The use of anti-inflammatories in arthritis is common. Typically, we will prescribe non-steroidal anti-inflammatory agent also known as a NSAIA or NSAID.
So, for purposes of our discussion, NSAIDs refer to arthritis pills in general. Some of the common ones that people know about off the shelf or that they can purchase at the drug store, is acetaminophen which is Tylenol, ibuprofen also known as Motrin, or naproxen also known as Aleve. Those are probably the three most common NSAIDs that patients that come to the office ask about. They may not realize– which one is which. But those are typical off-the-shelf patient purchased anti-inflammatories that may be helpful for arthritis. Usually I suggest that the patient checks with their family doctor or primary care physician first, because some of these medications even though they can be purchased over the counter, may have side effects or drug interactions that may affect issues they may have with their stomach or with their kidney or with their liver. So typically, we will recommend that the patient checks or informs their primary care physician before starting an anti-inflammatory or NSAID. That’s the initial treatment is this over-the-counter anti-inflammatories which are less expensive and may be quite effective in treating arthritic pain. If however the patient cannot take one of those common anti-inflammatories, there are other prescription strength anti-inflammatories available that can be selected to match the patients’ medical situation. They may require one that has a less effect on the kidney. They may require an anti-inflammatory that has less of an effect on the stomach as far as bleeding or stomach irritation. They may require one that requires a different formulation to avoid a problem with the liver. And again, all these things are issues that the primary care physician will discuss with patient before prescribing a prescription anti-inflammatory.
There are many different types of anti-inflammatories or NSAIDs available either over the counter or by prescription. There’re several classes of anti-inflammatories that all work through different metabolic pathways to interrupt the inflammatory cycle. For reasons we don’t know, some people respond better to one than another. So, if one doesn’t work, it doesn’t mean that your arthritis can’t be treated. It just means you may try a different class of the anti-inflammatory. Your primary care physician can work with you to select the class that might be appropriate for you based on what’s worked in the past, based on what hasn’t worked for you, and based on what medical issues you may have that would want to avoid a certain particular class of anti-inflammatory.
