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Medications and injections for knee arthritis

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Ask your health care provider about medicines that may help relieve your pain.

Over-the-counter pain relievers

Over-the-counter pain relievers can help with your arthritis symptoms. Over-the-counter means you can buy them without a prescription.

Most doctors recommend acetaminophen (such as Tylenol) first because it has fewer side effects than other drugs. DO NOT take more than 4 grams (4,000 mg) of acetaminophen on any one day.

If your pain continues, your doctor may suggest non-steroidal anti-inflammatory drugs (NSAIDs). You can buy some NSAIDs, such as ibuprofen and naproxen, without a prescription.

Taking acetaminophen or another pain pill before exercising is okay. But DO NOT overdo the exercise because you have taken the medicine.

NSAIDs, when taken in high doses, or taken for a long time, can cause serious side effects. Please make sure your primary care physician knows about your use.

If you are taking pain relievers on most days, tell your doctor. You may need to be watched for side effects.

Capsaicin (Zostrix) is a skin cream that may help relieve pain. You may feel a warm, stinging sensation when you first apply the cream. This sensation goes away after a few days of use. Pain relief usually begins within 1 to 2 weeks.

You can also buy over-the-counter or prescription NSAIDs that come in the form of a skin cream. The medicine can reduce inflammation and decrease pain.

"Steroid shots" for knee arthritis

Corticosteroids injected (steroid shot) right into the joint can also be used to help with swelling and pain.

However, relief lasts only for a short time. You should not have more than 4 injections a year as they can become harmful. These injections can be performed at your provider's office with the guidance of ultrasound or x-rays.

When the pain seems to go away after these injections, it may be tempting to go back to activities that may have caused your pain. When you receive these injections, ask your doctor or physical therapist to give you exercises and stretches that will decrease the chance of your pain returning.

Other injections for knee arthritis

Hyaluronic acid is a substance already in the fluid of your knee. It helps protect the joint. When you have arthritis, the hyaluronic acid becomes thinner.

Your doctor can inject a form of hyaluronic acid into your joint to help protect it. This is sometimes called artificial joint fluid or viscosupplementation.

These injections cannot help everyone, but if they do, the relief may last up to 3 to 6 months. However, the effect of an injection will depend on the severity of your arthritis.

Recently, platelet rich plasma (PRP) or stem cell extracts have been injected into the knee to decrease symptoms from arthritis. However, these treatments are still quite new, and providers don't have any long-term results from these treatments yet.

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Review Date: 8/9/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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