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I'm starting to be bothered by my knee arthritis more and more. Up until now, I've been able to manage with just Tylenol. Should I bump up the dosage on my Tylenol or switch to ibuprofen?

All drugs come with benefits and possible side effects or adverse events. For anyone suffering joint pain from osteoarthritis, acetaminophen (i.e., Tylenol) can be an effective pain reliever. There are no acidic components like with aspirin and no antiinflammatory effects, so it's used for pain control. When inflammation and swelling develop, nonsteroidal antiinflammatory drugs are often used. Reducing pain from inflammation helps improve function and quality of life. But since osteoarthritis is a chronic condition, that can mean taking these medications for a very long time. And that increases the risk of problems or complications. One way around this is with the use of topical (lotions or gels applied to the skin) NSAID formulations. One topical NSAID in particular may be helpful for those people who have mild to moderate knee arthritis. Diclofenac in a topical form has been shown just as effective as the oral form but without the adverse side effects (e.g., nausea, gastrointestinal bleeding). Joint stiffness does not seem to be affected by topical diclofenac, but some other topical antiinflammatory may work better. Before doing anything else, it's always best to check with your primary care physician or orthopedic surgeon for his or her recommendations. Your age, general health, past medical history, and the use of other medications for other health problems are all important factors in how you approach your arthritis. It may be necessary to complete some lab work and/or have X-rays taken to confirm the diagnosis. In any event, it's a good idea to establish a baseline for your disease. This will be invaluable information as the years go by in determining the rate of progression and best approach in treatment.

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