheumatic properties, meaning they relieve pain and inflammation, respectively. The most effective medications are internal analgesics like aspirin and other salicylates, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and acetaminophen.
Chronic arthritis pain often requires nonprescription drugs for long periods of time. Despite the fact that many drugs, such as aspirin and ibuprofen, do not require a prescription, their powerful effects should not be underestimated. Using any of these medications for more than 10 days requires the advice of a physician.
- Taking pain relievers with food can help reduce the stomach upset that you may experience from NSAIDs, aspirin, and salicylates. In fact, frequent ingestion of NSAIDs or salicylates without food may cause you to develop an ulcer.
- Never give aspirin to children or teenagers -- it has been associated with the rare, but often fatal Reye's syndrome. Naproxen and ketoprofen have not yet been approved for children; use only acetaminophen or ibuprofen for kids. Arthritis is usually not a condition of the very young. Check with your doctor if your child is complaining of arthritis-like symptoms.
- Acetaminophen can reduce arthritis pain, but it does not have an effect on inflammation. It may, however, be the only option for those who are allergic to aspirin or NSAIDs. Acetaminophen has fewer side effects than the other over-the-counter analgesics. However, prolonged use may increase your risk of liver damage.
- Aspirin -- acetylsalicylic acid -- is very effective at reducing mild to moderate pain associated with rheumatoid arthritis and osteoarthritis, and helps reduce inflammation.
- Other salicylic acids, like choline, magnesium, and sodium salicylate, may also be effective at relieving pain and helping reduce inflammation.
- Ibuprofen, ketoprofen, and naproxen are all NSAIDs which offer relief from pain and fever. They also relieve inflammation.
Dietary Considerations
Eat and Drink Smart
Gout, also known as the "rich man's disease", has been closely associated with "rich foods" and alcohol. Gout occurs when there is too much uric acid, which is the end product of a group of chemical substances called purines, in your body. For some people, excessive intake of purine-rich foods can lead to acute gouty attacks. Therefore, it is recommended by health care professionals that if you have gout you should eat and drink smart. Nutritionists recommend the following:
- Abstain from alcohol (especially beer and wine).
- Drink plenty of fluid (at least two quarts of non-alcoholic beverages daily) to dilute urine and prevent uric acid buildup.
- Avoid or limit the amount of foods ingested that are high in purines such as sweetbreads, organ meats, meat extract, gravies, sardines, anchovies, meat, lobster, crab, spinach, cauliflower, asparagus, mushrooms, oatmeal, and dried legumes.
- If you are overweight, try to gradually lose weight.
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Analgesics (acetaminophen)
Reduces pain and fever but has no anti-inflammatory activity. Works by acting directly on the central nervous system and blocking pain messages.
Analgesics (NSAID)
NSAIDs, or non-steroidal anti-inflammatory agents, are a class of drugs that reduce inflammation. Commonly used in the treatment of arthritic pain, they work by blocking the production of prostaglandins, chemicals linked to pain sensations and inflammation in the body. NSAIDs available without a prescription include ibuprofen, ketoprofen, and naproxen.
Analgesics (salicylate)
A class of drugs which reduce fever and relieve pain. They include aspirin, choline salicylate, magnesium salicylate tetrahydrate, and magnesium salicylate, and work by blocking the production of prostagladins, chemicals linked to pain sensations and inflammation in the body.
| Analgesics (Acetaminophen) | Ingredient | Description |
|---|
| Acetaminophen | ? | Safe and effective for treating minor aches and pains. If you have liver or kidney disease, consult a doctor before taking this drug. | | Analgesics (NSAID) | Ingredient | Description |
|---|
| Ibuprofen | ? | Effective in relieving moderate pain. Should not be used by people with gastrointestinal or bleeding disorders. | | Naproxen | ? | Effective in relieving moderate pain. Works longer (8 to 12 hours) than ibuprofen and ketoprofen. Should not be used by children under age 12, or people with gastrointestinal or bleeding disorders. | | Ketoprofen | ? | Effective in relieving moderate pain. Should not be used by children under age 16, or people with gastrointestinal or bleeding disorders. | | Analgesics (Salicylate) | Ingredient | Description |
|---|
| Aspirin (Acetasalicylic Acid) | ? | Useful only in treatment of mild pain symptoms. Does not have much effect on prostaglandin production. Present in many over-the-counter analgesics. Never administer to children with flu-like symptoms or fever due to the risk of the rare, but fatal, Reye's syndrome. | | Choline Salicylate | ? | A salicylate salt comparable to aspirin. Less irritating to the stomach. | | Magnesium Salicylate | ? | Comparable to aspirin but less potent and less irritating to the stomach. | | Potassium Salicylate (Conditionally Approved) | ? | Similar to magnesium and sodium salicylate. Safe and effective for minor pain relief. | | Sodium Salicylate | ? | A salicylate salt comparable to aspirin. Be cautious about using if you are on a low sodium diet. Not commonly found in nonprescription products. |
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© 1999-2000 PlanetRx.com, Inc. All rights reserved.
Copyright and Legal Disclaimer.
Information provided on PlanetRx.com is for informational purposes only and is not a substitute for professional medical advice. Only your healthcare provider should diagnose your healthcare problems and prescribe treatment.
Statements regarding dietary supplements are provided solely to offer our customers additional information about alternative medicine. No health claims for these products have been evaluated by the United States Food and Drug Administration (FDA), nor has the FDA approved these products to diagnose, cure or prevent disease. Please consult your healthcare provider before starting any course of supplementation or treatment, particularly if you are currently under medical care. Make sure you carefully read all product packaging prior to use. If you have or suspect you may have a health problem, you should consult your healthcare provider.
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Warnings
Analgesic (acetaminophen)
Consult a physician before using or do not use if you have:
- Alcoholism
- Allergy to acetaminophen or any component in acetaminophen products
- Kidney impairment
- Liver impairment
Or if you:
- Are pregnant or a nursing mother
- Are a senior; you may require a lower dosage
- Plan to use more frequently or at higher than recommended doses
- Still have a fever after three days
- Are using to treat symptoms for more than 10 days in adults
- Are using to treat symptoms for over five days in children
Or if you are taking:
- Chronic alcohol use: may increase the risk for acetaminophen-induced liver damage
- Isoniazid (Nydrazid): may increase the risk for acetaminophen-induced liver damage
- Phenobarbital (Luminal): may increase the risk for acetaminophen-induced liver damage
- Phenytoin (Dilantin): may increase the risk for acetaminophen-induced liver damage
- Sulfinpyrazone (Anturane): may increase the risk for acetaminophen-induced liver damage
- Warfarin (Coumadin): use of high dose acetaminophen might increase the risk of bleeding
Analgesic (NSAID)
Consult a physician before using or do not use if you have:
- Allergy to NSAIDs, aspirin, or iodides
- Anemia
- Asthma
- Blood clotting disorders
- Heart disease
- High blood pressure
- Kidney impairment
- Liver impairment
- Parkinson's disease
- Psychiatric disorder; NSAIDs may aggravate it
- Pre-existing infection; it might be masked by NSAIDs
- Ulcers or other gastrointestinal problems
Or if you:
- Are administering to a child under age 15 with a viral illness, due to the increased risk of Reye's syndrome
- Are pregnant or a nursing mother
- Are a senior; you may require a lower dosage
- Are bedridden or incapacitated
- Are in sunlight for prolonged periods, as photosensitivity may occur
- Are on a low-salt diet
- Develop blurred vision or other eye problems during treatment; consult a physician
- Experience headaches with drug usage that do not diminish as dose is lowered
- Plan to use for an extended period of time or at a higher dose
- Experience severe abdominal pain or cramps
Or if you are taking:
- Cyclosporin (Neoral, Sandimmune): may increase kidney damage
- Digoxin (Lanoxin): may increase digoxin levels and effect when ibuprofen is also used
- Furosemide (Lasix): may decrease furosemide levels when ibuprofen or ketoprofen is also used
- Lithium (Lithobid): may increase lithium levels or effect
- Methotrexate (Folex): may increase methotrexate levels and side effects
- Other NSAIDs: increases NSAID side effects
- Phenytoin (Dilantin): may increase phenytoin levels or effect when ibuprofen is also used
- Probenecid (Benemid): may increase NSAID levels and side effects
- Salicylates, such as
Aspirin (Ecotrin): may decrease NSAID levels and increase NSAID side effect
- Choline salicylate (Arthopan): may decrease NSAID levels and increase NSAID side effects
- Warfarin (Coumadin): may increase warfarin side effects and the risk of bleeding
Analgesic (salicylate)
Consult a physician before using or do not use if you have:
- Allergy to aspirin or other salicylate
- Asthma
- Blood clotting disorders
- Kidney impairment
- Liver impairment
- Nasal polyps
- Ulcers or other gastrointestinal problems
Or if you:
- Are administering to a child or teenager with a viral illness, as salicylates may increase the risk of developing Reye's syndrome
- Are pregnant or a nursing mother
- Are a senior; you may require a lower dosage
- Are on a low-salt diet
- Experience ringing in the ears; consult a physician
- Note that the drug has a vinegar-like odor; the pill may have decomposed
- Plan to have surgery; stop use seven days before the procedure
- Plan to use for an extended period of time or at a higher dose
- Drink more than three drinks of alcohol a day; may cause liver or stomach damage
Or if you are taking:
- Urinary acidifiers, such as:
- Ammonium chloride: decreases salicylate removal
- Ascorbic acid (Vitamin C): decreases salicylate removal
- ACE inhibitors, such as:
- Benazepril (Lotensin): may decrease benazepril effects
- Enalapril (Vasotec): may decrease enalapril effects
- Alcohol: increases the risk of stomach ulceration and bleeding
- Antacids: may decrease salicylate effects
- Beta blockers, such as:
- Atenolol (Tenormin): may decrease atenolol effects
- Metoprolol (Lopressor): may decrease metoprolol effects
- Corticosteroids, such as:
- Cortisone (Cortef): may decrease salicylate levels
- Methylprednisone (Medrol): may decrease salicylate levels
- Heparin (Hep-Lock): increases risk of bleeding
- Methotrexate (Folex): may increase methotrexate levels and effect
- Other salicylates: increases salicylate side effects
- Valproic Acid (Depakote): may increase valproic acid effects
- Warfarin (Coumadin): may increase warfarin side effects and the risk for bleeding
Common Side Effects
Analgesic (acetaminophen)
Analgesic (NSAID)
- Dizziness
- Fatigue
- Heartburn
- Nausea
- Rash
- Stomach cramps
Analgesic (salicylate)
- Abdominal discomfort
- Heartburn
- Indigestion
- Nausea
Infrequent to Rare Side Effects
Analgesic (acetaminophen)
- Bruising
- Nausea
- Rash
- Vomiting
Analgesic (NSAID)
- Confusion
- Fluid retention
- Headache
- Itching
- Nervousness
- Ringing in ears
- Stomach ulceration
- Vomiting
Analgesic (salicylate)
- Difficulty breathing
- Fatigue
- Rash
- Stomach ulceration
- Weakness
Effects of Overdose
Analgesic (acetaminophen)
- Kidney damage
- Liver damage
Analgesic (NSAID)
- Kidney failure
- Seizures
- Severe nausea
- Vomiting
- Ringing in ears
Analgesic (salicylate)
- Coma
- Confusion
- Headache
- Liver damage
- Low blood sugar
- Rapid breathing
- Ringing in ears
What to Do in Case of Overdose
- If you suspect that you or someone you know has taken an overdose of this medication, immediately STOP USING THE MEDICATION and SEEK MEDICAL HELP.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 11/16/88.
- 2. Food & Drug Administration. Federal Register 12/24/91.
- 3. Food & Drug Administration. Federal Register 2/2/94.
- 4. Food & Drug Administration. Federal Register 4/19/95.
- 5. Food & Drug Administration. Federal Register 6/13/96.
- 6. Food & Drug Administration. Federal Register 11/14/97.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S.The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
Find more books on health and wellness at  barnesandnoble.com.
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