What pain relievers work best for arthritis?

My husband, age 70, had been diagnosed with osteoarthritis in his neck, for which he would take Aleve to relieve his discomfort. Just before Christmas, his back began hurting so much that he went to his doctor, who said to get up and move more.

My husband then added ibuprofen to the Aleve he was already using. His doctor said that the pain is due to osteoarthritis in his mid back area. Apparently, there is nothing to do for it but take Extra Strength Tylenol at the recommended dose. Ibuprofen or Aleve isn’t recommended because it causes liver and kidney damage. So, we bought Tylenol, and he used this medication instead of his usual. But his pain only got worse.

So, this morning, he switched back to Aleve and ibuprofen. It is what helped before and is helping again now. In addition, he is using a drug-free Aleve Direct Therapy pad that uses waveform technology. He also uses an Icy Hot pain relief cream and a heating pad. These reduce his pain, but his back continues to hurt.

Should he use Aleve and ibuprofen instead of the Tylenol? He has used Aleve for a long time. He just had his blood tested, and the doctor said his liver and kidneys are good. Is there anything more we can do to relieve his pain?

S.F.A. Osteoarthritis in the neck is a common and painful condition, and there are not always good treatment options.

Anti-inflammatory medicines, like Aleve or ibuprofen, can be helpful for some people. However, taking both doesn’t improve pain relief; it does increase the risk of toxicity, so he should never take two anti-inflammatory medicines — choose just one. Tylenol helps some people, but most people do better with antiinflammatories. Tylenol does have a smaller risk of sideeffects.

In addition to liver and kidney problems, Aleve and similar medicines can cause stomach problems, ranging from mild upset to life-threatening ulcers; though this is uncommon with over-the-counter doses. I often recommend a trial of Tylenol to see if it is as good as the anti-inflammatories. Since it’s not for your husband, he should tell his doctor this, and it seems reasonable for him to go back to taking Aleve. However, I can’t tell you to disregard his physician’s advice. Some people benefit from Tylenol on top of Aleve.

The Aleve Direct Therapy pad uses electricity to relieve pain without meds. It’s fine to combine it with medicines.

In severe cases, injections can be used before considering surgery.