Understanding Over-the-Counter Pain Management

There are times when life with arthritis feels more like a trip to a shabby little haunted house than I'd like to admit. You know the kind I mean. They might have a maze made from hay bales or corn, and people dress up like monsters and jump out to scare you? I'm not a fan of that kind of thing, but we can certainly agree that pain is scary. It likes to pop up, invading our lives at the worst possible times.

We might find ourselves standing in the maze all alone just when we need help the most. Pain and fatigue are about even in my book for being the worst physical aspects of having arthritis. My pain, stiffness, and fatigue alternate in severity, but it was the nagging, gnawing, clawing, grinding nature of spondyloarthritis pain that scared me enough to see a rheumatologist.

Seeking pain care is anything but easy

The bad news about pain is that this moment in medical history is particularly ill-suited to meet our community's needs. Bad is about 1% of the down payment on the hellscape awaiting providers, patients, and the people who love them. A particularly foul brew of unhelpful politics, guidelines, and cultural stigmas and hostilities pervade every aspect of seeking pain care. This toxicity forces many patients out of medical settings and into the retail world of medications, home devices, extreme diets, and unregulated supplements.

It might be worth discussing the situation with especially close trusted friends or family.

Respect acetaminophen

Stay mindful of the amount of acetaminophen you’re taking and stay within the safe zone. The FDA revised its guidelines around the use of acetaminophen when it became clear that even small dosing errors can cause liver injury, and that taking more than needed does not have any additional clinical benefits.

Where is acetaminophen found?

Um, it's basically everywhere. It's used alone for fever and pain, but it also pops up in compound drugs used for headache, cold and flu, sinus complaints, hangovers, and digestive ailments. It's recently been added to new OTC arthritis treatments alongside NSAIDs.

Don't go it alone

Be sure to inform your health care providers if you are using medications, home devices, restricted diets, or supplements to prevent or treat your pain. Complete forms before your visits or make entries in your health system's portal to keep things current. Work with them to determine if any additional tests or cautions are warranted.

Be prepared to explain what you're doing with OTC meds when you go in for procedures and in an emergency. Wallet cards, thumb drives, and medical alert jewelry can help.

The takeaway: widespread use acetaminophen raises the risk of liver injury for chronic pain patients. As in, you might need a new liver or major changes to other aspects of your care plan because your liver can't handle those medications anymore.

I found this Mayo Clinic article on arthritis pain very helpful. The nuanced take on finding the right amount of treatment and knowing our limits is constructive. It also mentions the appropriate role of OTC treatments and medications, lifestyle, and mindset.