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Senior Correspondent

Q. My doctor said I need to reduce my reliance on pain relievers to manage my osteoarthritis pain because of the risk of side effects. Is there another option?
As we age, many of us develop chronic health ailments, such as osteoarthritis (OA), the most common form of arthritis. In fact, 27 million Americans suffer every day from the discomfort and stiffness caused by OA, according to the Centers for Disease Control and Prevention (CDC).

You get osteoarthritis when cartilage—the  cushioning tissue within the joints—wears down. This produces stiffness and pain. The disease affects both men and women. By age 65, more than 50 percent of us have osteoarthritis in at least one joint.

You can get osteoarthritis in any joint, but it usually strikes those that support weight. Common signs of osteoarthritis include joint pain, swelling, and tenderness. However, only a third of people whose x-rays show osteoarthritis report any symptoms.

Treatments for osteoarthritis include exercise, joint care, dieting, medicines and surgery. For pain relief, doctors usually start with acetaminophen, the medicine in Tylenol, because the side effects are minimal if taken according to instructions. If acetaminophen does not relieve pain, then non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen may be used. Opiods (narcotics) are prescribed, too.

An alternative to drugs is a “medical food.”

The term medical food, as defined in the Orphan Drug Act is "a food which is formulated to be consumed or administered enterally (through digestion) under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation."

Medical foods are not required to undergo premarket review or approval by FDA. They are exempted from the labeling requirements for health claims and nutrient content claims under the Nutrition Labeling and Education Act of 1990.

Manufacturers of medical foods must comply with all applicable FDA requirements for foods. The labeling of medical foods must contain: a statement of identity, an accurate statement of the net quantity of contents, the name and place of business of the manufacturer, packer, or distributor, and a complete list of ingredients. 

Prescription medical foods can be a safer option for managing the underlying cause of a disease such as OA. Like pharmaceuticals, medical foods require physician supervision. However, unlike synthetic prescription drugs, they use highly-purified, concentrated natural ingredients found in foods such as green tea, dark chocolate, fruits and vegetables.  

Long-term use of NSAIDs and opioids can have dangerous side effects; especially, for those who also suffer from kidney, stomach or heart conditions. Prescription opioid use — and resulting deaths — have quadrupled over the last 20 years. Opioids carry additional risks for older adults such as heart problems, addiction, falls and other accidents caused by extreme drowsiness.

Your doctor can work with you to create a personalized plan for managing OA that may include positive lifestyle changes, such as proper diet, exercise, and rest; and a prescription medical food. Limbrel, for example, is a prescription medical food available and indicated for the long-term dietary management of chronic joint discomfort caused by OA.

Physicians use prescription medical foods to treat a variety of conditions in dermatology, obstetrics/gynecology, orthopedics, pain management, podiatry, rheumatology, and vascular health.

Some of the other medical foods are Axona for Alzheimer's disease, Banatrol Plus for diarrhea, Deplin for depression, Fosteum for osteoporosis, Metanx for diabetic neuropathy, and Theramine for myalgia.

Talk with your doctor for more information about prescription medical foods and to find out if they are right for you.

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