Creams
Many natural treatments for arthritis come in the form of a topical remedy.

Creams that contain capsaicin, a chemical found in red peppers, may help in easing your pain. Capsaicin is said to reduce inflammation and pain when absorbed through the skin.
Counter-irritants, another group of topical pain relievers, trick your pain receptors by producing a cold or hot feeling. These include menthol, oil of wintergreen, eucalyptus oil, and camphor.
 Salicylates are compounds commonly found in oral pain relievers, but they can also be found in cream forms. They are said to seep into the skin where they take action to relieve pain.

Glucosamine
Glucosamine and chondroitin sulfate, substances found in the synovial fluid in the knee, are sold as supplements as treatment for osteoarthritis. Some studies suggest that these supplements provide pain relief and improved function for osteoarthritis patients, however, not enough has been done to provide conclusive evidence.

As supplements, glucosamine and chondroitin sulfate are not regulated by the FDA, so purchase with care. There are a wide variety of manufacturers, but choose the product from the more well-established company over its counterpart as it is more reliable. The price for a daily dose ranges between $1 and $3.

COX 2s
In September 2004, Merck, Inc. suddently withdrew Vioxx from the world market due to findings from the VIGOR study. The FDA then convened an advisory committee that following February of 2005 on the remaining two Cox-2s, Celebrex and Bextra. They concluded unanimously that Cox-2 drugs increase the risk of heart attacks and strokes and also mandated that strong warnings about the risks be added to the drugs' labels, as well as labels for all NSAIDS. (The label changes have been made.)

Because of the benefits of the drugs (pain and inflammation relief with lowered stomach ulcer risk) felt by many people outweighed the cardiovascular risks, the majority of the advisory committee voted to keep all three drugs on the market, even the previously pulled Vioxx.

However, in April 2005, the FDA reversed its stance on Bextra and asked Pfizer Inc., its maker, to withdraw it from the market. Pfizer has since done so. Therefore, at this time, Celebrex is the only remaining Cox-2 inhibitor on the market.

Cox 2 inhibitors are a different class of NSAIDs (non-steroidal anti-inflammatories). Often referred to as "COX 2s," it includes Vioxx (rofecoxib), Celebrex (celecoxib), and Bextra (valdecoxib). In order to understand the advantages of COX 2s, it is important to learn about NSAIDS.

The most widely used medications by arthritis patients, NSAIDS are used to relieve pain and reduce inflammation. NSAIDs work by blocking the production of prostaglandins, chemicals in the body that contribute to pain. Traditional NSAIDs, however, do not differentiate between good and bad prostaglandins, and therefore block the production of each.

COX 2s are just as effective with pain relief as the other NSAIDs, however, they have the ability to distinguish between the bad prostaglandins from the good. For this reason, they do not generally upset the stomach like the traditional NSAIDs.

Though COX 2s are more gentle on the stomach than other NSAIDS, ulcers are still a possible side effect with these drugs. In addition, COX 2s do not provide the protection against heart attack and stroke afforded by aspirin and other NSAIDs, which thin the blood.

Viscosupplementation
A relatively new form of arthritis treatment, hyaluronic acid therapy is often used when other conservative treatment methods have failed and use of corticosteroids would like to be put off. Through viscosupplementation, or the use of hyaluronic acid to supplement the joint fluid, this treatment aims at restoring elasticity of the fluid in the joint. A healthy knee contains synovial fluid in the joint capsule. One important ingredient of synovial fluid is hyaluronic acid, a natural substance that lubricates the joint. With age, however, the synovial fluid tends to lose some of its elasticity, resulting in pain as its lubricating and cushioning effects are lost.

Hyaluronic acid treatments are designed to replace some of this lost elasticity in the joint fluid. Three name brand drugs, Synvisc, Supartz, and Hyalgan, are derived from the hyaluronic acid found in synovial fluid in rooster combs while Euflexxa is the first bioengineered (fermentation-derived) hyaluronic acid on the market.

In all cases, the hyaluronic acid treatment is injected into the joint space to improve lubrication in osteoarthritic joints. Most treatments involve three to five injections, with about one injection per week. The treatment is less likely to work with fewer injections. While hyaluronic acid treatments can provide effective pain relief for months, it does not necessarily work for everyone. One common side effect of viscosupplementation is joint effusion, or the swelling of the joint due to excess fluid in the joint capsule.

Total Joint Replacement
When other treatment methods have failed, many patients turn to surgery to relieve their pain. One common type of surgery is a total joint replacement. While it is most common in the hip and knee, it is available on other joints including the ankle, foot, shoulder, elbow and fingers.

In a total joint replacement, the osteoarthritic joint is replaced with an artificial joint, or prosthesis. In the knee, for example, the ends of the femur (thigh bone) and tibia (shin bone) are replaced with metal pieces shaped like the healthy bone. A plastic disk that acts like the cartilage is inserted between the two to aid smooth movement between the metal pieces.

In a socket joint, such as the hip, a metal shaft with a ball is inserted into the top of the femur, or thigh bone, and a metal cup is put in the hip socket. Again, a plastic lining is added into the cup to act like cartilage and allow for smooth movement between the metal surfaces.

While surgery can prove to be effective in relieving your pain, it is by no means an easy process. Especially with the weight-bearing joints of the hip and knee, a total joint replacement requires a long recovery period and a good deal of support during rehabilitation.