Prescription medications for arthritis

By Dr Christopher M. Phoon

MBBS BSc(Med) FRACS(Orth) FAOrthA

Orthopaedic Surgeon, Queenstown Joint Clinic

Painkillers for Arthritis: What Really Helps (and What to Avoid)

Start with Non-Medication Management

The best treatment for arthritis often doesn’t come from a bottle.Simple, consistent habits can reduce pain and keep joints moving well:

• Use heat packs to relax muscles and ease stiffness

• Modify activities to avoid overloading sore joints

• Strengthen supporting muscles to improve joint stability

• Allow for rest and recovery after exertion

You can find more practical information about non-operative strategies here:

👉 Non-Surgical Arthritis Treatment – Queenstown Joint Clinic

When Painkillers Are Needed

If symptoms remain difficult despite these measures, a few simple painkillers can be used safely in the long term.

• Paracetamol is usually the first choice.The typical adult maximum is two tablets, four times daily.

• Anti-inflammatories such as over-the-counter ibuprofen can be very effective, but check with your doctor first if you have stomach, kidney, or heart issues.

If you consistently need more than this to control pain, it may be time to discuss surgical options or further evaluation.

Why Strong Painkillers Are Not the Answer

Arthritis is a long-term condition, and strong painkillers — particularly opioids — are not suitable for chronic use. Tolerance and dependence develop quickly, meaning doses must increase for the same effect, while side-effects accumulate.

If you need long-term opioids to function, you may be better served by reviewing your joint for definitive surgical treatment rather than escalating medication.

Short-Term or Occasional Use

In short-term flare-ups, or after surgery, stronger medications can play a role when supervised properly:

• Codeine combinations – available only by prescription; best reserved for short use (e.g., before bed or after acute flare-ups).

• Narcotics (morphine, oxycodone, fentanyl) – effective for post-operative pain but should never be used long-term for arthritis. Always have one prescriber — your regular GP — to avoid complications and duplication.

• Atypical opioids (tramadol, tapentadol/Palexia) – useful if standard opioids aren’t tolerated, but they can interact with antidepressants and other medications.

• Pain-modulating agents such as gabapentin, pregabalin, or amitriptyline – work by reducing nerve sensitivity rather than blocking pain directly.

All of these should be discussed with your GP or pharmacist, who can tailor a plan to your medical history and other medications.

Key Takeaway

• Start with non-medication approaches — they work best and carry no long-term risk.

• Use paracetamol and occasional anti-inflammatories as first-line medication.

• Avoid long-term strong opioids for arthritis.

• Always have one GP coordinating your prescriptions.

• If pain is uncontrolled despite these steps, surgical consultation may be appropriate.