For osteoarthritis pain, the most effective options are anti-inflammatory medications, either taken by mouth or applied directly to the skin over the affected joint. Beyond those, a range of injections, supplements, and non-drug approaches can help, though they vary widely in how well they work. What’s right for you depends on which joint is affected, how severe your pain is, and what other health conditions you have.
Anti-Inflammatory Medications (NSAIDs)
Oral NSAIDs like ibuprofen and naproxen are the most widely recommended medications for osteoarthritis of the hand, knee, and hip. They reduce both pain and the low-grade inflammation that drives joint damage. Guidelines from the American College of Rheumatology strongly recommend them, with the caveat that you should use the lowest effective dose for the shortest time needed. Long-term use raises the risk of stomach ulcers, kidney problems, and cardiovascular events, so these aren’t always ideal for everyday, indefinite use.
Topical NSAIDs, particularly diclofenac gel, are a strong alternative for knee and hand osteoarthritis. In clinical trials totaling over 1,200 patients, topical diclofenac matched oral ibuprofen and oral diclofenac for pain relief, stiffness, and physical function. Because the medication is absorbed locally rather than throughout the body, it causes far fewer stomach and cardiovascular side effects. If your pain is concentrated in one or two accessible joints, a topical NSAID is often the smartest first choice.
Acetaminophen (Tylenol)
Acetaminophen can help with moderate osteoarthritis pain, though it’s generally less effective than NSAIDs because it doesn’t reduce inflammation. A 12-week trial found that 3,900 mg per day significantly improved pain in hip and knee osteoarthritis compared to placebo, while the lower dose of 1,950 mg per day showed only modest benefits. The FDA sets the maximum daily limit at 4,000 mg across all products you’re taking, and exceeding that raises the risk of serious liver damage. Many cold medicines, sleep aids, and combination painkillers contain acetaminophen, so check labels carefully to avoid accidentally doubling up.
Acetaminophen works best as a supporting option for people who can’t tolerate NSAIDs due to stomach, kidney, or heart concerns. On its own, it’s unlikely to provide substantial relief for anything beyond mild to moderate symptoms.
Duloxetine for Chronic Joint Pain
Duloxetine, a prescription antidepressant, is conditionally recommended for osteoarthritis pain. It works by changing how your brain and spinal cord process pain signals, which can be useful when osteoarthritis pain has become persistent and centralized, meaning your nervous system has become more sensitive to pain over time. It’s typically considered when NSAIDs aren’t enough or aren’t safe for you. Common side effects include nausea, drowsiness, and dry mouth, and it requires a prescription and gradual dose adjustment.
Corticosteroid Injections
Steroid injections directly into the affected joint can provide short-term improvement in pain and function for knee and hip osteoarthritis. The relief typically lasts a few weeks to a few months, making these most useful for flare-ups or when you need a window of reduced pain to participate in physical therapy. Ultrasound-guided injections tend to produce better results and less discomfort during the procedure. Most doctors limit these to three or four injections per joint per year, since repeated steroid exposure can thin cartilage over time.
Hyaluronic Acid Injections
Hyaluronic acid injections aim to supplement the natural lubricating fluid in your joint. They’re given as a series of three or four weekly shots into the knee. Some people report meaningful relief, but the overall evidence is mixed. The American College of Rheumatology and Arthritis Foundation actually recommend against hyaluronic acid injections, citing insufficient evidence of clinical benefit. Insurance coverage varies as a result. If you’ve tried other options without success, some doctors still offer these on a case-by-case basis.
Supplements: What Works and What Doesn’t
Glucosamine and Chondroitin
Glucosamine and chondroitin are among the most popular joint supplements, but current guidelines recommend against them. Studies funded independently of supplement manufacturers have not shown meaningful improvements in knee or hip osteoarthritis pain or function. Some combination products pairing glucosamine with omega-3 fatty acids or MSM have shown larger pain reductions in network analyses, but the evidence quality is moderate at best. If you’ve been taking glucosamine and feel it helps, it’s generally safe to continue, but don’t expect dramatic results.
Curcumin (Turmeric Extract)
Curcumin, the active compound in turmeric, has more promising evidence. A systematic review of 19 randomized controlled trials found that curcumin and turmeric extracts reduced arthritis symptoms at doses ranging from 120 mg to 1,500 mg daily over 4 to 36 weeks. Most successful trials used doses of 1,000 to 1,500 mg per day of a standardized extract. The catch is that curcumin is poorly absorbed on its own, so formulations designed for better absorption (often labeled as “bioavailable” or combined with black pepper extract) tend to perform better. Curcumin is not a replacement for NSAIDs in moderate to severe cases, but it may help as an add-on or for people with mild symptoms who want to avoid medications.
SAMe
SAMe (S-adenosylmethionine) is a compound your body produces naturally that appears to support cartilage repair and reduce inflammation. Clinical studies have used a starting dose of 1,200 mg per day, tapering to a maintenance dose of 400 mg per day. SAMe also has antidepressant properties, which may independently help with the mood effects of living with chronic pain. It’s expensive compared to other supplements and can cause digestive upset, but it has a reasonable evidence base for mild to moderate osteoarthritis.
Fish Oil, Vitamin D, and Colchicine
Fish oil, vitamin D, and colchicine have all been studied for osteoarthritis. While they carry little risk of harm, current guidelines find insufficient benefit to recommend them. If you’re already taking fish oil or vitamin D for other health reasons, there’s no need to stop, but don’t expect them to meaningfully change your joint pain.
What to Avoid
Several treatments that sound promising are specifically recommended against. Opioids other than tramadol carry high risks of dependency and side effects that outweigh their modest pain benefits. Platelet-rich plasma (PRP) injections and stem cell therapies have not demonstrated consistent clinical benefit despite heavy marketing. Immunosuppressant drugs used for rheumatoid arthritis, such as methotrexate and hydroxychloroquine, don’t work for osteoarthritis and carry significant toxicity risks.
Tramadol remains a conditional option for people who’ve exhausted other choices, but it’s generally reserved as a last resort before considering surgical options. It still carries dependency risks, though lower than stronger opioids.
Non-Drug Approaches That Matter
Medications and supplements work best alongside physical strategies. Exercise is one of the most consistently effective treatments for osteoarthritis, particularly low-impact activities like swimming, cycling, and walking. Strengthening the muscles around an arthritic joint reduces the load on damaged cartilage and often produces pain relief comparable to medication. Weight loss, even a modest 10 to 15 pounds, significantly reduces knee pain because every pound of body weight translates to roughly three to four pounds of force across the knee joint with each step.
Braces, supportive shoe inserts, and assistive devices like canes can also redistribute mechanical stress. Physical therapy focused on range of motion and joint stability helps many people delay or avoid the need for stronger medications or surgery. These approaches don’t have the side effect concerns that come with long-term drug use, which is why every major guideline places them at the foundation of osteoarthritis management.