Anti-inflammatories decrease irritation in tissues. They range from powerful steroid medications to non-steroidal anti-inflammatory drugs (NSAIDS -- pronouced EN-seds). There are a wide variety of prescription NSAIDS and over-the-counter NSAIDS like ibuprofen, naproxen sodium, and ketoprofen. The over-the-counter medications usually need to be taken at relatively high doses to effectively suppress inflammations. In fact, until they’re taken for several days to build up their levels in the blood, most of the effect of the medication is analgesic and not anti-inflammatory.
Salicylates are a subcategory of NSAIDs, but because they have some unique side effects they are considered separately. Aspirin, known for its anti-clotting properties and tendency to cause stomach irritation, is the most commonly used salicylate.
Cyclooxygenase-2 (COX-2) inhibitors, like valdecoxib (Bextra), rofecoxib (Vioxx), and celecoxib (Celebrex), are a new subset of NSAIDs. They appear to be more stomach-friendly than the traditional medications.
Analgesics, like acetaminophen, dampen pain but do not actually treat the site of the injury. These drugs may be narcotic or non-narcotic based and are prescribed based on severity of pain experienced.
Topical analgesics work well for mild muscular and rheumatic pain, fibrositis (pain from damaged tendons or musles), lumbago (discomfort in the area of the lower back), sprains, strains, bruises and stiffness. These creams, gels, salves and ointments are rubbed directly on the painful area and generally work only where they are applied. They work in a variety of ways – some include a local anaesthetic that numbs the area, some create a feeling of cold or heat and some are absorbed through the skin to inhibit pain and inflammation.
Muscle relaxants loosen the tension of muscle tissue due to spasming and cramping. With a severe muscle spasming, even a mild muscle relaxant will be more effective in pain relief than narcotic analgesics.
Disease modifying anti-rheumatic drugs (DMARDs) can slow down the disease process in inflammatory arthritis and delay joint damage. However, many of these drugs can cause serious side effects.
Antidepressants may offer relief from chronic and nerve related pain. These medications are generally used in an off-label way (prescribing a drug intended for one disorder for another disorder). These drugs may help by blocking pain messages to the brain or by enhancing the body's natural painkillers (endorphins).
Bisphosphonates suppress or reduce bone breakdown. Used to relieve pain and slow the progress of osteoporosis, Paget's disease, non-malignant bone disorders like osteogenesis imperfecta, fibrous dysplasia, and primary hyperparathyroidism and metastatic cancer to bone.
Glucocorticoids (also called corticosteroids), like prednisone, control inflammation. They also suppress the immune system, which may be overactive in people with rheumatoid arthritis. However, these drugs can have serious side effects with long- term use.
Antibiotics are used to treat bone or joint infections. Depending on the type and severity of the infection, intravenous antibiotics may be given first, followed by a course of oral antibiotics for several weeks or longer.
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