Medication That Knocks Out Knee Pain

There is a variety of medication available for knee pain, including both oral and injectable medication, depending on the source of your pain. But most medication used by people with knee pain falls into one of two categories: anti-inflammatories and pain relievers, also known as analgesics.

Over-The-Counter Medication for Knee Pain

Most medication that falls in the anti-inflammatory category also has analgesic effects, says William Bargar, MD, director of the Joint Replacement Center with Sutter General Hospital in Sacramento, Calif., and a spokesman for the American Academy of Orthopaedic Surgeons.

The main over-the-counter drugs are acetaminophen (Tylenol and other brands) and non-steroidal anti-inflammatory drugs (or NSAIDs), including aspirin (such as Bayer), ibuprofen (Advil, Motrin), and naproxen (Aleve). These can help with simple sprains or even arthritis.

Dr. Bargar points out that even though knee pain-relieving medication is available without a prescription, you should use care when taking it. Be sure to follow the instructions for any medication and read the warnings.

“What you also have to watch for is that some of these over-the-counter drugs are sold as ‘arthritis strength,’ and that means they are larger doses. For example, too much arthritis-strength Tylenol can damage the liver,” he says. “Ibuprofen can cause gastrointestinal damage, such as ulcers and bleeding, if you take too much. You have to be careful about overdoing it with over-the-counter drugs for knee pain.”

Another option to try is glucosamine and chondroitin sulfate, which are oral supplements believed to relieve the pain of osteoarthritis. Side effects can include headache, upset stomach, and skin reactions. The American Academy of Orthopaedic Surgeons reports that these supplements might help you during the earliest stages of knee pain caused by osteoarthritis, but it can take up to two months of consecutive use to notice any relief. Be sure to tell your doctor you are taking the supplements, because they can interfere with other medication.

Prescription Medication for Knee Pain

Prescription medication is usually a more potent pain reliever than the over-the-counter variety. These include prescription-strength NSAIDs and COX-2 inhibitors (meant to decrease gastrointestinal side effects like stomach bleeding). These drugs are typically used if your pain level is considered moderate to severe. The only COX-2 inhibitor currently on the market is celecoxib (Celebrex). Rofecoxib (Vioxx) and others were removed from the market because it was discovered that they led to an increased risk of heart complications.

Bargar says that although the data wasn’t completely clear, the consensus was to remove Vioxx and valdecoxib (Bextra), both COX-2 inhibitors, from the market because of associated cardiac issues. Celebrex was not shown to have a significant increased risk of heart problems. “I don’t think [COX-2 inhibitors] work better than standard anti-inflammatories, they just don’t have the gastrointestinal side effects,” he says. “I would prescribe Celebrex for someone who isn’t tolerating conventional NSAIDs because of GI side effects.”

Bargar also advises people with knee pain who are taking large doses of ibuprofen regularly to have blood tests every four months to check for kidney toxicity and anemia.

Injectable Medication for Knee Pain

Injecting medication to reduce knee pain is usually the step between taking oral medication and replacing arthritic knee joints with surgery. Corticosteroids or viscosupplementation with hyaluronic acid can be injected when knee pain becomes severe.

• Corticosteroids reduce inflammation and offer pain relief and are injected directly into the knee. These injections aren’t permanent solutions, and you may need to return for repeat injections every few months (though not to exceed four injections in the same joint per year).
• Viscosupplementation is an injection of hyaluronic acid that lubricates your joint to reduce knee pain and increase mobility. A series of three to five weekly injections is necessary to complete the therapy. These injections are helpful if you have early stage arthritis and haven’t responded well to oral medication.

“The whole concept of viscosupplementation was developed by rheumatologists to get some lubrication into the joint, but I found it doesn’t work very well,” Bargar says. “It’s also expensive, but a lot of people will try it before surgery.”

If you have modest knee pain caused by a simple strain, try an over-the-counter medication. If your knee pain or injury is severe, visit your physician for a prescription medication that may improve your particular condition.

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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.

causes, symptoms, diagnosis and treatment

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Natalia Vladimirovna

Experience 19 years

First category local general practitioner

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Pain under the knee, sharp and cutting or, on the contrary, aching and intrusive, significantly worsens the quality of life and in most cases requires an appointment with a specialist. Inability to walk or run fast, lameness, increased swelling – these are just some of the side effects of the symptom, and in order to get rid of them, you should figure out what caused it.

Causes of knee pain

There are many reasons for knee pain. The most common are:

Physical injuries:

• fracture of the knee joint, may be accompanied by displacement of the knee disc. With a fracture, the patient experiences unbearable pain, which increases with pressure on the affected area; the knee cannot be bent, as the joint swells and fills with blood;
• dislocation – displacement of the position of the bones. In terms of symptoms, it is similar to a fracture: the knee also swells and hurts;
• torn or sprained ligaments and tendons. Often at the same time, the knees hurt and crunch; while walking, the victim may hear uncharacteristic clicks, observe swelling and excessive joint mobility. The pain is most often cutting or shooting;
• bursitis – inflammatory processes in the knee area. Puffiness appears, especially knees hurt at night and with excessive physical exertion;
• meniscus tear – occurs as a result of abnormal cartilage development or injury (impact, displacement, etc.). The victim has severe pain in the joints of the knees, increased swelling is observed, and activity decreases.

Diseases of the joints:

• rheumatism – a disease characterized by alternating unpleasant sensations, i. e. first the right knee hurts, and then the left, and vice versa. Teenagers are most susceptible to it, as well as people who have recently had streptococcal diseases;
• reactive arthritis – inflammation of the joint, which appears mainly in people aged 25-35 years. With it, the knee may hurt from the inside, front, back, side or bottom, swelling appears, redness of the affected area, may be accompanied by conjunctivitis;
• Reiter’s syndrome – the symptoms are completely similar to reactive arthritis, however, in addition to them, urethritis and intestinal failure are noted;
• Osteoarthritis is a disease that affects the elderly. Characterized by aching pain in the knee, aggravated during bad weather, the knee also hurts at night and when walking;
• Osgood-Schlatter disease – knee hurts when bending, walking up stairs, squats;
• Rheumatoid arthritis is a completely unexplored autoimmune disease. Manifested in the form of increased swelling. The patient has unbearable pain in the front of the knee, especially at night;
• gout – appears due to an unbalanced diet, excessive consumption of junk food and alcohol. The patient experiences an obsessive aching pain in the patella.

What to do?

Patients with knee pain should be treated by a doctor. Nevertheless, everyone should be able to competently respond and provide first aid in case of injury to the designated area, because the salvation of the patella itself may depend on this.

So, it is necessary to completely immobilize the injured limb together with the joint and apply a cold compress to it, and then seek qualified medical help by calling an ambulance.

The specialist will first of all conduct an examination and prescribe drugs that relieve pain behind the knee or in front, after which treatment will be carried out depending on the cause of discomfort.

Arthritis is treated with drugs that reduce inflammation and kill germs. They are prescribed exclusively by a doctor. Arthrosis requires heat, so experts prescribe warming herbal compresses and ointments to patients, which increase the protective properties of cartilage.

JSC “Medicina” (clinic of academician Rothyberg) has the most advanced equipment, which allows for a quick and accurate examination of the knee joints. The specialists of the medical center will make the necessary diagnostics, after which they will prescribe the required treatment.

To receive the highest level of care, it is enough to make an appointment with a therapist who will determine the exact cause of pain. Also, in our clinic in the center of Moscow, the best traumatologists, rheumatologists, surgeons and neurologists are waiting for you.

You can make an appointment by round-the-clock phone +7 (495) 775-73-60 or through the feedback form on the official website of the clinic. The medical center is located at 10, 2nd Tverskoy-Yamskoy pereulok, Moscow. Geographically, we are located near Mayakovskaya, Belorusskaya, Novoslobodskaya, Chekhovskaya, Tverskaya metro stations.

Treatment of knee pain at home

Treatment of the symptom at home is reduced to regular preventive measures. Should:

• maintain a healthy diet with a balanced amount of proteins, fats and carbohydrates;
• limit consumption of spicy, salty, fatty and sweet foods;
• reduce physical activity;
• regularly do exercises and exercise therapy.

If knee pain occurs while walking or at rest, traditional treatments include applying cabbage leaves, mustard compress, gelatin compress to the affected area of ​​the skin, and lubricating it with an ointment for knee pain based on propolis tincture.

Pain in the knee joint of the right or left leg: causes and treatment

Symptoms of knee pain

Symptoms of knee pain depend on its causes and severity. Knee pain is a common problem.

Pain in the knee can occur suddenly with too much stress and injury.

The knees can often become unstable or weak, to the point of feeling like the legs are about to give way.

Depending on the cause of the pain, other symptoms may occur: stiffness of movement, clicking in the knee, jamming of the knee joint in one position, inability to straighten the leg.

How does knee pain affect us?

Knee pain is more common in older people, who are overweight (due to increased stress on the joints) and when playing sports. The knee joints are actively involved in movement, so knee pain greatly affects our lives. With knee pain, we cannot play sports, it is difficult for us to walk and climb stairs.

Relieve Pain

The knee joint is made up of three bones, tendons that attach muscles to bones, and ligaments that stabilize and connect bones. In the cavity of the knee joint are two C-shaped cartilages – menisci. Their main role is to cushion the joint. A fluid-filled bursa keeps the joint moving smoothly.*

80% of people surveyed have experienced knee pain**

Relieve Pain

*Knee (human anatomy): images, functions, ligaments, muscles. 2016 Knee (Human Anatomy): Images, Functions, Ligaments, Muscles. [ONLINE] available at: http://www.webmd.com/pain-management/knee-pain/picture-of-the-knee. [checked 02/19/2019].
** According to the 2018 Global Pain Index survey, 80% of 24,000 respondents experienced knee pain

Why knee pain occurs

Knee pain is often caused by trauma (sprains and tendons, dislocations, torn ligaments or menisci), as well as osteoarthritis, tendinitis (inflammation of the tendons) and bursitis (fluid accumulation in joint capsules).

Sports injuries

Knee injuries are common among athletes. They often have a ligament tear in the knee joint, accompanied by sudden pain in the knee. Excessive stress on the knee joint, such as when running, walking, jumping and cycling, can cause the so-called “runner’s knee” (or tibial tract friction syndrome). It usually manifests itself in the form of pain in the patella and occurs due to excessive exertion, injury, disease of the leg bones or muscle weakness.

Other causes

Knee injuries can develop gradually with osteoarthritis. If, as a result of problems with the hip or ankle joints, a person’s gait is disturbed, this, in turn, can cause an asymmetry in the load on the knee joints, which, in turn, is fraught with injuries. Knee injuries, even minor ones, increase the likelihood of similar injuries in the future.

Determine the cause of the pain

Pain in the side of the knee may be due to ligament damage and a tear in the meniscus (cartilage that stabilizes the joint). Pain in the front of the knee is usually due to inflammation of the joint capsule and cartilage problems. Pain in the back of the knee can be caused by osteoarthritis.

Treatment

Diagnosis and treatment of knee pain depends on the cause of the pain. To determine it, you need to consult a doctor. The doctor will examine your knee, check its mobility, swelling, bruising and local temperature increase. The doctor may recommend physical therapy and a knee brace to relieve pain, refer you for additional tests (X-rays, MRI, ultrasound, or CT), as well as show you exercises to strengthen the knee joint, and prescribe non-steroidal anti-inflammatory drugs to relieve pain and treat its cause. In addition, after consulting a doctor, at home, you can provide protection and rest to the injured knee, apply ice, apply a compression bandage and keep the knee in an elevated position. Over-the-counter topical and internal pain relievers can help relieve short-term, moderate pain and reduce inflammation.

Exercises to relieve knee pain

Knee pain is common: out of 100 people complaining of pain, 80 reported knee pain*. Three simple exercises will help make the muscles that support the knee stronger and more flexible. Doing these exercises regularly will help prevent or relieve knee pain.

* According to the Global Pain Index 2018, based on 24,000 people surveyed

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