For arthritis pain and inflammation, no class of drugs is bigger or more widely used than nonsteroidal anti-inflammatory drugs (NSAIDs, pronounced EN-saids).

Twenty traditional NSAIDs are available with a doctor's prescription, with three of those -- ibuprofen (marketed as Advil, Nuprin, Motrin, and others), naproxen sodium (sold as Aleve), and ketoprofen (marketed as Actron and Orudis) -- available over the counter. At OTC doses, NSAIDs are effective pain relievers. At prescription doses, they control inflammation as well.

A common side effect of NSAIDs is stomach irritation, which can often be reduced by changing the dosage or medication.

New NSAIDs, including celecoxib (Celebrex) and rofecoxib (Vioxx), were introduced to reduce gastrointestinal side effects and offer treatment options.

COX-2 Inhibitors: If you've had ulcers or find traditional NSAIDs hard on your stomach, your doctor may prescribe one a relatively new class of NSAIDs called the cyclooxygenase-2 (COX-2) inhibitors.

In clinical studies, COX-2 drugs were shown to be comparable to traditional NSAIDs for relieving arthritis pain and inflammation. while causing less stomach damage. Some doctors now routinely prescribe COX-2s to their arthritis patients.

Three COX-2 drugs are approved for arthritis treatment.

Salicylates: Despite the numerous new NSAIDs, many people still turn to the original: aspirin, which has been marketed in its present form for more than a century. This salicylate medication is a powerful reliever of pain and inflammation, but to effectively control arthritis, it must be taken in large, continuous doses. If you are taking aspirin more than occasionally, you will want to discuss with your doctor the right dosage to guard against serious side effects.

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