Patients with arthritis pain now have fewer choices.  Many NSAID medications work as well as COX-2 inhibitors but may have a higher risk of ulcers when used long-term.  Tramadol (Ultram) is the strongest non-opiate pain reliever and may have some benefit for arthritis patients.

Acetaminophen (Tylenol) can relieve pain, but it does not relieve inflammation.  That won't stop the new ad campaign for Tylenol Arthritis.  Some patients with severe arthritis may take opiates, but these medications cause dependence and may have side-effects.  Ask your physician which pain medication you should take for your arthritis.

Many NSAIDs are available without a prescription.  Tramadol and opiates require prescriptions.  Tramadol is sometimes available Online, but opiates are tightly controlled and only available with a paper prescription.