I often get asked what drug I prefer for osteoarthritis pain relief. Over the years it has changed based on the most current medical knowledge. As a doctor I am always looking for the best way to help each patient. This means looking at treatments that provide the greatest benefit with the least risk. Because I also suffer from osteoarthritis I am very familiar with both the benefits and risks of

The pain medication that doctors most often prescribed for arthritis pain is a class of drugs called Non Steroidal Anti Inflammatory Drugs or NSAIDs. These drugs work by reducing inflammation in the joint, which then reduces the pain and improves mobility.

NSAIDs includes such drugs as Aleve (Naproxen), Celebrex, Ibuprofen, etc. While drugs in this class help reduce joint inflammation and pain their most common side effect is an increased rate of stomach ulcers. This increase can be quite dramatic. For instance, 25.7% of the participants in the UCLA Medical School study developed stomach ulcers after twelve weeks of taking Naproxen.

In practice, I have seen patients develop bleeding ulcers after a few days using NSAIDs. This is a very frightening scenario when those patients come into the emergency room, with what can be a life-threatening bleed... it can be quite scary.

When Cox-2 Inhibitors (Vioxx, Celebrex, Bextra) where approved by the FDA they reduced the single largest risk that NSAIDs such as Naproxen had... stomach ulcers. At the time they were viewed by many as a very safe anti-inflammatory pain reliever.

Unfortunately as we found out... they were anything but safe. Now, due to the significantly increased risk of heart attacks and stroke, the only Cox-2 Inhibitor still on the market is Celebrex, but with stronger risk warnings on the label.

Before I tell you which drug I prescribe most for osteoarthritis I will tell you what I do for myself and recommend for many of my patients.

1) Low Impact Exercise. While the last thing you may want to do is exercise when you have joint pain, studies have shown that people who exercise regularly show a 25% improvement in arthritis symptoms. They have less pain, less stiffness and greater flexibility.

2) Weight Control. Maintaining a healthy weight alone can make a large difference for 2 reasons. First the added weight puts additional stress on your joints. When you walk the impact is about 4x the weight. So an extra 10 pounds creates impact on your knees, ankles, hips, and back of about 40 pounds with each step.

Second when you are overweight your body produces higher levels of pro-inflammatory compounds, increasing your body's systemic inflammation.

3) Eat An Anti-inflammatory Diet. Your diets should be high in fresh fruits, vegetables and fish. Fruits, vegetables and fish contain numerous natural anti-oxidant's and anti-inflammatory compounds that help reduce inflammation throughout your body and joints.

4) Supplement with a Glucosamine, Chondroitin, MSM, Boron Joint Complex. These supplements work together to help your joints rebuild cartilage that is lost due to osteoarthritis and help your joints stay healthy, strong and flexible.

5) Supplement with Natural Anti-inflammatories. You should avoid ones that act as a Cox-2 Inhibitor which we know can cause heart issues. Safe effective ones include Boswellia Serrata, Devils Claw and Bromelain all are proven natural anti-inflammatories that reduce inflammation and pain - often better than drugs with significantly fewer side effects.

Because there are few joint formulas that contain both the essential joint ingredients and natural anti-inflammatory ingredients in sufficient amounts to be therapeutic I developed Zymosine ( http://Zymosine.com ), which I take daily to provide both for maximum joint support and pain relief.

What drug do I prescribe most often? Well until all the facts were known, it was Vioxx, which provided the highest level of relief for most people and was considered as safe as the other Cox-2 Inhibitors. Now, for most patients who prefer a drug I prescribe the lowest dose (200mg or less per day) of Celebrex. This dosage is fairly safe and generally gives most patients sufficient relief. However it will not help to stop the progression of cartilage destruction as glucosamine and chondroitin do.

Why Celebrex? From our latest knowledge it appears that the risk of heart problems is only slightly higher with Celebrex compared to other NSAIDs, but the rate of ulcers is significantly less - about 5.6%. So the risk profile appears to offer the best drug alternative for patients.

In addition, I discuss the cardiovascular risk directly with the patient and consider the patient's actual tendency to develop a heart attack or stroke. I look at the usual risk factors such as cholesterol and hypertension and often use a special lab test called "high sensitivity C-reactive protein" which gives a good indication of someone's actual cardiovascular risk. If that test comes back high, I would tend to avoid prescribing Celebrex for that particular patient.

Interestingly, the latest National Institute of Health Study demonstrated that Glucosamine & Chondroitin was better than Celebrex for people with moderate to severe arthritis. (79.2% had improvement with Glucosamine and Chondroitin compared to 69% improvement with Celebrex.) A prudent and cautious approach to medical care is to start with the alternatives with the least risk first. So you may want to avoid the higher risk drugs and start with the healthiest alternative: supplementation, diet and exercise.

This article is intended for information purposes only and not intended as medical advice which should be provided by your personal healthcare provider.

About the Author

Dr. Hays has practiced medicine for 16 years in both family practice & emergency services. He developed the premier joint health & anti-inflammatory pain relief formula Zymosine http://Zymosine.com . Read more health articles at http://bouldernaturallabs.com