Arthritis and Over-the-Counter Medications

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Q: What over-the-counter medications can I get to help the arthritis in both my hands?

A: While there are non-prescription products (anti-inflammatory medications, pain relievers, topical creams, others) that may treat your symptoms, it is important to know they won’t cure or halt the potential damage to your hands. And, given that arthritis expresses itself as a condition (joint inflammation and destruction) in more than 100 diseases (osteoarthritis, rheumatoid, gout, others), it is important to coordinate your care with a physician familiar with this concern (family physician, internist or rheumatologist). This will provide the best chance to identify the cause and limit the future consequences of your arthritis.

Even though you didn’t mention which form(s) of arthritis has affected your hands, common themes are joint pain, limitation of movement, stiffness, and sometimes, swelling. There are products (over the counter, dietary supplements, others), nutritional suggestions and integrative therapies that may be used to maintain—and even improve—the function of the joints in your hands.

In reviewing the following options, it is important to keep in mind that it is best to work with your physician before adding or making changes to your treatment plan. That said, and with the caveat that what works for one may not work for another, here are some potential options:

Non-steroidal anti-inflammatory medications (ibuprofen, naproxen) and aspirin may be very effective in relieving the pain and swelling while also helping to improve the mobility and flexibility of your fingers and hands. Please keep in mind that these medications are not without risk, especially if used on a continual basis for more than two weeks (stomach irritation and bleeding, increase in blood pressure, kidney concerns).
Pain relievers such as acetaminophen may reduce your level of discomfort, but they will not relieve the inflammation of arthritis. Caution is advised when used on a continual basis (more than two weeks) by those who drink alcohol, have high blood pressure or are affected with liver disease.
S-adenosylmethionine is a supplement that may help to reduce the symptoms of pain and limited mobility in those affected with osteoarthritis. Improvement may not be seen for at least 30 days.
Glucosamine sulfate is a supplement that may help to relieve the joint pain (takes three to four weeks to show results) resulting from the inflammation caused by osteoarthritis. There has been some success in those affected by osteoarthritis of the knee, and anecdotal reports of improvement in other affected joints. However, studies are ongoing and not conclusive. The same can be said for another supplement known as chrondroitin sulfate, which also may be of benefit to some—but studies have not proven its effectiveness for use in the hands.
Fish oil supplements, either alone or in combination with a non-steroidal anti-inflammatory medication, may help to decrease the duration of morning stiffness in those with rheumatoid arthritis. This product has the potential to increase the risk of bleeding, and may contain fish proteins that can trigger an allergic reaction in those with a seafood allergy.
Capsaicin cream, made from an ingredient in chili peppers, may help relieve some of the joint pain. However, it can cause burning, redness and stinging of the skin, and should not be used in areas that are open or infected.
Physical therapy and exercise techniques guided by a certified hand therapist may greatly help to improve the mobility, as well as function, of your hands and fingers.

It is important to note that the dietary supplements mentioned above are not regulated by the U.S. Food and Drug Administration for safety, effectiveness and quality. This makes it important to look for labels such as USP-verified (United States Pharmacopeia),which indicate the companies’ adherence to good manufacturing standards. Products with this verification may be found at www.naturaldatabase.com.

Lastly, a single or combination of different medical conditions may be causing the arthritis in your hands. Complications include the possible injury or destruction of the joints, tendons, muscles and cartilage of your fingers, hands and wrist, as well as the potential to affect various systems of your body. That’s why it’s important to speak with your physician, especially since we have newer and very effective treatments such as disease-modifying anti-rheumatic drugs and biologic response modifiers that may help to slow, and possibly prevent, further damage.

For more information, please check out the Arthritis Foundation at www.arthritis.org as well as the American College of Rheumatology at www.rheumatology.org.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)