Over-the-Counter Pain Relief for Arthritis: A Complete Guide

Key Takeaways

• Acetaminophen (Tylenol) is safer for your stomach but doesn’t reduce inflammation
• NSAIDs like ibuprofen and naproxen fight both pain and inflammation but have more risks
• Seniors need to be extra careful with dosing and drug interactions
• Topical creams can provide relief without affecting your whole body
• When OTC medications stop working, it may be time to explore other treatment options

Living with arthritis doesn’t mean accepting constant pain. Over-the-counter (OTC) pain relievers can help you stay active and comfortable—if you know which ones to choose and how to use them safely.

Understanding Your OTC Options

The pharmacy aisle is full of pain relief products. Let’s break down the main types and how they work.

Acetaminophen (Tylenol)

Acetaminophen is often the first choice for arthritis pain relief, especially for people over 65.

How it works: Reduces pain signals in your brain but doesn’t fight inflammation in your joints.

Pros:

• Gentle on your stomach
• Fewer drug interactions than NSAIDs
• Safe for people with heart disease
• Works well for mild to moderate pain

Cons:

• Doesn’t reduce joint swelling
• Can damage your liver if you take too much
• Less effective for inflammatory arthritis

Typical dose: 650-1,000 mg every 6-8 hours (maximum 3,000 mg daily for seniors)

Important warning: Many cold medicines and prescription pain pills contain acetaminophen. Always read labels to avoid taking too much.

Ibuprofen (Advil, Motrin)

Ibuprofen belongs to a class of drugs called NSAIDs (non-steroidal anti-inflammatory drugs).

How it works: Blocks chemicals in your body that cause pain, swelling, and inflammation.

Pros:

• Reduces both pain and joint inflammation
• Starts working within 30-60 minutes
• Available in different strengths
• Works well for flare-ups

Cons:

• Can irritate your stomach and cause ulcers
• May raise blood pressure
• Can affect kidney function
• Increases bleeding risk

Typical dose: 200-400 mg every 4-6 hours (maximum 1,200 mg daily without doctor supervision)

Naproxen (Aleve)

Naproxen is another NSAID that lasts longer than ibuprofen.

How it works: Similar to ibuprofen—fights pain and inflammation.

Pros:

• Longer-lasting relief (8-12 hours)
• Take it less often (twice daily)
• Good for steady, daily pain control
• Reduces morning stiffness

Cons:

• Same stomach, heart, and kidney risks as ibuprofen
• May take longer to start working
• Higher risk if you’re over 75

Typical dose: 220 mg every 8-12 hours (maximum 660 mg daily without doctor supervision)

Topical Pain Relievers

Creams, gels, and patches applied directly to painful joints can work without affecting your whole body.

Common types:

• Capsaicin cream (from hot peppers)—depletes pain signals over time
• Diclofenac gel (Voltaren)—NSAID that absorbs through skin
• Menthol/camphor (Bengay, Icy Hot)—creates cooling or warming sensation
• Lidocaine patches—numbs the area

Pros:

• Fewer side effects than pills
• Targets specific painful joints
• Won’t interact with other medications
• Safe for people who can’t take oral NSAIDs

Cons:

• May not work for deep joint pain
• Can irritate sensitive skin
• Takes regular application
• Some have strong smells

Safety Considerations for Seniors

If you’re over 65, your body processes medications differently. Here’s what you need to know.

Stomach Protection

NSAIDs can cause stomach bleeding, especially in older adults. Protect yourself by:

• Taking NSAIDs with food
• Avoiding alcohol while using NSAIDs
• Watching for warning signs (dark stools, stomach pain, nausea)
• Asking your doctor about protective medications if you need daily NSAIDs

Heart Health

Long-term NSAID use may increase heart attack and stroke risk. Be cautious if you have:

• High blood pressure
• Heart disease
• History of stroke
• High cholesterol

If you have heart conditions, acetaminophen or topical options may be safer choices.

Kidney Function

Both acetaminophen and NSAIDs can affect kidney function, especially with daily use. Your doctor should check your kidney function regularly if you take these medications long-term.

Drug Interactions to Watch

OTC pain relievers can interact with common medications:

NSAIDs may interact with:

• Blood thinners (warfarin, aspirin)
• Blood pressure medications
• Diuretics (water pills)
• Steroids (prednisone)
• Antidepressants (SSRIs)

Acetaminophen may interact with:

• Blood thinners (warfarin)
• Seizure medications
• Alcohol (even moderate amounts)

Always tell your doctor and pharmacist about all medications and supplements you take—including OTC products.

How to Choose the Right Option

Not sure which OTC pain reliever is best for you? Here’s a simple guide:

Choose acetaminophen if you:

• Have stomach problems or ulcers
• Take blood thinners
• Have heart disease
• Need occasional pain relief
• Experience mild to moderate pain

Choose NSAIDs (ibuprofen or naproxen) if you:

• Have significant joint swelling
• Experience inflammatory flare-ups
• Have tried acetaminophen without success
• Need both pain relief and anti-inflammatory effects
• Don’t have stomach, heart, or kidney problems

Choose topical products if you:

• Have pain in one or two specific joints
• Can’t tolerate oral medications
• Want to avoid drug interactions
• Have sensitive stomach or kidneys

When to Use—and When to Skip

Best Times to Use OTC Pain Relievers

• Before activities that typically cause pain (gardening, walking)
• When morning stiffness is severe
• During arthritis flare-ups
• To help you sleep when pain disrupts rest

When OTC Medications Aren’t Enough

You may need to explore other treatment options if:

• You need pain relievers daily for more than 10 days
• Your pain is getting worse despite medication
• OTC medications don’t provide adequate relief
• You’re experiencing medication side effects
• Your arthritis is limiting your daily activities

What Comes Next?

OTC medications can be helpful for managing arthritis pain, but they’re not the only option—and sometimes they’re not enough.

If you’re taking maximum doses of OTC pain relievers regularly and still struggling with pain, it may be time to discuss other treatments with your doctor. Options like hyaluronic acid injections, physical therapy, or other interventions might provide better long-term relief without daily medication.

Many people find that treatments like viscosupplementation can reduce their need for daily pain medications while improving joint function and quality of life.

Smart Usage Tips

Keep a pain diary: Track when you take medication and how well it works. This helps you find the best timing and dosage.

Don’t mix NSAIDs: Taking ibuprofen and naproxen together doesn’t work better—it just increases side effects.

Read every label: Many products contain the same active ingredient under different brand names.

Set a reminder: Taking medication at the same time each day provides more consistent pain control.

Store safely: Keep medications in original containers, away from heat and moisture.

Check expiration dates: Expired medications may not work as well and could be unsafe.

Frequently Asked Questions

Can I take acetaminophen and ibuprofen together?

Yes, but ask your doctor first. Some people alternate them for better pain control, but you need to be careful about timing and dosages to avoid taking too much of either medication.

Is it safe to take NSAIDs every day?

Long-term daily NSAID use increases risks for stomach bleeding, kidney problems, and heart issues. If you need daily pain relief, talk with your doctor about the safest approach for your situation.

Why does my doctor recommend acetaminophen instead of ibuprofen?

Acetaminophen has a better safety profile for many seniors, especially those with heart disease, high blood pressure, or stomach problems. While it doesn’t reduce inflammation, it can effectively manage arthritis pain with fewer risks.

Do topical creams really work?

Yes, for many people. Topical NSAIDs and other creams can provide significant relief for joints close to the skin surface (like hands and knees) without the side effects of oral medications. They work best when applied regularly as directed.

How do I know if I’m taking too much acetaminophen?

The maximum safe dose for most seniors is 3,000 mg per day. Remember that many cold, flu, and prescription pain medications contain acetaminophen. Always read labels and keep a list of everything you take. Signs of liver damage include yellowing skin or eyes, dark urine, and abdominal pain.

Should I take pain medication before or after meals?

NSAIDs should be taken with food to protect your stomach. Acetaminophen can be taken with or without food, but taking it with food may reduce stomach upset in sensitive individuals.

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This article is for informational purposes only and does not replace medical advice. Always consult your healthcare provider before starting any new medication or treatment regimen.

Last medically reviewed: February 2025