Use of Oral Over the Counter Medicines

1. These can be highly effective in the initial stages of knee arthritis. Use the common medicines you would use for a headache.  Use only when the knee has pain and use for a day or a couple of days.  This includes Tylenol, Advil or Aleve.  Patients usually know which one works best for pain. Advil and Aleve are a class of nonsteroidal medications referred to as NSAIDS and are used in smaller doses to decrease pain and swelling. Make sure these medications to not upset your stomach and if you have any GI issues your family doctor should advise you on your medications.
2. Combine the above low dose medicines with icing, activity modification, and some element of rest to allow the knee “headache” to resolve. Remember knee arthritis comes and goes based on your activity and commonly doing too much at one time.
3. With a flare-up of knee arthritis pain, examine carefully your activity and what you may have done to trigger the flare-up to avoid in the future.
4. If symptoms do not resolve in 7 days it is best to see a doctor, waiting weeks to get better allows too much muscle atrophy and disuse. It is better to allow your doctor to determine if these is knee swelling which may require stronger medication.
5. With established arthritis and low-grade chronic symptoms these medications can still be used every other day or so along with ice and a knee brace to avoid stronger medications. Sometimes your doctor will recommend a knee steroid injection which lasts for up to three months an avoids using stronger oral medications that go thru your stomach and liver and have side effects.
6. The use of glucosamine – chondroitin sulfate combination supplements is controversial although studies have shown they may provide some relief of knee pain in one-third of patients. These supplements are very safe, and their use is advantageous to avoid the side effects of stronger medications.  The rule is to select a brand name that is recognized as studies show that these medications are not controlled by the FDA and may vary greatly in concentrations and what is actually present.

One brand name that is recommended is COSAMIN DS (NUTRAMAX LABORATORIES) that is produced in the USA. One suggestion is to take the supplement for 4 weeks and determine if pain symptoms and joint stiffness improves.  Another approach is to stop taking the medication after 4 weeks and see if there is a change in your symptoms.  Often times these medications will help arthritis in other parts of your body such as hand arthritis so be aware other joints may benefit.  It is appropriate to also take other over the counter medications as listed above as they do not have a cross reaction with these supplements.

7. There are oral supplements such as Turmeric, and other herbs that patients will frequently ask a doctor if they are beneficial. I am very reluctant to recommend these other forms of supplements as medical science has not arrived at a precise opinion on their safety and use with other medications a patient may be taking.  Also, with herb products, there may be contaminants or other potent chemicals as the quality of the product is not tested.  Be careful of any herb or medication that you do know precisely the positive or negative effects.
8. Following the above rules, I have had patients go many years, living an active life and avoiding side effects of stronger medications. Remember the use of cautious rehabilitation exercises and weight control is absolutely essential for success.
9. Remember when knee arthritis flares up, your activity and the calories you burn will decrease therefore as already mentioned, it is important you stay as active as possible to effectively burn off calories. You may need serious modifications in your food intake and type of food you eat. Taking you weight weekly is recommended.