A study published in the Annals of the Rheumatic Diseases shows that “combination treatment using ibuprofen plus acetaminophen provided better relief of chronic knee pain than acetaminophen alone.”MedPage Today reports, however, that the effect comes with the cost of increased side effects “such as decreased hemoglobin, which was likely due to GI bleeding.” MedPage Today noted that “current recommendations favor acetaminophen for the treatment of osteoarthritis, mainly because it has fewer gastrointestinal adverse effects than nonsteroidal anti-inflammatory drugs (NSAIDs)” but “NSAIDs are generally thought to be more effective pain relievers.”

Nevertheless, if you suffer from osteoarthritis and an NSAID (ibuprofen, naproxen, others) OR acetaminophen (Tylenol, others) is not effective for controlling your joint pain, you may want to discuss with your doctor alternating the two.

Here are two protocols I use in the office:

• OTC naproxen (Aleve, others), 220 to 440 mg twice a day with food (at breakfast and supper) ALONG WITH acetaminophen 1000 mg taken three times a day (mid morning, mid afternoon, and bedtime).
• OTC ibuprofen (Motrin, Advile, others), 200 to 800 mg three times a day with food (at breakfast, lunch, and supper) ALONG WITH acetaminophen 1000 mg taken three times a day (mid morning, mid afternoon, and bedtime).