Osteoarthritis is the most common form of arthritis — a joint condition in which cartilage gradually wears down, most often in the knees, hips, and hands — and MedlinePlus is clear that there is no cure: the goal of treatment is to manage symptoms and keep the joint working. The honest first-line, echoed by the CDC, NHS, and NIH, isn't a drug at all. Staying physically active (the CDC recommends about 150 minutes a week of joint-friendly activity like walking, cycling, or water exercise), losing excess weight to take pressure off weight-bearing joints, and physiotherapy or strengthening are the foundation of care — the NHS calls exercise "one of the most important treatments for people with osteoarthritis, whatever your age or level of fitness." When medication is added, it's for pain relief on top of that foundation, not instead of it. For pain in the knees or hands, the NHS suggests trying a topical NSAID (such as diclofenac gel — now sold over the counter in the US as Voltaren Arthritis Pain) before oral tablets, because it works locally with less whole-body exposure. Oral options — acetaminophen (which the NHS notes often helps only modestly and is usually reserved for when you can't take other medicines) and NSAIDs like ibuprofen or naproxen — can ease pain, but NSAIDs carry real stomach, kidney, and heart cautions, and prescription options (stronger NSAIDs, the antidepressant duloxetine for ongoing pain, and steroid joint injections) are decisions a clinician makes with you. Glucosamine and chondroitin supplements are popular, but the evidence that they meaningfully help is weak — see our supplement guide before spending money on them.
For options we rate, we show our independent FDA recall-safety rating(0–100) — a signal GoodRx and Drugs.com don’t provide. Higher is safer.
Available without a prescription — follow each label.
Voltaren Arthritis Pain NSAID (topical) Our rating 72/100 | A gel rubbed onto the painful joint, now available over the counter in the US at 1% strength. It's often a sensible first choice for osteoarthritis of the knees or hands because it eases pain and inflammation locally with less whole-body exposure than NSAID pills; MedlinePlus lists nonprescription diclofenac gel for arthritis pain in joints close to the skin's surface (knees, ankles, feet, elbows, wrists, hands). Wash hands after applying, and don't combine it with oral NSAIDs unless a clinician says so. |
Tylenol Analgesic (non-NSAID pain reliever) Our rating 70/100 | An oral pain reliever that's gentler on the stomach than NSAIDs, so it's an option if you can't take them — the NHS notes it's usually only tried when you can't take other medicines. Be realistic about it: many people find it doesn't relieve osteoarthritis pain very well. Stay within the daily limit on the Drug Facts label because too much acetaminophen can damage the liver, and count it in any combination cold or pain products you also take. |
A doctor may prescribe these — not for self-treatment.
Celebrex NSAID (COX-2 inhibitor) Our rating 56/100 | A prescription NSAID (MedlinePlus classifies it as a COX-2 inhibitor) used to relieve the pain, tenderness, swelling, and stiffness of osteoarthritis. A clinician may choose it or another prescription-strength NSAID — higher-dose ibuprofen or naproxen, diclofenac, or meloxicam — frequently paired with a stomach-protecting proton pump inhibitor. Like all NSAIDs it carries FDA warnings about heart attack, stroke, and serious stomach bleeding, plus kidney cautions; the doctor weighs these and decides the drug and dose. |
Cymbalta SNRI (serotonin-norepinephrine reuptake inhibitor) | An antidepressant that MedlinePlus also lists for ongoing bone or muscle pain; it's prescribed for some people with chronic osteoarthritis pain, acting on the body's pain-signaling pathways rather than on the joint itself. A clinician may consider it when NSAIDs aren't enough or aren't suitable. It is started and stopped gradually under medical supervision and is not a take-as-needed painkiller. |
Kenalog Corticosteroid (joint injection) | A steroid injected directly into the affected joint by a clinician to calm inflammation and pain. The NHS notes injections work quickly and can ease pain for several weeks or months, and are used when other treatments haven't worked; relief is temporary and the number of injections into a single joint is limited over time. Whether and when to inject is a clinician's decision based on the joint and your overall health. |
There's no single "best" osteoarthritis drug, and clinicians generally build treatment from the ground up rather than starting with the strongest medicine. The foundation — physical activity, weight management if needed, and physiotherapy — comes first and continues no matter what else is added, because health authorities agree it's the part that most changes how the condition progresses, not just the pain. For medication, the NHS describes a stepwise approach: a topical NSAID (such as diclofenac gel) is often tried first for knee or hand osteoarthritis, with oral NSAID tablets used if topical treatment isn't easing the pain; acetaminophen is usually reserved for when you can't take other medicines and often helps only modestly. Which NSAID — and whether one is safe for you at all — depends on your other conditions and medicines: a clinician weighs any stomach-ulcer history, asthma, kidney function, blood pressure, heart disease or past stroke, and blood thinners, and usually pairs an oral NSAID with a stomach-protecting proton pump inhibitor. If NSAIDs are unsuitable or insufficient, a doctor may consider duloxetine for ongoing pain or a steroid injection into the joint for temporary relief; the choice hinges on which joints are affected, how severe the pain is, and your overall health. On supplements: glucosamine and chondroitin are sold widely for joint health, but the evidence they meaningfully help osteoarthritis is weak — talk to a clinician or pharmacist before spending on them, and see our supplement guide. None of the prescription options are do-it-yourself decisions; the point of knowing them is to have a better-informed conversation with your clinician.
See a doctor if joint pain, stiffness, or swelling is limiting your daily activities, getting steadily worse, waking you at night, or not improving with self-care and over-the-counter treatment — a clinician can confirm osteoarthritis (versus another type of arthritis) and tailor a plan. Seek prompt medical care for a joint that is hot, red, and swollen with fever (which can signal infection or an inflammatory arthritis rather than osteoarthritis), for sudden severe pain or a joint that locks or gives way, or after a significant injury. Stop and get urgent care if warning signs appear while taking NSAIDs: black or bloody stools, vomiting blood, severe stomach pain, or signs of a heart attack or stroke such as chest pain, shortness of breath, weakness on one side, or trouble speaking — the FDA warns NSAIDs can raise these risks. Always check with a pharmacist or doctor before starting an NSAID if you have a stomach ulcer, kidney disease, heart failure, high blood pressure, asthma, or take blood thinners, and never combine multiple oral NSAIDs.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
| An oral anti-inflammatory that relieves osteoarthritis pain and swelling. Take it with food and use the lowest dose that works for the shortest time needed. NSAIDs aren't suitable for everyone — the NHS flags caution with stomach ulcers, asthma, angina, or a past heart attack or stroke — so check with a pharmacist if you're unsure. |
Aleve NSAID (oral) Our rating 70/100 | A longer-acting oral NSAID for osteoarthritis pain and inflammation; a dose lasts longer than ibuprofen. The same NSAID cautions apply (stomach, kidney, heart), take it with food, and never combine two different oral NSAIDs. Ask a pharmacist first if you take blood thinners or have heart or kidney problems. |
capsaicin (topical cream) Capzasin, Zostrix Topical analgesic (from chili peppers) | A cream made from the compound that makes chili peppers hot. The NHS lists it as an option for hand or knee osteoarthritis when topical NSAIDs haven't helped or aren't suitable. It's rubbed into the joint a few times a day and commonly causes a burning or stinging feeling at first; wash hands well after use and keep it away from eyes and broken skin. |