NSAIDS, DMARDs, Corticosteroids: What’s the Difference?

March 2, 2017

If you’ve experienced stiffness or pain in your hands, knees or other joints, you may have wondered whether you have arthritis — if so, you’re not alone. The Arthritis Foundation estimates that 54 million adults in the United States suffer from arthritis.

If you have pain and stiffness in your joints, you owe it to yourself to see a doctor before you reach for an over-the-counter arthritis drug. Early treatment with the appropriate type of arthritis medication can help preserve joints and halt progression of the condition.

The Type of Arthritis You Have Makes a Difference

The Arthritis Foundation has identified more than 100 different types of arthritis and related conditions that affect people of all ages. While there is no cure, there are plenty of medications that can help with symptoms.

Many types of arthritis may stem from a combination of viruses, toxins and genetic factors. Among the 100 types of arthritis, the Arthritis Foundation classifies them into four categories:

• Degenerative arthritis: Osteoarthritis is the most common type, and it stems from degeneration of the protective cartilage between bones.
• Inflammatory arthritis: When the immune system mistakenly attacks joints, it causes inflammation, swelling and damage to internal organs.
• Infectious arthritis: Infectious arthritis can be the result of inflammation caused by bacterial, viral or fungal infections, including chlamydia, gonorrhea and hepatitis C, among others.
• Metabolic arthritis: When high levels of uric acid build up, it forms needle-sharp crystals in joints. Some refer to metabolic arthritis as gout.

Types of Medications

Your doctor will want to diagnose the type of arthritis you have before recommending or prescribing medication to deal with pain and other symptoms.

The medications that may help with symptoms fall into four categories: analgesics, non-sterioidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs) and corticosteroids.

• Analgesics: Often referred to simply as pain relievers, common analgesics include acetaminophen (Tylenol), codeine, dihydrocodeine and tramadol for mild-to-moderate pain. Topical analgesics include BenGay, Aspercreme and Theragen. For severe pain, your doctor might prescribe powerful analgesics such as oxycodone or morphine.
• NSAIDs: Aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve and Naprosyn) are over-the-counter NSAIDs. Newer versions include COX-2 inhibitors such as Celebrex.
• DMARDs: Disease-modifying antirheumatic drugs work to suppress inflammation caused by overactive or abnormal immune responses. These drugs take effect over time and are not designed to provide immediate pain relief. Examples include methotrexate, sulfasalazine, azathioprine and cyclosporine.

Side Effects

You must consider the side effects associated with any drug used to treat arthritis pain. Side effects for analgesics and NSAIDs typically include stomach irritation such as bleeding, ulcer or nausea. Other drugs can cause kidney problems, high blood pressure, heart problems and fluid retention. Topical analgesics can sometimes create burns or blistering.

Common side effects of DMARDs include upset stomach, sore mouth, low blood cell counts, fever, infections, nausea and swollen lymph nodes, among others.

If you think you suffer from symptoms of arthritis, consult your doctor. If your doctor has already diagnosed you with a form of arthritis, it’s important to understand the type you have and get the treatment that’s right for you. Specialists at Healthcare Associates of Texas work with you to help you find the best fit. Book an appointment today.