What is the safest pain medication? Many people with osteoarthritis have asked this question, especially after studies linked the painkillers called COX-2 inhibitors to increased heart attack risk. Some people with arthritis have switched from a COX-2 drug to other medications, including traditional nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. But although NSAIDs are effective at reducing pain and inflammation, they can cause serious gastrointestinal problems, including bleeding and ulcers.

A new report from Harvard Medical School provides detailed advice about what types of NSAIDs are most stomach-friendly, and how you can limit your risk of bleeding and ulcers. Arthritis: Keeping your Joints Healthy provides a step-by-step guide to safe use of NSAIDs if you have arthritis, based on your particular risks. People at high risk of problems include the elderly, people who have had ulcers in the past, those with rheumatoid arthritis, and those taking a blood thinner or corticosteroids in addition to arthritis medications.

In such cases, it may be wise to take a COX-2 inhibitor or to combine an NSAID with one of several stomach-protecting drugs now available. Those at lower risk - who have experienced stomach distress with NSAIDs, but no bleeding or ulcers -  may benefit from reducing the dose of the NSAID they’re taking or trying an entirely different pain reliever (such as acetaminophen). In any case, talk with your doctor before changing or combining medicines.

Arthritis: Keeping your Joints Healthy is a 48-page report edited by Robert Shmerling, M.D., associate professor of medicine at Harvard. The report also includes information on:
• new medications for rheumatoid arthritis that work by dampening the immune system response
• the latest evidence about glucosamine and chondroitin, and why these supplements may be useful
• how exercise and weight loss help.

Source: Harvard Health Publications