People who have trouble swallowing pills (including tablets and gel-caps) may want to try specific swallowing techniques or consider alternatives to oral pain medications. Both are described below.

See Pain Medications for Arthritis Pain Relief

In This Article:

Two Techniques for Swallowing Pills

Researchers have found that these two pill-swallowing techniques help most people:

The lean-forward method

  • Place the pill on the tongue
  • Take a sip of water but do not swallow it
  • Lean the head slightly forward, bringing the chin slightly down toward the chest (do not touch the chin to the chest, as this will narrow the throat opening)
  • In this position, swallow the pill

The pop-bottle method

  • Fill a flexible plastic water or soda bottle with water
  • Place the pill on the tongue
  • Wrap lips tightly around the bottle opening (so no air escapes)
  • Keep lips pursed, tilt head back, and drink from the bottle with a sucking motion, swallowing pill right away

No air is allowed in or out of the bottle during this process, so drinking water will cause the bottle to collapse in on itself a bit. Experts recommend patients consult a physician or speech therapist before trying this method because leaning the head back may increase the risk for breathing in water directly into the lungs.

These techniques are successful for most but not all people who have trouble swallowing pills. A doctor or therapist may be able to recommend different pill-swallowing techniques that work better for certain individual patients.


Potential Alternatives to Oral Arthritis Pain Medication

Oral medications are typically the most convenient, reliable, and inexpensive way to deliver pain relief, but there are alternatives for people who have difficulty swallowing pills:

Topical joint pain medications that are absorbed through the skin. Pain relievers that are applied to the skin, such as:

Injections. Depending on the medication and the source of pain, injections may be made into a muscle, joint, or spine. For example, a person may get an injection of cortisone shot or hyaluronic acid (e.g. Synvisc, Hylagan, or Euflexxa) a few times a year rather than take oral NSAIDs each day to treat knee pain.

See Cortisone Injection Procedure and Hyaluronic Acid Injections for Knee Osteoarthritis

Joint pain medications that can be sprinkled on soft foods. The FDA has approved some pain medication capsules to be either swallowed whole or opened and the contents sprinkled on applesauce or other soft foods (consult your physician or pharmacist first). Soft foods are required because the medication must be swallowed without being chewed.


Integrative arthritis care. Massage, acupuncture, anti-inflammatory diets, and exercise are examples of pain treatments that can decrease reliance on oral medication.

See Integrative Medicine for Arthritis Pain Relief

Medical marijuana. Some states have legalized medical marijuana to treat certain conditions, such as rheumatoid arthritis and spinal cord injuries and diseases. Approved conditions vary by state, and medical evidence is very limited to support its use.

Nasal sprays and rectal suppositories. Drug companies have developed a few opioid medications that are administered through the nose or rectum, where they are then absorbed into the bloodstream. These medications are not common but are appropriate for some patients.

Breaking the cycle of chronic pain requires uninterrupted pain relief, so doctors and patients may need to use multiple pain-relieving strategies.

Dr. Thomas Cohn is a physiatrist at the Center for Diagnostic Imaging in Minneapolis, MN. He specializes in interventional pain medicine and has more than 30 years of experience providing non-surgical spine care.