What are the most effective medications for treating knee pain. How do over-the-counter and prescription options compare. What precautions should be taken when using pain relievers for knee issues. What are potential side effects of common knee pain medications.

Understanding Knee Pain: Causes and Treatment Options

Knee pain can arise from various sources, ranging from overuse and injuries to chronic conditions like arthritis. Identifying the underlying cause is crucial for determining the most appropriate treatment approach. Common causes of knee pain include:

• Overuse or repetitive stress
• Osteoarthritis or rheumatoid arthritis
• Baker’s cyst
• Joint infections
• Bursitis
• Cartilage tears
• Strains or sprains

Depending on the severity and cause of knee pain, treatment options may include over-the-counter medications, prescription drugs, or even injections. This article explores the various medication choices available for managing knee pain, their effectiveness, and important considerations for use.

Over-the-Counter Pain Relievers: NSAIDs and Acetaminophen

For mild to moderate knee pain, over-the-counter (OTC) medications are often the first line of defense. The two primary categories of OTC pain relievers for knee issues are nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are widely used for their ability to reduce inflammation and manage pain. Popular OTC NSAIDs include:

• Ibuprofen (Motrin, Advil)
• Naproxen sodium (Aleve)

These medications work by inhibiting the production of prostaglandins, which are responsible for inflammation and pain. NSAIDs can be particularly effective for knee pain associated with conditions like osteoarthritis or injuries that involve inflammation.

Acetaminophen

Acetaminophen, also known as paracetamol, is an analgesic and fever reducer that can help alleviate knee pain without targeting inflammation. Common brands include:

• Tylenol
• Panadol
• Actamin

While acetaminophen may be less effective than NSAIDs for conditions involving significant inflammation, it can be a suitable option for those who cannot tolerate NSAIDs or have certain medical conditions that preclude their use.

Dosage Guidelines for OTC Pain Relievers

Proper dosing is crucial for the safe and effective use of OTC pain medications. Here are the general guidelines for adults:

NSAID Dosage

• Ibuprofen: 800-1,200 mg per day, not exceeding 3,200 mg in 24 hours
• Naproxen sodium: Up to 1,375 mg per day

Acetaminophen Dosage

• Maximum single dose: 1,000 mg
• Maximum daily dose: 4,000 mg

Is it safe to take the maximum dosage of pain relievers regularly? While these medications can be effective when used as directed, long-term use at maximum doses may increase the risk of side effects. It’s advisable to use the lowest effective dose for the shortest duration necessary to manage pain.

Precautions and Side Effects of OTC Pain Medications

While OTC pain relievers are generally safe when used as directed, they can pose risks, especially with prolonged use or in certain populations.

NSAID Precautions

NSAIDs may increase the risk of cardiovascular events, particularly in individuals with:

• A history of heart attack or stroke
• Smoking habits
• Diabetes
• High cholesterol

Additionally, NSAIDs can cause gastrointestinal complications, including ulcers and bleeding. The risk is higher for:

• Older adults
• Those with a history of ulcers
• Frequent alcohol consumers
• People taking certain medications, such as blood thinners or oral steroids

Acetaminophen Precautions

The primary concern with acetaminophen is the potential for liver damage when taken in excessive amounts. This risk is particularly significant for individuals who:

• Consume alcohol regularly
• Have pre-existing liver conditions
• Take multiple medications containing acetaminophen

How can one minimize the risks associated with OTC pain relievers? To reduce the likelihood of adverse effects, it’s crucial to:

• Carefully read and follow dosage instructions
• Be aware of all medications you’re taking and their ingredients
• Inform your healthcare provider about your use of OTC pain relievers
• Avoid alcohol consumption while taking these medications
• Consider alternating between different types of pain relievers as recommended by a healthcare professional

Prescription Medications for Knee Pain

When OTC medications prove insufficient for managing knee pain, healthcare providers may prescribe stronger options. These can include higher-dose NSAIDs, COX-2 inhibitors, and other pain management medications.

Prescription-Strength NSAIDs

Prescription NSAIDs often come in higher doses or different formulations than their OTC counterparts. Examples include:

• High-dose ibuprofen
• High-dose naproxen
• Diclofenac (Voltaren)

COX-2 Inhibitors

COX-2 inhibitors, also known as coxibs, are a subset of NSAIDs that specifically target the COX-2 enzyme, potentially reducing gastrointestinal side effects. Examples include:

• Celecoxib (Celebrex)
• Etoricoxib

These medications can be taken orally as tablets or applied topically as gels or creams, depending on the specific product and prescription.

Dosage and Administration of Prescription Pain Relievers

Prescription pain medications typically have higher maximum daily doses compared to their OTC counterparts. However, it’s crucial to adhere strictly to the prescribed dosage. General maximum daily doses for common prescription pain relievers include:

• Ibuprofen: 2,400 mg
• Naproxen: 1,000 mg
• Naproxen sodium: 1,375 mg
• Diclofenac: 150 mg
• Celecoxib: 400 mg
• Etoricoxib: 60 mg

How do prescription pain relievers differ in their administration? While many prescription pain medications are taken orally, some, like diclofenac, are available as topical gels or patches. These topical formulations can be particularly beneficial for localized knee pain, as they deliver the medication directly to the affected area while potentially reducing systemic side effects.

Safety Considerations for Prescription Pain Medications

Prescription pain relievers, while more potent, come with additional safety considerations. Patients taking these medications should be aware of potential risks and interactions.

Risk Factors for Complications

Certain factors can increase the risk of adverse effects from prescription NSAIDs and COX-2 inhibitors:

• Frequent alcohol consumption
• Concurrent use of corticosteroids or SSRIs
• Use of blood-thinning medications
• History of gastrointestinal issues (e.g., ulcers, Crohn’s disease)
• Helicobacter pylori infection
• Advanced age (65 years or older)

Potential Side Effects

Common side effects of prescription pain medications may include:

• Gastrointestinal discomfort (indigestion, stomach pain)
• Bloating and gas
• Constipation
• Dizziness
• Increased risk of cardiovascular events

What steps can patients take to minimize risks associated with prescription pain relievers? To reduce the likelihood of complications:

• Inform your healthcare provider of all medications and supplements you’re taking
• Report any unusual symptoms or side effects promptly
• Follow dosage instructions carefully
• Consider using the medication for the shortest duration necessary
• Discuss alternative pain management strategies with your healthcare provider

Beyond Oral Medications: Alternative Treatments for Knee Pain

While oral medications are common in treating knee pain, they are not the only option available. Other treatments can be used alongside or in place of oral medications, depending on the specific condition and patient needs.

Topical Treatments

Topical NSAIDs and analgesics can be applied directly to the skin over the painful knee. These may include:

• Diclofenac gel (Voltaren)
• Capsaicin cream
• Menthol-based rubs

Topical treatments can provide localized pain relief with potentially fewer systemic side effects compared to oral medications.

Intra-articular Injections

For more severe or persistent knee pain, healthcare providers may recommend injections directly into the joint. Common types of injections include:

• Corticosteroid injections to reduce inflammation
• Hyaluronic acid injections to improve joint lubrication
• Platelet-rich plasma (PRP) injections to promote healing

How do these alternative treatments compare to oral medications in terms of effectiveness? The efficacy of these treatments can vary depending on the individual and the specific condition causing the knee pain. While some patients find significant relief from topical treatments or injections, others may require a combination of approaches for optimal pain management.

Lifestyle Modifications and Non-Pharmacological Approaches

Medication is often just one component of a comprehensive knee pain management plan. Incorporating lifestyle changes and non-pharmacological treatments can enhance the effectiveness of pain relief strategies and promote long-term joint health.

Physical Therapy and Exercise

Targeted exercises and physical therapy can help:

• Strengthen muscles supporting the knee
• Improve flexibility and range of motion
• Reduce stress on the joint

Weight Management

Maintaining a healthy weight can significantly reduce stress on the knees. Even modest weight loss can lead to noticeable improvements in knee pain, especially for individuals with osteoarthritis.

Assistive Devices

Using supportive devices can help alleviate knee pain during daily activities:

• Knee braces or sleeves
• Orthotic insoles
• Canes or walking aids

Hot and Cold Therapy

Applying heat or cold to the affected knee can provide relief:

• Heat therapy can relax muscles and increase blood flow
• Cold therapy can reduce inflammation and numb pain

How can patients integrate these non-pharmacological approaches with their medication regimen? It’s essential to work with healthcare providers to develop a comprehensive treatment plan that combines appropriate medications with lifestyle modifications and complementary therapies. This integrated approach can often lead to better pain management outcomes and improved quality of life for individuals suffering from knee pain.

When to Seek Medical Attention for Knee Pain

While many cases of knee pain can be managed with over-the-counter medications and home remedies, certain situations warrant prompt medical attention. Recognizing these signs can help prevent further complications and ensure appropriate treatment.

Red Flags for Immediate Medical Care

Seek immediate medical attention if you experience:

• Severe pain or swelling
• Inability to bear weight on the affected leg
• Visible deformity of the knee joint
• Signs of infection (fever, redness, warmth around the joint)
• Popping or clicking sounds accompanied by pain

Indications for Routine Medical Evaluation

Consider scheduling an appointment with a healthcare provider if:

• Pain persists for more than a few weeks despite home treatment
• You experience recurring knee pain
• The pain interferes with daily activities or sleep
• You notice progressive weakness or instability in the knee

How can patients differentiate between normal aches and pains and more serious knee issues? While some discomfort after physical activity or minor injuries is normal, persistent or worsening pain, especially when accompanied by swelling or limited mobility, should not be ignored. If in doubt, it’s always best to consult with a healthcare professional for proper evaluation and guidance.

By understanding the various medication options, their proper use, and when to seek additional help, individuals suffering from knee pain can make informed decisions about their treatment. Remember that effective pain management often involves a combination of approaches, and working closely with healthcare providers can help ensure the best possible outcomes.

Best medication for knee pain: Types and side effects

Several medication options are available to treat knee pain, including over-the-counter drugs, prescription options, and injections.

Knee pain can start slowly and gradually worsen over time. The medication a person takes to treat knee pain will depend on the cause and severity of the pain.

There are many potential causes of knee pain, including:

• overuse
• arthritis
• Baker’s cyst
• infection in the joint
• bursitis
• torn cartilage
• strain or sprain

This article looks at the best medication for knee pain, home remedies, prevention of knee pain, and when to contact a doctor.

People may treat mild to moderate knee pain with over-the-counter (OTC) medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.

NSAIDs relieve inflammation and help with pain management. Some types of NSAIDs are available OTC to treat mild to moderate pain.

OTC NSAIDs includeibuprofen, available under brand names such as Motrin and Advil, and naproxen sodium, available under the brand name Aleve.

Dosage

An adult can take ibuprofen at 800–1,200 milligrams (mg) per day. For naproxen sodium, the daily dose should not be more than 1,375 mg.

A person should follow the instructions on the medication guide and never exceed the recommended daily dose.

Precautions

NSAIDs may increase the risk of stroke or heart attack, which may occur suddenly. These risks may be even higher in people who:

• smoke
• have previously had a heart attack or stroke
• have diabetes or high cholesterol

Doctors also associate NSAIDs with a risk of ulcers and holes and bleeding in the intestine and stomach. These risks may be higher for people who drink alcohol frequently, are older adults, or have other health conditions.

The risks associated with NSAIDs may increase for people who take the medication for a long time.

NSAIDs may also interact with certain medications, including:

• other NSAIDs
• anticoagulants, such as warfarin
• oral steroids, such as prednisone
• selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and citalopram
• serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine

Read on for the differences between SSRIs and SNRIs.

Potential side effects

NSAIDs such as naproxen may cause side effects, which can include:

• diarrhea
• bloating and gas
• constipation
• ringing in the ears
• dizziness
• drowsiness
• nervousness

People should speak with a medical professional to discuss the potential side effects of NSAIDs.

Acetaminophen is an analgesic or pain reliever that also reduces fever. Some people take acetaminophen to reduce pain caused by osteoarthritis, a type of arthritis that affects the joints, including the knee. People also take acetaminophen to relieve other mild to moderate pain.

Examples of medications that contain acetaminophen include:

• Panadol
• Tylenol
• Actamin
• FeverAll

Dosage

The maximum amount of acetaminophen a person should take in one dose is 1,000 mg. A person should not take more than 4,000 mg per day.

Precautions

If a person takes too much acetaminophen, there is a risk of liver damage. This may be severe, require a liver transplant, or be fatal.

Potential side effects

Possible side effects include:

• rash
• itching
• hives
• swelling in the:
  • tongue
  • face
  • throat
  • ankles
  • feet
  • legs
• blistering or peeling skin
• difficulty swallowing or breathing
• hoarseness

People should speak with a doctor if they experience these symptoms after taking acetaminophen.

A person may require stronger medication for more severe pain, which a doctor can prescribe. These may include higher dosage NSAIDs and COX-2 inhibitors, also called coxibs.

Examples of prescribed NSAIDs include:

• high dose ibuprofen
• high dose naproxen
• diclofenac (Voltaren)

Examples of coxibs include celecoxib (Celebrex) and etoricoxib. A person can take these medications as tablets orally or apply them to the knee as a gel or cream.

Dosage

According to the National Library of Medicine, the maximum daily dose of each medication is:

• ibuprofen: 2,400 mg
• naproxen: 1,000 mg
• naproxen sodium: 1,375 mg
• diclofenac: 150 mg
• celecoxib: 400 mg
• etoricoxib: 60 mg

Precautions

People who take NSAIDs or coxibs are at risk of gastrointestinal problems. There is a greater risk of complications if a person:

• drinks alcohol frequently
• takes corticosteroids
• takes SSRIs
• takes blood thinning medication
• takes several anti-inflammatory pain relief medications together
• has had stomach bleeding or gastritis
• has gastrointestinal conditions, such as Crohn’s disease or ulcerative colitis
• has a bacterial infection with Helicobacter pylori, which can cause ulcers
• is 65 years or older

Potential side effects

Side effects of prescription NSAIDs and coxibs may include:

• indigestion and stomach pain
• gas and bloating
• ulcers
• constipation
• gastritis
• sore throat
• dizziness
• cold symptoms

If a person experiences any of these symptoms and is at high risk, they should consult a medical professional.

If a person has severe pain from injury or illness, such as arthritis, a doctor may administer an injection to treat the pain. Doctors may recommend hydrocortisone or hyaluronic acid injections.

Hydrocortisone injection

This type of injection is a corticosteroid. A doctor may administer a hydrocortisone injection directly into the knee joint.

This medication can treat knee pain from various causes, including injury, arthritis, and bursitis. The injection helps reduce swelling and pain and makes movement easier.

Dosage

A person may be able to have injections in the knee up to four times a year. The dosage can vary between 5 mg and 50 mg of hydrocortisone.

Precautions

Hydrocortisone may not be suitable for people who:

• have an infection
• have or have had depression
• have been in recent contact with a person who has:
  • measles
  • shingles
  • chickenpox
• have recently had vaccinations or are having vaccinations soon
• are pregnant, breastfeeding, or trying to become pregnant

Hydrocortisone may also cause complications in people who have:

• high blood pressure
• diabetes
• osteoporosis
• glaucoma
• unhealed wounds

People should speak with a doctor about the injections’ potential risk factors and complications.

Potential side effects

Side effects of hydrocortisone injections may include pain and swelling at the injection site and bruising.

Serious side effects include:

• signs of infection such as:
  • fever
  • chills
  • sore throat
  • ear or sinus pain
• depression or mood swings
• puffy face or weight gain in the upper belly or back
• swelling and throbbing in the legs or arms
• chest pain
• confusion and sleepiness
• changes to vision

A person can speak with a medical professional if experiencing any of the side effects described above.

Hyaluronic acid

A doctor may inject hyaluronic acid into the knee to increase the supply of the acid. This can help relieve pain and may improve other symptoms of conditions that affect the knee joint, such as osteoarthritis.

Dosage

Depending on which hyaluronic acid a doctor uses, they may administer one to five injections over several weeks.

Precautions

If a person is pregnant or breastfeeding, they should let a doctor know before starting this medication. People should also inform a doctor if they develop an infection in the knee or a skin problem.

Potential side effects

Side effects of hyaluronic acid injection may include pain and swelling at the injection site and difficulty moving the knee immediately after the injection. These symptoms are usually temporary, and applying ice helps ease the pain.

Less common side effects include:

• bleeding
• blistering
• burning or coldness
• discoloration of skin
• hives or rash
• joint infection
• inflammation
• itching or stinging
• lumps
• numbness and tingling
• redness, soreness, and tenderness
• ulceration and warmth at the injection site

People should seek medical attention if they experience mild or more severe reactions.

Knee pain may sometimes go away on its own. If the pain is not severe, a person may be able to treat it at home by:

• putting as little weight as possible on the knee
• avoiding standing for a long time
• using an ice pack on the knee for up to 20 minutes every 2–3 hours
• taking acetaminophen

Learn more about the home remedies for knee pain.

To help prevent knee pain, a person can:

• balance rest and exercise
• maintain a moderate body weight
• wear suitable footwear with arch supports

A person should contact a doctor about knee pain if:

• the pain is severe
• there is swelling in the knee
• there is no improvement after a week
• there is no movement
• the knee cannot bear weight
• the knee locks or buckles

The medication a person receives for knee pain can depend on the cause and severity of the pain.

A person may take OTC medication for mild to moderate pain, such as ibuprofen or naproxen. If the pain is more severe, a person may require medication prescribed by a doctor, such as a higher dose of NSAID or COX-2 inhibitors. A doctor may sometimes administer injections and inject hydrocortisone or hyaluronic acid into the affected area.

A person can also treat knee pain at home by resting, raising the knee, and applying ice.

Medications for Arthritis Pain Relief: Risks and Benefits

Written by WebMD Editorial Contributors

Medically Reviewed by Jennifer Robinson, MD on April 24, 2023

• Treatments Without Medicine
• Over-the-Counter (OTC) Pain Medications
• Other OTC Pain Relievers
• Prescription Drugs: NSAIDs
• Prescription Opioids
• Prescription Drugs: Steroids
• Prescription Hyaluronan Injections
• Antidepressants for Osteoarthritis Pain
• More

If osteoarthritis (OA) causes you pain, you don’t have to grin and bear it. Several types of medications and other treatments can bring you relief. They may not get rid of your pain totally, but they can often ease it enough for you to do the things you want and need to do.

There are many types of medicines to choose from, but like all drugs, each has its pros and cons. Talk to your doctor about them to decide what’s best for you.

Nondrug treatments are the first option for relieving OA pain. They have many benefits and few, if any, risks. Even if you need medication, it’s still important to make lifestyle changes, too.

Exercise relieves joint pain and stiffness. One study of people with knee OA showed exercise worked as well as anti-inflammatory pain relievers. But you have to do it regularly. Like most treatments, if you don’t stick with exercise, the benefits go away.

Your routine should include cardio to keep your heart and lungs strong. Good low-impact options include walking, swimming, biking, tai chi, and yoga. Also include resistance exercises to build your muscles so they can support your joints. And stay flexible with stretching moves. Check with your doctor or a physical therapist to make sure you’re doing the right type of exercise for you.

If you’re overweight, slimming down will make a big difference in your OA. Weight loss greatly lowers the stress on your joints, especially in the knees and hips. It also relieves pain and helps your joints work better. Losing at least 10% of your body weight (20 pounds in a 200-pound person) can cut your pain in half.

Walking aids, such as canes, and knee braces also help, especially if your knee is out of alignment. Splints can help with OA of the thumb. Ask your doctor or physical therapist about any other devices that may help.

Pain relief drugs you can buy at the pharmacy, like acetaminophen (such as Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs, such as Advil or Motrin), are usually easy to get and don’t cost a lot.

Acetaminophen can ease mild arthritis pain. But you have to take it carefully. Many other types of medications also have acetaminophen, so it’s easy to take too much without realizing it. Make sure you don’t take more than 3,000 milligrams per day. Too much acetaminophen can cause liver damage. People with liver disease and people who drink more than three alcoholic drinks a day may not be able to take acetaminophen.

NSAIDs also lower swelling and ease pain but do not have a significant effect at these lower doses. Most healthy people can safely take them for short periods without any problems. But NSAIDs can raise your odds of having a heart attack, stroke, high blood pressure, and kidney disease. The FDA says people who’ve had a heart attack should be careful using NSAIDs because it raises their chances of having another heart attack.

Also, NSAIDs keep your stomach from making substances that protect it from acids. After a long time, some people can get side effects like stomach irritation and bleeding. Your doctor may recommend you take a medication that decreases stomach acid to protect your stomach. Your odds for side effects are higher if you’re over age 65, take higher doses of NSAIDs, take them for a long time, or are on medications to prevent blood clots.

Along with medications, there are supplements and creams that you can buy at the drugstore to relieve arthritis pain. People may also use topical treatments along with other medications.

Many people with OA use the supplements glucosamine and chondroitin. For those with moderate to severe OA knee pain, the combination of the two may ease aches, although medical studies have not shown clear proof that they help a lot. If you choose to try it, take it for at least 3 months before you decide if it helps.

There don’t seem to be any major side effects from glucosamine and chondroitin supplements, but because they are supplements, the FDA doesn’t regulate them in the same way as drugs. That means it’s tough to be sure of the content and quality of supplements you see in stores.

Though the benefit is still unclear, one study showed long-term use of fish oil supplements improved pain and function.

Skin creams made from capsaicin, an extract from chili peppers, may help relieve mild arthritis pain. You may notice a mild stinging or burning feeling when you rub it on your skin, but it usually fades over time. Test the medication on a small part of your skin to make sure you’re not sensitive to any of the ingredients.

You should never apply a topical ointment to broken or irritated skin, and keep them away from your eyes and mouth. Never combine a topical ointment with any sort of heat therapy, such as a heating pad or hot towel, because the combination could cause severe burns.

Cold or warm compresses on a painful joint a few times per week may also improve pain, swelling, and range of motion. Cold therapy may also help you feel better right after you exercise.

You can ask your doctor for prescription NSAIDs — stronger than those you buy over the counter — to treat arthritis pain and inflammation. Besides ibuprofen and naproxen, other examples of prescription NSAIDs include diclofenac (Cambia, Cataflam, Voltaren), etodolac, meloxicam (Mobic), oxaprozin (Daypro), and piroxicam (Feldene).

Like over-the-counter NSAIDs, taking these medications for a long time may cause serious side effects like a heart attack, stroke, kidney disease, and stomach irritation and bleeding for some people, especially in those who are older. If you take a daily aspirin, you should also talk with your doctor about whether it’s safe for you to take other NSAIDs.

NSAIDs you rub on your skin, such as diclofenac cream, also work well for hand and knee arthritis and are less likely to cause side effects than pills that you swallow.

Another type of NSAID is celecoxib (Celebrex). It relieves pain as well as other NSAIDs and also lowers inflammation. Some studies have shown that the drug is less likely to cause stomach bleeding. But like other NSAIDs, it can raise your chances for heart disease, and higher doses are riskier for your health.

You might want to take the medicine with food or along with another medication called a proton pump inhibitor to help prevent stomach bleeding. Other medications include an NSAID and a drug to help protect the stomach in one pill, such as diclofenac sodium/misoprostol (Arthrotec) and naproxen/esomeprazole magnesium (Vimovo), though they can be taken separately at a lower cost.

Certain people may be at higher risk of side effects when taking NSAIDs. Because the side effects of these medications can be serious, it’s important to tell your doctor right away about any problems. Also, certain people respond to different NSAIDs better than others, so be patient. You might have to try a few before finding the one that works for you.

In special cases, strong pain drugs such as codeine, hydrocodone, or oxycodone can help people with OA pain. Due to their side effects, doctors prescribe them only for those with severe pain who can’t take NSAIDs or for those waiting for joint replacement.

If other treatments don’t work, your doctor may prescribe a medication related to opioids called tramadol (Ultram).

Your doctor will decide if you need these drugs to treat your pain. Keep in mind that they can cause some serious side effects if you use them for a long time, including nausea, constipation, dizziness, drowsiness, dependence, and addiction. Yet when you take them exactly as prescribed, these pain relievers can be safe and work well against pain.

Opioids can make you drowsy, cloud your thinking, and cause constipation. You should not drive or operate dangerous equipment when you first take these medicines, and you may need to avoid these activities if you take them long-term.

Because some prescription pain drugs may have a narcotic ingredient along with acetaminophen, it’s important to monitor the total amount of acetaminophen taken in a day if you are taking both prescription and over-the-counter pain relievers.

If over-the-counter or prescription NSAIDs don’t help you, there are other prescription treatments you can try.

Steroid medications ease pain by lowering inflammation, but they help for only a short time. You usually get them as a shot into the affected joint, such as your knee. The benefit of corticosteroids is that they act quickly.

Steroid shots do have side effects, but they’re often less than those from pills. They include infections, allergic reactions, bleeding, skin discoloration, and, rarely, the rupture of a tendon near where the needle went in. Because frequent injections to the same joint can damage the joint structures, you generally should not have more than three shots in the same site per year. Injections should not be done if you have a skin infection.

A substance called hyaluronan, which is part of your normal joint fluid, helps to lubricate and cushion the joints and keep them working properly. Shots of hyaluronic acid into joints may help relieve pain in some people with mild to moderate knee OA. It may take 4 to 12 weeks to feel the full effect, and pain relief can last for up to several months in some people.

The most common side effect is pain where the needle went in. Also, hyaluronan shots cannot be used by people with skin or joint infections. Examples of hyaluronic acid injections include Euflexxa, Hyalgan, Orthovisc, Supartz, and Synvisc.

If your OA reaches a point where you can’t do the things you want and need to do, and none of the pain relief options give you enough relief, then it may be time to talk with your doctor about other options such as surgery.

Your doctor may recommend the use of antidepressant medication to help treat chronic OA pain even if you don’t have depression. It’s not clear how it works, but brain chemicals affected by antidepressant medications may play a role.

One antidepressant, duloxetine (Cymbalta), is FDA-approved for the treatment of chronic musculoskeletal pain, including chronic osteoarthritis pain. Common side effects include nausea, dry mouth, sleepiness, and constipation.

Doctors sometimes prescribe a tricyclic antidepressant such as amitriptyline, desipramine (Norpramin), and nortriptyline (Pamelor) for chronic pain. These are most often taken near bedtime because they can make you sleepy. Other side effects include dry mouth, nausea, weight change, and constipation.

All antidepressant drugs carry a boxed warning of higher risk of suicidal thinking and behavior in children, adolescents, and young adults. Anyone starting antidepressant drugs should be monitored closely for any unusual behavioral changes, suicidal thinking and behavior, or worsening of a psychiatric disorder.

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How to effectively get rid of joint pain?

Who among us has not made fun of the familiar “you creak all over, your joints hurt, you are twisting, soon, look, and you will crumble”? So, we are accustomed to associate joint problems with advanced age, but the first signs can also appear in youth [1]. In this situation, it is extremely important to provide the necessary assistance to the joints as soon as possible in order to prevent deterioration of the condition. What drug could confidently, without a doubt, recommend to the visitor for this purpose – safe, effective and affordable, in order not only to eliminate pain and inflammation, but also to protect the articular tissue? The head of pharmacy No. 9 spoke in detail about the solution of this problem”Eximed” by Antonina Melnik.

Diseases of the musculoskeletal system, primarily of the joints, are dangerous due to their progressive development, which can lead to a violation of the ability to move normally, to disability and even disability. In addition, the treatment of such diseases continues, if not for a lifetime, then for many years, and this increases the risk of side effects from long-term use of various drugs in addition to all the negative consequences of the disease itself [2]. ” During the day, a lot of patients come to the pharmacy complaining of pain in the joints. Increasingly, young people are also such patients. Unfortunately, perhaps due to mentality, people seek help only when the pain becomes severe ,” notes A. Melnik.

HOW TO TREAT?

There are two main directions in the treatment of joint diseases: elimination of symptoms (symptom-modifying therapy) and inhibition of cartilage destruction processes and its protection (disease-modifying therapy) [3]. As a rule, the first type of therapy includes non-steroidal anti-inflammatory drugs (NSAIDs). They reduce the severity of pain and inflammation, however, with prolonged treatment, they can affect the mucous membrane of the gastrointestinal tract (GIT), causing dyspepsia, stomach and duodenal ulcers, and sometimes dangerous bleeding [4–5].

« Of course, when treating joint pain, inflammation must first be eliminated. However, we must not forget about the protection of the joints, so that the cartilage tissue does not further break down and the patient’s condition does not worsen , ”the specialist emphasized.

Many clients may have heard about drugs that contain glucosamine and chondroitin – chondroprotectors (disease-modifying therapy). Despite the widespread use of these drugs, specialists have no confidence in their effectiveness. Even the recommendations of such a significant organization as the International Association for the Study of Osteoarthritis indicate that “the effect of the use of these particular chondroprotectors is doubtful and uncertain” [6].

WHAT TO ADVISE?

“SUSTAMAR ^® I can safely call the No. 1 drug today, because it effectively protects cartilage tissue from destruction, and its anti-inflammatory and analgesic properties make it indispensable for patients with chronic joint diseases,” notes A. Melnik.

SUSTAMAR ^® in Ukraine is the only highly concentrated (480 mg) single preparation of martini fragrant (Harpagophytum procumbens)*. It is produced by Esparma GmbH, Aristo group (Germany). It is important to note that SUSTAMAR ^® has anti-inflammatory and analgesic effects confirmed in European studies, and also has a chondroprotective effect. “From my personal observation, SUSTAMAR ^® also helps to effectively get rid of swelling around the joints. This is very important, because edema gives a person considerable discomfort and pain, and its elimination will help “come back to life” much faster” , – said A. Melnik. Multi-vector action SUSTAMARA ^® just allows you to effectively use it both as a monotherapy and as part of a complex treatment for a wide range of acute and chronic diseases of the musculoskeletal system. For example, osteoarthritis, osteochondrosis, inflammatory diseases of the musculoskeletal system (tendonitis, tendovaginitis). The drug can also be used to prevent joint damage during intense exercise [4, 7, 8].

“Due to its effectiveness and the absence of a negative effect on the gastrointestinal tract, the drug based on martini extract is widely used abroad, and now Ukraine can join the world experience. In my opinion, SUSTAMAR ^® can be considered as a better and definitely safer supplement or even an alternative to NSAIDs,” emphasized A. Melnik. Indeed, the results of clinical studies indicate that taking martini extract can reduce the use of NSAIDs, and in 60% of cases, completely abandon them [4, 9].

The recommendation of the drug SUSTAMAR ^® will provide the visitor with the necessary effective and safe care

We cannot ignore the safety profile of SUSTAMAR ^® . Even with very long-term use (observations lasted up to a year), side effects with its use developed quite rarely [4, 9]. The good tolerability of the treatment is confirmed by the data of the European study, during which the adherence of patients to treatment with the preparation of fragrant martini (SUSTAMAR ^® ) was studied. It amounted to 96%. At the same time, the tolerance of the drug was rated by doctors as “very good” and “good” in 98% of patients [4; 9].

It should be noted that SUSTAMAR ^® has a better tolerability profile not only compared to the classic NSAID diclofenac, but also to safer selective cyclooxygenase-2 (COX-2) inhibitors [4].

TO WHOM SHOULD SUSTAMAR

^® be RECOMMENDED?

“I can distinguish several types of visitors who come to the pharmacy with pain in the joints: those who come to the pharmacy with the question “how to escape?”, And those who, limping, come to the pharmacy for NSAIDs, – noted A. Melnik. — In both cases, SUSTAMAR ^® will be an excellent recommendation for the client, because it is a 2-in-1 remedy: it will eliminate symptoms and protect the joint. Even if, with severe acute pain, such a patient needs NSAIDs, they cannot be taken for a long time due to high toxicity. In addition, these drugs do not have the necessary protective effect on the joint. Therefore, if circumstances develop in such a way that the doctor is forced to recommend NSAIDs to the patient, then it is better to immediately add the drug SUSTAMAR 9 to it.0116® . This will provide more effective treatment, gradually reduce the dose of NSAIDs and subsequently refuse to take them, continuing maintenance monotherapy with only SUSTAMAR ^® “.

The favorable safety profile of SUSTAMAR ^® makes it possible to use it for a long and very long time [4; 9], which is especially important in chronic joint diseases. The duration of the course of treatment depends on the severity of the manifestations of the disease in each case [8]. If the condition of the joints does not require constant intake, then SUSTAMAR ^® is taken in courses several times a year, for example, in spring and autumn.

“Another, so to speak, bonus is the affordable price of SUSTAMARA ^® . This is extremely important for our visitors, given that the treatment of a joint problem lasts for months, or even years. Offering SUSTAMAR ^® , you can be sure that you are recommending a worthy drug from a respected German manufacturer, available to many pharmacy visitors. The drug that I tested on myself or my relatives and is 100% sure of it.

It is pleasant to note that many people who used SUSTAMAR ^® once, come back for it again. And who, if not grateful visitors, who have experienced a decrease in the severity of the painful symptoms of a hated disease, will become an indicator of the effectiveness of treatment? emphasized A. Melnik.

Thus, the recommendation of the drug SUSTAMAR ^® , which stands out for its anti-inflammatory, analgesic and chondroprotective effects, will provide the visitor with the necessary effective and safe care. And the impeccable German quality and affordable price will help win a grateful client who will come to the pharmacy again.

“SUSTAMAR ^® is a real joint dream!”

APTEKA Weekly Press Service

*According to the State Register of Medicinal Products as of November 6, 2017

REFERENCES

1. Pasieshvili L.M. The state and role of adipocytokines in the course of osteoarthritis in young obese patients // Actual issues of improving medical care and professional medical education: collection of abstracts of the medical forum. – 2017. – S. 172-173.

2. Kryukova A.I., Vladimirova I.M. Analytical review of the current benefits of dew climbing, which can stop when the musculoskeletal system becomes ill // SCIENCERISE. – 2015. – No. 4 (15). — P. 24–31.

3. Korshunov N.I., Ershova O.B. Modern approaches to the pharmacotherapy of osteoarthritis // Consilium medicum. – 2006. – V. 8. – No. 2. – S. 38–41.

4. SUSTAMAR ^® (martinia extract) — an alternative to non-steroidal anti-inflammatory drugs // Bill. Suglobi. Ridge. – 2017. – Vol. 7. – No. 1.

5. Moura Mdel G., Lopes L.C., Biavatti M.W. et al. Brazilian oral herbal medication for osteoarthritis: a systematic review protocol / Syst Rev. — 2016 — V. 5. Numb. of publ. — 86.

6. Physician Summary: Non-Surgical Treatment of Osteoarthritis of the Knee.