What medications are used to support joint health?

From the Guidelines

For joint health, I strongly recommend starting with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) to reduce inflammation and pain, as supported by the most recent and highest quality study 1.

Medication Options

• NSAIDs: ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) to reduce inflammation and pain
• Acetaminophen (500-1000mg up to four times daily) for pain relief without anti-inflammatory effects
• Topical options: diclofenac gel (apply to affected joints 2-4 times daily) or capsaicin cream (apply 3-4 times daily)
• Prescription medications: celecoxib (100-200mg daily) for more severe joint issues
• Supplements: glucosamine (1500mg daily) and chondroitin (800-1200mg daily) may help maintain cartilage, though evidence is mixed

Important Considerations

• Always take NSAIDs with food to protect your stomach
• Stay within recommended dosages
• Consult a healthcare provider before starting any regimen, especially if you have other health conditions or take other medications
• Intra-articular corticosteroid injections may be considered for acute exacerbation of knee pain, especially if accompanied by effusion, as recommended by 1

Additional Recommendations

• Use validated disease activity measures to facilitate treat-to-target, as suggested by 1
• Consider physical therapy and/or occupational therapy for children and adolescents with JIA and polyarthritis, as conditionally recommended by 1
• For inflammatory arthritis, consider analgesics, NSAIDs, and prednisone, and conduct serial rheumatologic examinations, as recommended by 1

From the FDA Drug Label

Naproxen has been studied in patients with rheumatoid arthritis, osteoarthritis, juvenile arthritis, ankylosing spondylitis, tendonitis and bursitis, and acute gout Improvement in patients treated for rheumatoid arthritis was demonstrated by a reduction in joint swelling, a reduction in duration of morning stiffness, a reduction in disease activity as assessed by both the investigator and patient, and by increased mobility as demonstrated by a reduction in walking time In patients with osteoarthritis, the therapeutic action of naproxen has been shown by a reduction in joint pain or tenderness, an increase in range of motion in knee joints, increased mobility as demonstrated by a reduction in walking time, and improvement in capacity to perform activities of daily living impaired by the disease

Naproxen is a medication that can be used for joint health, specifically for conditions such as:

• Rheumatoid arthritis: to reduce joint swelling, morning stiffness, and disease activity
• Osteoarthritis: to reduce joint pain or tenderness, increase range of motion, and improve mobility
• Ankylosing spondylitis: to decrease night pain, morning stiffness, and pain at rest
• Acute gout: to clear inflammatory changes and relieve pain and tenderness 2

From the Research

Medication for Joint Health

• The NIH Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) found that glucosamine and chondroitin sulfate combined provided statistically significant pain relief compared to placebo in participants with moderate-to-severe pain 3.
• A review of clinical trials on glucosamine and chondroitin for osteoarthritis management reported that these compounds have a good safety profile and may have symptomatic and structure-modifying effects 4.
• Methotrexate, a commonly used drug for rheumatoid arthritis, has been shown to have a substantial clinical and statistically significant benefit compared to placebo in short-term treatment, although its use is associated with a higher discontinuation rate due to adverse events 5.
• A network meta-analysis comparing the efficacies of oral glucosamine, chondroitin, acetaminophen, and celecoxib for knee and/or hip osteoarthritis found that celecoxib was the most effective option for pain relief, followed by the combination of glucosamine and chondroitin 6.
• A study on rats with rheumatoid arthritis found that combined treatment with glucosamine and chondroitin sulfate improved symptoms by regulating the gut microbiota, inhibiting potential LPS-producing bacteria, and reducing inflammation 7.

Types of Medication

• Glucosamine and chondroitin sulfate: may have symptomatic and structure-modifying effects in osteoarthritis management 4, and may improve rheumatoid arthritis symptoms in rats by regulating the gut microbiota 7.
• Methotrexate: has a substantial clinical and statistically significant benefit compared to placebo in short-term treatment of rheumatoid arthritis, although its use is associated with a higher discontinuation rate due to adverse events 5.
• Celecoxib: is the most effective option for pain relief in knee and/or hip osteoarthritis, according to a network meta-analysis 6.
• Acetaminophen: is likely the least efficacious intervention option for knee and/or hip osteoarthritis, according to a network meta-analysis 6.