What Is the Best Prescription Medicine for Arthritis Pain? A Comprehensive Analysis

October 6, 2025 •

4 min read

In 2022, an estimated 18.9% of U.S. adults had diagnosed arthritis, a condition where managing discomfort is crucial [1.2.1]. Determining what is the best prescription medicine for arthritis pain depends on the type of arthritis, its severity, and individual patient factors.

Quick Summary

The most effective arthritis medication is different for each person [1.3.4]. Treatment options include NSAIDs, corticosteroids, DMARDs, and biologics, each with specific uses for either osteoarthritis or inflammatory arthritis like RA.

Key Points

No Single 'Best' Medicine: The most effective medication depends on the arthritis type (OA vs. RA), severity, and the individual patient [1.3.4].
NSAIDs for Symptom Relief: Prescription NSAIDs like celecoxib and diclofenac reduce pain and inflammation but don't slow disease progression [1.4.1].
Corticosteroids for Flares: Powerful drugs like prednisone provide rapid, short-term relief from severe inflammation but have significant side effects with long-term use [1.6.6].
DMARDs Slow the Disease: For inflammatory arthritis like RA, DMARDs (Methotrexate, Humira) are essential to slow down joint damage [1.4.1].
Targeted Therapies: Biologics and JAK inhibitors are advanced DMARDs that target specific parts of the immune system when conventional treatments are insufficient [1.7.1].
Consult a Professional: Choosing an arthritis medication requires a doctor's evaluation to balance effectiveness with potential risks like infection or heart problems [1.7.1].
Treatment Goals: The aim of prescription medication is to alleviate pain, reduce inflammation, improve function, and, in inflammatory arthritis, prevent long-term joint damage [1.2.2, 1.4.1].

Understanding Arthritis and Pain Management

Arthritis encompasses over 100 conditions that affect joints and surrounding tissues, with osteoarthritis (OA) and rheumatoid arthritis (RA) being the most common [1.2.2]. OA is a degenerative disease caused by wear and tear, while RA is an autoimmune disorder where the body's immune system attacks the joints [1.2.2, 1.4.1]. An estimated 53.2 million adults in the U.S. reported a diagnosis of arthritis between 2019 and 2021 [1.2.6]. The primary goal of treatment is to reduce pain, control inflammation, and slow disease progression [1.4.1]. Finding the "best" prescription medicine is not a one-size-fits-all solution; it requires a careful diagnosis and a treatment plan tailored by a healthcare professional [1.3.4].

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Prescription-strength NSAIDs are a cornerstone for managing arthritis pain and inflammation. They work by blocking cyclooxygenase (COX) enzymes, which produce prostaglandins—chemicals that cause inflammation and pain [1.3.4].

Examples: Celecoxib (Celebrex), Diclofenac (Voltaren), Meloxicam (Mobic), and prescription-strength Ibuprofen [1.4.2].
Best For: Both OA and RA for pain and inflammation relief [1.3.4, 1.4.1]. Celecoxib, a COX-2 inhibitor, is designed to have fewer stomach-related side effects [1.5.1]. Topical NSAIDs like Diclofenac gel are effective for localized pain, especially in the knees and hands, with lower systemic risk [1.3.4].
Considerations: Long-term use of oral NSAIDs can increase the risk of stomach ulcers, heart problems, and kidney damage [1.7.1]. Your doctor may prescribe a proton pump inhibitor (PPI) to protect the stomach lining [1.5.2].

Corticosteroids

Corticosteroids are powerful anti-inflammatory agents that mimic the body's natural hormone, cortisol [1.6.1]. They are highly effective at providing rapid relief from severe pain and inflammation.

Examples: Prednisone, Methylprednisolone (Medrol) [1.6.2].
Administration: They can be taken as oral pills or injected directly into an affected joint (intra-articular injection) for localized relief [1.6.4, 1.4.1].
Best For: Short-term control of severe flare-ups in RA and other inflammatory arthritis types. They act quickly while waiting for slower-acting drugs like DMARDs to take effect [1.6.6].
Considerations: Due to significant side effects like bone thinning (osteoporosis), weight gain, diabetes, and increased infection risk, corticosteroids are typically used at the lowest effective dose for the shortest possible time [1.6.2, 1.7.1].

Disease-Modifying Antirheumatic Drugs (DMARDs)

DMARDs are specifically for inflammatory types of arthritis like RA. Unlike NSAIDs and corticosteroids that only treat symptoms, DMARDs work to slow or stop the underlying disease progression, preventing permanent joint damage [1.4.1]. There are three main sub-classes.

Conventional Synthetic DMARDs (csDMARDs): These are often the first-line treatment once RA is diagnosed [1.7.1]. Methotrexate is the most common and is considered a cornerstone of RA therapy [1.6.3]. Other examples include Leflunomide (Arava), Hydroxychloroquine (Plaquenil), and Sulfasalazine (Azulfidine) [1.4.2].
Biologic DMARDs (bDMARDs): Biologics are complex proteins derived from living cells that target specific parts of the immune system responsible for inflammation [1.8.3, 1.8.2]. They are often prescribed when csDMARDs are not effective enough [1.8.3]. Examples include TNF inhibitors like Adalimumab (Humira) and Etanercept (Enbrel), and other types like Abatacept (Orencia) and Rituximab (Rituxan) [1.7.1, 1.4.4]. They are given by injection or intravenous (IV) infusion [1.8.2].
Targeted Synthetic DMARDs (tsDMARDs): This is a newer class of small-molecule drugs taken orally [1.9.2]. Known as Janus kinase (JAK) inhibitors, they work by blocking specific signaling pathways within immune cells to calm inflammation [1.9.3, 1.9.5]. Examples include Tofacitinib (Xeljanz), Baricitinib (Olumiant), and Upadacitinib (Rinvoq) [1.7.1].

Comparison of Arthritis Medications


Medication Class	Examples	How it Works	Primary Use	Common Side Effects
NSAIDs	Celecoxib, Diclofenac	Reduces pain and inflammation by blocking COX enzymes [1.3.4].	Symptom relief in OA and RA [1.3.4].	Stomach irritation, heart and kidney risks [1.7.1].
Corticosteroids	Prednisone	Potent anti-inflammatory and immune suppression [1.6.1].	Short-term relief of severe flares [1.5.2].	Weight gain, osteoporosis, diabetes, infection risk [1.6.2].
csDMARDs	Methotrexate, Leflunomide	Suppresses the overactive immune system to slow disease [1.7.3].	Slowing progression of inflammatory arthritis (RA) [1.4.1].	Liver damage, lung infections, stomach upset [1.7.1, 1.7.3].
Biologic DMARDs	Adalimumab (Humira)	Targets specific inflammatory proteins like TNF [1.8.4].	RA not responsive to csDMARDs [1.8.3].	Increased risk of serious infections, injection site reactions [1.7.1].
JAK Inhibitors	Tofacitinib (Xeljanz)	Blocks specific inflammation signaling pathways inside cells [1.9.3].	RA not responsive to other DMARDs [1.7.1].	Increased risk of infections, blood clots, heart-related events [1.7.1, 1.9.4].

Conclusion: Partnering with Your Doctor

There is no single "best" prescription medicine for all arthritis pain. The most effective treatment depends on an accurate diagnosis, the type and severity of arthritis, your overall health, and potential side effects [1.3.4]. For OA, treatment often starts with NSAIDs, while for RA, early use of DMARDs is crucial to prevent joint destruction [1.7.1]. Biologics and JAK inhibitors offer powerful, targeted options for those with moderate to severe RA who haven't found relief with conventional DMARDs [1.9.3]. The decision on which medication to use is complex and must be made in consultation with a rheumatologist or healthcare provider who can weigh the benefits against the risks for your specific situation.

For more information, a valuable resource is the Arthritis Foundation.

Frequently Asked Questions

OA treatment primarily focuses on managing pain and symptoms with medications like NSAIDs [1.3.4]. RA treatment requires medications called DMARDs, which not only relieve symptoms but also suppress the immune system to slow or stop the disease from causing permanent joint damage [1.4.1].

Prescription NSAIDs are available at higher strengths than their over-the-counter counterparts [1.5.6]. A doctor may prescribe them when OTC versions are not sufficient to control pain and inflammation [1.4.2].

Conventional DMARDs like methotrexate can take several weeks or even months to become fully effective [1.7.3, 1.7.4]. This is why doctors may prescribe fast-acting corticosteroids to manage symptoms in the meantime [1.5.2].

Biologics are a class of DMARDs made from living cells that target specific inflammatory proteins in the immune system [1.8.3, 1.8.2]. They are typically used for moderate to severe RA when conventional DMARDs haven't worked well enough and are administered by injection or IV infusion [1.8.3].

JAK inhibitors, such as tofacitinib (Xeljanz), are a newer class of targeted synthetic DMARDs that come in pill form [1.9.2, 1.9.3]. They work inside immune cells to block signals that cause inflammation and are an option if DMARDs or biologics have not been effective [1.7.1].

Long-term use of corticosteroids like prednisone can cause serious side effects, including osteoporosis (bone thinning), weight gain, high blood pressure, diabetes, and an increased risk of infection [1.6.2, 1.7.1]. They are used for short-term flare control whenever possible.

Yes, combination therapy is common. For example, a biologic drug is often used together with methotrexate for better results in RA [1.7.1]. However, you generally should not take two different biologic therapies at the same time [1.8.3]. Always follow your doctor's guidance.