Knee Pain Tablets
Contents
What can I buy for knee pain?
“What can I do to make my knee pain go away?” is an all too common question. As knee pain becomes more prevalent in today’s society as people live longer and with higher BMIs, myths and cures for the ailment have exploded. Supplements, in particular, have become extremely popular in recent years as people try and find alternative ways in dealing with often very painful knees.
- Word-of-mouth, the rise of alternative medicine, distrust in our healthcare system, and ease of access are also contributors to their increasing popularity.
- And so even if you, as a patient, are proactive in doing your research on supplements and medications, it is difficult to differentiate fact from fiction and you end up staring at an aisle of hundreds of pill bottles at your local drugstore without a clue and leaving with your wallet a little emptier and your mind still not much at ease.
Degenerative joint disease, also known as knee osteoarthritis (OA), is the most common cause of knee pain and is the result of progressive loss of articular cartilage from wear and tear in the knees. In more severe cases, surgery or injections may be necessary, but for the majority of patients, exercise routines, physical therapy, weight loss, and bracing can ease the pain.
Many also opt for medications and/or supplements. With my experience working in an orthopedic clinic and having family members of my own facing the same problem, I hope that by writing this article I can help you understand the products that are marketed for improving your knee pain and help you decide which ones are best for you,
NSAIDs (such as Aspirin, Ibuprofen, and Naproxen) are over-the-counter medications with overwhelming support for their effectiveness in managing knee pain and other osteoarthritis symptoms. However, many negative side effects are attributed to their use, and increasingly so at high doses and with long-term use, so it is important to take care in choosing which one is best for you and to talk with your doctor before starting one of these medications.
- Glucosamine and Chondroitin Sulfate are by far the most popular supplements marketed for knee pain as they are components of the human connective tissue found in cartilage and bone in the knee and in other joints.
- They claim not only to treat knee pain, but also improve joint function and slow the development of osteoarthritis.
In terms of knee pain, some studies have shown a small effect, while others show no effect at all. However, recent studies show that when taken separate and/or together, these supplements do not slow down the development of osteoarthritis as marketed 1,
Overall, these supplements have little support for their reported effects, but their use has also shown few harmful side effects and thus experimenting with them may be warranted with the goal of reducing knee pain. Lesser-known supplements, shown in the chart (fatty acids, Vitamin D and E, Collagen, MSM, HA, Willow Bark, Tumeric/curcumin, Boswellia serrata, and Pycnogenol), are even more difficult to assess due to a lack of testing.
And when studies are performed, some show minor benefits, but most show little to none at all. For example, more current research has shown no effect with Omega-3, Vitamin D and E, Collagen, HA in management of osteoarthritis, but that these supplements do have different health benefits beyond knee pain 2,3,
Medication/Supplement | Reported Effect(s) | Study Results |
NSAIDs (Aspirin, Ibuprofen, Naproxen, etc.) | Reduce pain, inflammation, and stiffness | Strong support for all reported effects |
Glucosamine | Reduce pain, improves joint function and slows progression of osteoarthritis (OA) | Little or no effect on joint function and progression of OA. Possible reduction in pain |
Chondroitin Sulfate | Reduce pain, inflammation, improves joint function and slows progression of osteoarthritis (OA) | Little or no effect on joint function and progression of OA. Possible reduction in pain |
Omega-3 fatty acids | Reduce pain, inflammation, and stiffness | Inconclusive |
Vitamin D and E | Reduce pain, slow progression of OA | Inconclusive |
Collagen | Reduce pain, slow progression of OA | Inconclusive |
MSM (Methylsulfonylmethane) | Reduce inflammation, formation of collagen | Inconclusive |
HA (Hyaluronic Acid) | Joint lubrication | Inconclusive |
Willow Bark Extract | Reduce pain, inflammation, and stiffness | Inconclusive |
Tumeric/curcumin | Reduce inflammation | Inconclusive |
Boswellia serrata extract | Reduce inflammation | Inconclusive |
Pycnogenol | Reduce inflammation | Inconclusive |
All in all, choosing supplements to approach worsening knee pain is a discussion you should be open to have with your doctor. After realizing the lack of quality research around the topic and the potential dangers associated with supplement use, you can take the appropriate steps in experimenting with these therapies.
Most physicians in my practice do not make definitive recommendations on any supplements for knee pain due to a lack of medical evidence for their use and the financial strain that purchasing these products can have for you as their patient. Taking that into account, because each person’s case is a little different and because there are few risks to taking supplements (except NSAIDs), you may find one or all of them to be highly effective.
The only way to know is by trying them. On the other hand, these supplements may prove no benefits at all, be extremely costly, trigger adverse side effects, and cause you undue stress and anxiety. Until more conclusive evidence is reported on these “cures,” what is most important is that you feel you have control over your own health and body and that you remain vigilant and aware of the uncertainty of supplements.
Wandel S, Juni P, Tendal B, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta‐analysis, BMJ,2010; 341 ( sep16 2 ):c4675. doi: 10.1136/bmj.c4675 Xiaoqian Liu, Jillian Eyles, Andrew J McLachlan, Ali Mobasheri, Which supplements can I recommend to my osteoarthritis patients?, Rheumatology, 57 (4), iv75-iv87. Retried from https://doi.org/10.1093/rheumatology/key005 3. Oe M, Tashiro T, Yoshida H, Nishiyama H, Masuda Y, Maruyama K, et al., Oral hyaluronan relieves knee pain: a review, Nutr Res, (2016) 15 :11. doi: 10.1100/2012/167928
What is the best medicine for inflammation in the knee?
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You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Taking care of yourself when you have a swollen knee includes:
Rest. Avoid weight-bearing activities as much as possible. Ice and elevation. To control pain and swelling, apply ice to your knee for 15 to 20 minutes every 2 to 4 hours. When you ice your knee, be sure to raise your knee higher than the level of your heart. Place pillows under your knee for comfort. Compression. Wrapping your knee with an elastic bandage can help control the swelling. Pain relievers. Over-the-counter medicines such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin IB, others) can help reduce your knee pain.
Is ibuprofen or Tylenol better for knee pain?
Either of these common pain relievers could be beneficial for your arthritis, but you need to know how to use them properly. A major symptom of arthritis is joint pain. Sometimes it’s mild, sometimes it’s intense. Sometimes the pain can even be disabling.
Fortunately, different drugs can help relieve this pain. Popular pain-relieving drugs that you can purchase over the counter at any drugstore are Advil and Tylenol. Both can temporarily relieve mild to moderate arthritis pain. What’s in these drugs? Are they safe? Is one better at relieving arthritis pain than the other? What else do they treat? Advil is a brand name for the non-narcotic, pain-relieving drug called ibuprofen.
It’s available in oral tablets and liquid-filled capsules. Other over-the-counter brand names for ibuprofen include Midol, Motrin, and Nuprin. Advil can be used to treat general aches and pains as well as help relieve mild fever. Advil may relieve mild to moderate joint pain from:
osteoarthritisrheumatoid arthritis (RA)psoriatic arthritisankylosing spondylitisgouty arthritis
Other Advil products are specifically marketed to treat other types of pain. People who are older than 12 years can take Advil. The typical recommended dose is one or two tablets or capsules every four to six hours, taking no more than six tablets or capsules in a 24-hour period.
Advil is a nonsteroidal anti-inflammatory drug (NSAID). It helps temporarily relieve pain and fever by reducing tissue inflammation. Advil blocks the production of certain chemicals in the body. This reduces inflammation and pain. It also accounts for ibuprofen’s fever-reducing action. In arthritis, the soft tissues surrounding the joints become inflamed.
This causes pain. RA, an autoimmune disease, causes inflammation when the body’s immune system attacks the soft tissues that surround the joints. Learn more: Inflammatory vs. non-inflammatory arthritis: What’s the difference? » Possible side effects of Advil include:
constipation or diarrheagas or bloatingdizzinessnervousnessadverse skin reactionsringing in the ears
Serious side effects include a higher risk of heart attack or stroke. Talk with your doctor if you experience any side effects. Don’t take Advil if you take blood thinners or steroids. Advil may also cause sores, bleeding, or holes in the stomach or intestines. This is not common. However, the risk is higher for people who:
take doses that are higher than recommendedare oldertake NSAIDs for a long timeare in poor healthdrink three or more alcoholic drinks per day
Tylenol is one brand of the non-narcotic pain-reliever called acetaminophen. Other brands of acetaminophen include Anacin Aspirin Free and Daytril. Tylenol may relieve minor aches and pains and reduce fever. It has little anti-inflammatory effect, though, which means it won’t do much for pain from inflammatory arthritis.
Acetaminophen comes in many forms and strengths. The dose depends on both the form and strength of the product. Acetaminophen, the active ingredient in Tylenol, is one of the most widely used pain relievers in the world. However, scientists don’t know exactly how it works to relieve pain. It is thought that this drug increases the body’s pain threshold so that pain is actually felt less.
Tylenol may cause serious liver damage — even death — if you take more than recommended. Always follow the package directions with care. Note the milligrams per dose. Never take more than 4,000 mg of acetaminophen per day. Acetaminophen can be sold by itself, like in Tylenol.
It can also be mixed with other drugs in many OTC cough and cold remedies. Reading the labels of these drugs, especially when you take them together, can help you avoid taking too much acetaminophen. The U.S. Food and Drug Administration (FDA) recently came out with a new warning about acetaminophen. The drug has been associated with a risk of rare but serious skin reactions.
If you have a skin reaction when you take Tylenol, stop and consult your doctor immediately. Overall, both OTC drugs are safe and effective as long as you use them correctly. They both do a good job of relieving pain. However, if you take them incorrectly both can cause severe side effects.
Deciding which one is best for you may come down to your type of pain and your medical history. Advil reduces inflammation, which reduces pain. It works best on pain caused by inflammation, such as pain from RA. Tylenol works to lower your body’s pain threshold. It works best for pain that is not specifically from inflammation, such as pain from osteoarthritis.
You should talk with your doctor before you use either of these drugs if you have any medical conditions. You should also talk with your doctor or pharmacist if you take other drugs, including other over-the-counter drugs and herbal remedies, to make sure they won’t interact with either of these drugs.
Do painkillers stop knee pain?
Osteoarthritis pain can often be treated effectively with anti-inflammatory painkillers. But higher doses are often needed. Due to the possible associated risks, it’s recommended that the painkillers be taken as needed rather than all the time. Osteoarthritis is typically treated with painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs).
These medications have an anti-inflammatory and pain-relieving effect. Examples of NSAIDs include diclofenac, ibuprofen and naproxen. Two other anti-inflammatory painkillers with a similar effect are celecoxib and etoricoxib. These are COX-2 inhibitors (also known as coxibs). They are taken as tablets or directly applied to the painful joint in the form of a gel or cream.
Some NSAIDs can be bought at pharmacies without a prescription – for example, to treat a headache or menstrual pain. To achieve noticeable pain relief in osteoarthritis, though, higher doses are often needed, and they have to be prescribed by a doctor.
- NSAIDs and coxibs can relieve pain effectively, but they can also have side effects.
- The risk of serious side effects depends on your age and any other medical conditions you may have.
- But anti-inflammatory painkillers aren’t suitable for everyone.
- People who already have other illnesses, like kidney problems or stomach ulcers, may not be able to take them or may have to go for regular check-ups.
Sometimes reducing the dose is enough. Other reasons not to take NSAIDs or coxibs may include interactions with certain medications like acetylsalicylic acid (ASA). Alternatively, you can apply a cream or gel with a drug like diclofenac to your knee. Studies show that this can effectively relieve pain in some people with osteoarthritis of the knee.
- The drug etofenamate is available in the form of a cream or gel too.
- But its effectiveness hasn’t been studied in good-quality studies.
- Some people worry too much about the possible risks associated with painkillers.
- A few also worry about becoming dependent on them.
- But unlike opiate-based painkillers (opioids), NSAIDs and coxibs have no addictive effect.
Other people worry that taking painkillers might prevent them from feeling alarm signals sent by their bodies. There’s no medical reason to worry, though: Chronic pain tells you much less about the condition of your joints than you might think. It’s best to use anti-inflammatory painkillers in addition to other treatments, like exercise therapy.
What vitamins help knee pain?
Learn which supplements and vitamins might help with arthritis symptoms, and what risks some can pose. Several nutritional supplements have shown promise for relieving pain, stiffness and other arthritis symptoms. Glucosamine and chondroitin, omega-3 fatty acids, SAM-e and curcumin are just some of the natural products researchers have studied for osteoarthritis (OA) and rheumatoid arthritis (RA).
Some of these natural remedies may offer arthritis symptom relief, especially when you use them in conjunction with traditional treatments. Here’s the evidence on some of the most popular supplements used to treat arthritis, and how they work. Glucosamine and Chondroitin Glucosamine and chondroitin are two of the most commonly used supplements for arthritis.
They’re components of cartilage—the substance that cushions the joints. Research on these supplements has been mixed, in part because studies have used varying designs and supplement types. A large National Institutes of Health study called the GAIT trial compared glucosamine and chondroitin, alone or together, with an NSAID and inactive treatment (placebo) in people with knee osteoarthritis (OA).
Glucosamine improved symptoms like pain and function, but not much better than a placebo. Yet a 2016 international trial found the combination to be as effective as the NSAID celecoxib at reducing pain, stiffness and swelling in knee OA. Studies have also differed on which form of the supplements is most effective.
Some evidence suggests glucosamine sulfate is best. Others find glucosamine hydrochloride to be more effective. One study that compared the two forms head to head showed they offered equivalent pain relief. Mayo Clinic researchers say evidence supports trying glucosamine sulfate – not hydrochloride – with or without chondroitin sulfate for knee OA.
Fish oil The polyunsaturated omega-3 fatty acids found in fish have potent anti-inflammatory properties. “Omega-3 fats seem to work better for rheumatoid arthritis than for osteoarthritis, most likely because rheumatoid arthritis is mainly driven by inflammation,” says Chris D’Adamo, PhD, director of Research & Education at the University of Maryland School of Medicine Center for Integrative Medicine.
A 2017 systematic review of studies found that omega-3 supplements reduced joint pain, stiffness and swelling in RA. Taking these supplements might help some people cut down on their use of pain relievers – and avoid their side effects. “For mild cases of arthritis, it may be better to reach for the supplements before you go for the ibuprofen,” says Farshad Fani Marvasti, MD, MPH, director of Public Health, Prevention, and Health Promotion at The University of Arizona.
- Omega-3s have the added benefit of protecting against heart disease and dementia, he says.
- Plant-based sources such as flax and chia seeds also contain omega-3s, but in the form of short-chain alpha-linolenic acid (ALA).
- It’s the long-chain omega-3 fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – that have the majority of the health benefits,” D’Adamo says.
When you buy fish oil, make sure the supplement lists the EPA and DHA content, and that you take at least one gram each of EPA and DHA, he adds. Vegans can get these omega-3s from an algae-based supplement. SAM-e S-adenosyl-methionine (SAM-e) is a natural compound in the body that has anti-inflammatory, cartilage-protecting and pain-relieving effects.
- In studies, it was about as good at relieving OA pain as NSAIDs like ibuprofen and celecoxib, without their side effects.
- SAM-e has a bonus benefit, too.
- The supplement is most useful when you also have depression, because it has a mild to moderate antidepressant effect,” Marvasti says.
- The typical SAM-e dose is 1,200 mg daily.
If you plan to try this supplement, be patient. “It’s going to take a few weeks to see the full effects,” D’Adamo says. Curcumin Curcumin is the active compound in the yellow-hued spice, turmeric, which is a staple of Indian curries. In the body, it acts as a powerful anti-inflammatory agent, blocking the same inflammation-promoting enzyme as the COX-2 inhibitor drug, celecoxib.
In a study of 367 people with knee OA, a 1,500 mg daily dose of curcumin extract was as effective as 1,200 mg a day of ibuprofen, without the gastrointestinal side effects. This supplement also appears to relieve RA swelling and tenderness. One downside to curcumin is that it’s hard for the body to absorb.
“You want to take it with a source of fat. Some of the supplements will be in an oil base, which is really important,” D’Adamo says. Black pepper also increases the absorption. Some supplements add the black pepper extract, piperine. However, piperine could potentially cause liver damage, and it can increase the absorption of medications like carbamazepine (Tegretol) and phenytoin (Dilantin), making them more potent.
- Vitamins Several vitamins have been studied for their effects on arthritis, including the antioxidant vitamins A, C, and E, and vitamins D and K.
- So far there’s no evidence that taking antioxidant vitamins improves arthritis symptoms, although eating a diet rich in these nutrients is healthy overall.
Vitamins D and K are both important for bone strength, and vitamin K is involved in cartilage structure. Supplementing these two nutrients may be helpful if you’re deficient in them. Supplement Risks When you take supplements as directed and under your doctor’s supervision, they’re generally safe.
Yet even though they’re labeled “natural,” supplements can sometimes cause side effects or interact with the medicines you take. For example, high-dose fish oil supplements can thin the blood and may interact with anticoagulant medicines such as warfarin (Coumadin). Sometimes you can overdo it and take too much, especially when it comes to vitamins.
Some vitamins – like B and C – are water soluble. That means if you take too much of them, your body will flush out the extra. Yet fat-soluble vitamins such as A, D, E and K can build up in your body to the point where they become harmful, so check with your doctor about safe amounts.
Finally, supplements don’t go through the same rigorous approval process from the Food and Drug Administration (FDA) as medicines. The FDA has to review and approve every medication to make sure it works and that it’s safe. With supplements, the ingredients listed on the label may not be the same ones that are in the bottle.
How to Take Supplements Safely If you do want to try supplements, use them as an add-on to arthritis drugs, not as a replacement. They should never take the place of medications, which are the only proven way to slow joint damage. Always check with your doctor before you try any new supplement to make sure that it’s right for you, and that you’re taking a safe dose.
What is the safest painkiller to take?
Acetaminophen – Acetaminophen is usually recommended as a first line treatment for mild to moderate pain. It might be taken for pain due to a skin injury, headache, or conditions that affect the muscles and bones. Acetaminophen is often prescribed to help manage osteoarthritis and back pain. It also may be combined with opioids to reduce the amount of opioid needed.
- Generic (brand) names. Acetaminophen (Tylenol, others).
- How it works. Acetaminophen is thought to block the production of prostaglandins in the central nervous system. Prostaglandins are hormonelike substances that are involved in pain and inflammation. Unlike NSAIDs, acetaminophen doesn’t target inflammation at the site of injury — only pain.
- Benefits and risks. Acetaminophen is generally considered safer than other pain relievers. It doesn’t cause side effects such as stomach pain and bleeding. However, taking more than the recommended dose or taking acetaminophen with alcohol increases the risk of kidney damage and liver failure over time.
- Bottom line. Acetaminophen is generally a safe option to try first for many types of pain, including chronic pain. Ask your health care provider for guidance about other medications to avoid while taking acetaminophen. Acetaminophen is not as effective as NSAIDs for the treatment of knee and hip pain related to osteoarthritis.
Is paracetamol good for knee pain?
Background Osteoarthritis of the hip or knee is a progressive disabling disease affecting many people worldwide. Although paracetamol is widely used as a treatment option for this condition, recent studies have called into question how effective this pain relief medication is.
Search date This review includes all trials published up to 3 October 2017. Study characteristics We included randomised clinical trials (where people are randomly put into one of two treatment groups) looking at the effects of paracetamol for people with hip or knee pain due to osteoarthritis against a placebo (a ‘sugar tablet’ that contains nothing that could act as a medicine).
We found 10 trials with 3541 participants. On average, participants in the study were aged between 55 and 70 years, and most presented with knee osteoarthritis. The treatment dose ranged from 1.95 g/day to 4 g/day of paracetamol and participants were followed up between one and 12 weeks in all but one study, which followed people up for 24 weeks.
Six trials were funded by companies that produced paracetamol. Key results Compared with placebo tablets, paracetamol resulted in little benefit at 12 weeks. Pain (lower scores mean less pain) Improved by 3% (1% better to 5% better), or 3.2 points (1 better to 5.4 better) on a 0- to 100-point scale. • People who took paracetamol reported that their pain improved by 26 points.
• People who took placebo reported that their pain improved by 23 points. Physical function (lower scores mean better function) Improved by 3% (1% better to 5% better), or 2.9 points (1.0 better to 4.9 better) on a 0- to 100-point scale. • People who took paracetamol reported that their function improved by 15 points.
• People who had placebo reported that their function improved by 12 points. Side effects (up to 12 to 24 weeks) No more people had side effects with paracetamol (3% less to 3% more), or 0 more people out of 100. • 33 out of 100 people reported a side effect with paracetamol. • 33 out of 100 people reported a side effect with placebo.
Serious side effects (up to 12 to 24 weeks) 1% more people had serious side effects with paracetamol (0% less to 1% more), or one more person out of 100. • Two out of 100 people reported a serious side effect with paracetamol. • One out of 100 people reported a serious side effect with placebo.
Withdrawals due to adverse events (up to 12 to 24 weeks) 1% more people withdrew from treatment with paracetamol (1% less to 3% more), or one more person out of 100. • Eight out of 100 people withdrew from paracetamol treatment. • Seven out of 100 people withdrew from placebo treatment. Abnormal liver function tests (up to 12 to 24 weeks): 5% more people had abnormal liver function tests (meaning there was some inflammation or damage to the liver) with paracetamol (1% more to 10% more), or five more people out of 100.
• Seven out of 100 people had an abnormal liver function test with paracetamol. • Two out of 100 people had an abnormal liver function test with placebo. Quality of the evidence High-quality evidence indicated that paracetamol provided only minimal improvements in pain and function for people with hip or knee osteoarthritis, with no increased risk of adverse events overall.
None of the studies measured quality of life. Due to the small number of events, we were less certain if paracetamol use increased the risk of serious side effects, increased withdrawals due to side effects, and changed the rate of abnormal liver function tests. However, although there may be more abnormal liver function tests with paracetamol, the clinical implications are unknown.
If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions. Authors’ conclusions: Based on high-quality evidence this review confirms that paracetamol provides only minimal improvements in pain and function for people with hip or knee osteoarthritis, with no increased risk of adverse events overall.
Subgroup analysis indicates that the effects on pain and function do not differ according to the dose of paracetamol. Due to the small number of events, we are less certain if paracetamol use increases the risk of serious adverse events, withdrawals due to adverse events, and rate of abnormal liver function tests.
Current clinical guidelines consistently recommend paracetamol as the first-line analgesic medication for hip or knee osteoarthritis, given its low absolute frequency of substantive harm. However, our results call for reconsideration of these recommendations.
Read the full abstract. Background: Paracetamol (acetaminophen) is vastly recommended as the first-line analgesic for osteoarthritis of the hip or knee. However, there has been controversy about this recommendation given recent studies have revealed small effects of paracetamol when compared with placebo.
Nonetheless, past studies have not systematically reviewed and appraised the literature to investigate the effects of this drug on specific osteoarthritis sites, that is, hip or knee, or on the dose used. Objectives: To assess the benefits and harms of paracetamol compared with placebo in the treatment of osteoarthritis of the hip or knee.
Search strategy: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, AMED, CINAHL, Web of Science, LILACS, and International Pharmaceutical Abstracts to 3 October 2017, and ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (ICTRP) portal on 20 October 2017.
Selection criteria: We included randomised controlled trials comparing paracetamol with placebo in adults with osteoarthritis of the hip or knee. Major outcomes were pain, function, quality of life, adverse events and withdrawals due to adverse events, serious adverse events, and abnormal liver function tests.
Data collection and analysis: Two review authors used standard Cochrane methods to collect data, and assess risk of bias and quality of the evidence. For pooling purposes, we converted pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function) scores to a common 0 (no pain or disability) to 100 (worst possible pain or disability) scale.
Main results: We identified 10 randomised placebo-controlled trials involving 3541 participants with hip or knee osteoarthritis. The paracetamol dose varied from 1.95 g/day to 4 g/day, and the majority of trials followed participants for three months only.
Most trials did not clearly report randomisation and concealment methods and were at unclear risk of selection bias. Trials were at low risk of performance, detection, and reporting bias. At 3 weeks’ to 3 months’ follow-up, there was high-quality evidence that paracetamol provided no clinically important improvements in pain and physical function.
Mean reduction in pain was 23 points (0 to 100 scale, lower scores indicated less pain) with placebo and 3.23 points better (5.43 better to 1.02 better) with paracetamol, an absolute reduction of 3% (1% better to 5% better, minimal clinical important difference 9%) and relative reduction of 5% (2% better to 8% better) (seven trials, 2355 participants).
Physical function improved by 12 points on a 0 to 100 scale (lower scores indicated better function) with placebo and was 2.9 points better (0.95 better to 4.89 better) with paracetamol, an absolute improvement of 3% (1% better to 5% better, minimal clinical important difference 10%) and relative improvement of 5% (2% better to 9% better) (7 trials, 2354 participants).
High-quality evidence from eight trials indicated that the incidence of adverse events was similar between groups: 515/1586 (325 per 1000) in the placebo group versus 537/1666 (328 per 1000, range 299 to 360) in the paracetamol group (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.92 to 1.11).
There was less certainty (moderate-quality evidence) around the risk of serious adverse events, withdrawals due to adverse events, and the rate of abnormal liver function tests, due to wide CIs or small event rates, indicating imprecision. Seventeen of 1480 (11 per 1000) people treated with placebo and 28/1729 (16 per 1000, range 8 to 29) people treated with paracetamol experienced serious adverse events (RR 1.36, 95% CI 0.73 to 2.53; 6 trials).
The incidence of withdrawals due to adverse events was 65/1000 participants in with placebo and 77/1000 (range 59 to 100) participants with paracetamol (RR 1.19, 95% CI 0.91 to 1.55; 7 trials). Abnormal liver function occurred in 18/1000 participants treated with placebo and 70/1000 participants treated with paracetamol (RR 3.79, 95% CI 1.94 to 7.39), but the clinical importance of this effect was uncertain.
Is Voltaren good for knee pain?
What is Voltaren
An alternative to pills, Voltaren gel is a topical analgesic that targets pain directly at the source to deliver nonsteroidal anti-inflammatory medicine for powerful arthritis pain relief. Voltaren is clinically proven to relieve joint pain, reduce stiffness, and improve mobility.
The active ingredient in Voltaren is diclofenac sodium, a nonsteroidal anti-inflammatory drug (NSAID). It falls in the same category of ibuprofen and naproxen. Diclofenac sodium topical gel works by temporarily blocking the production of pain-signaling chemicals called prostaglandins to help provide relief.
Voltaren helps alleviate joint pain due to arthritis in the hands, wrists, elbows, feet, ankles, and knees. Apply Voltaren gel to the skin over the affected part of the body. Do not use on more than two body areas at the same time.
Use the enclosed dosing card to measure the correct dose, and then gently rub the Voltaren gel into the skin using your hand. Using the dosing card, apply the following amounts as directed on the package four times daily: Upper body areas (hand, wrist, elbow): 2.25 inches (2 grams)Lower body areas (foot, ankle, knee): 4.5 inches (4 grams)
Do not use on more than two body areas at the same time. Voltaren should not be used on the same area as any other medicine or products applied to the skin.
Voltaren is intended to be used 4 times a day every day for up to 21 days. With 4-times-a-day use, you may start to feel arthritis relief within a few days. You should feel significant relief in 7 days.
Voltaren contains an effective nonsteroidal anti-inflammatory medicine which is clinically proven to relieve arthritis joint pain. With 4-times-a-day use, you may start to feel relief within a few days. You should feel significant pain relief within 7 days of continuous use.
First, you take the cap off the Voltaren gel tube and open the seal by firmly pressing the indent on the top of the cap onto the star-shaped seal on the tube. Then, you will need to firmly turn the cap to remove the safety seal. Do not open the seal with scissors or other sharp objects.
Use the dosing card to measure the correct dose. Gently rub Voltaren into your skin using your hand. You should apply it 4 times a day for best results. Do not use on more than two body areas at the same time. Only apply Voltaren gel to clean, dry skin that doesn’t have any cuts, open wounds, infections, or rashes. Do not apply Voltaren to areas of the skin where other medicine or products have been applied.
: What is Voltaren
Is it OK to take ibuprofen for knee pain?
Over-The-Counter Medication for Knee Pain 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.
Why my knee is so painful?
Overview – Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions — including arthritis, gout and infections — also can cause knee pain.
Can I ignore knee pain?
Delaying joint care can lead to injury and other problems – For patients who have joint pain or mobility issues, it’s important to stay current with your joint health. In some cases, ignoring joint pain for too long may increase pain or mobility problems, or even result in a fall or injury.
The more proactive you are in preserving your joints, the longer we anticipate they will last,” says Dr. Lange. “Taking care of your joint pain early could delay or prevent the need for surgery. If you do need surgery, having surgery earlier can lead to better outcomes in many cases. The details differ for every person, which is why we always suggest having an evaluation with a clinician to better understand your own unique situation.” A check-in with your orthopaedic specialist can help you understand all the available options for your unique situation.
Together, you and your orthopaedic specialist can:
Address your joint symptoms and concerns Review or order imaging, such as an x-ray or an MRI Discuss exercises or other lifestyle changes that can reduce pain and improve mobility Discuss the role of pain medicine Schedule a cortisone injection to help relieve pain and inflammation in a joint Pursue a referral to physical therapy or other non-surgical treatments Discuss joint replacement surgery or another procedure Discuss the risks and benefits of continuing care versus waiting for a period of time
Is ibuprofen good for knee pain?
Over-The-Counter Medication for Knee Pain 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.
Is paracetamol good for knee pain?
Background Osteoarthritis of the hip or knee is a progressive disabling disease affecting many people worldwide. Although paracetamol is widely used as a treatment option for this condition, recent studies have called into question how effective this pain relief medication is.
- Search date This review includes all trials published up to 3 October 2017.
- Study characteristics We included randomised clinical trials (where people are randomly put into one of two treatment groups) looking at the effects of paracetamol for people with hip or knee pain due to osteoarthritis against a placebo (a ‘sugar tablet’ that contains nothing that could act as a medicine).
We found 10 trials with 3541 participants. On average, participants in the study were aged between 55 and 70 years, and most presented with knee osteoarthritis. The treatment dose ranged from 1.95 g/day to 4 g/day of paracetamol and participants were followed up between one and 12 weeks in all but one study, which followed people up for 24 weeks.
Six trials were funded by companies that produced paracetamol. Key results Compared with placebo tablets, paracetamol resulted in little benefit at 12 weeks. Pain (lower scores mean less pain) Improved by 3% (1% better to 5% better), or 3.2 points (1 better to 5.4 better) on a 0- to 100-point scale. • People who took paracetamol reported that their pain improved by 26 points.
• People who took placebo reported that their pain improved by 23 points. Physical function (lower scores mean better function) Improved by 3% (1% better to 5% better), or 2.9 points (1.0 better to 4.9 better) on a 0- to 100-point scale. • People who took paracetamol reported that their function improved by 15 points.
• People who had placebo reported that their function improved by 12 points. Side effects (up to 12 to 24 weeks) No more people had side effects with paracetamol (3% less to 3% more), or 0 more people out of 100. • 33 out of 100 people reported a side effect with paracetamol. • 33 out of 100 people reported a side effect with placebo.
Serious side effects (up to 12 to 24 weeks) 1% more people had serious side effects with paracetamol (0% less to 1% more), or one more person out of 100. • Two out of 100 people reported a serious side effect with paracetamol. • One out of 100 people reported a serious side effect with placebo.
Withdrawals due to adverse events (up to 12 to 24 weeks) 1% more people withdrew from treatment with paracetamol (1% less to 3% more), or one more person out of 100. • Eight out of 100 people withdrew from paracetamol treatment. • Seven out of 100 people withdrew from placebo treatment. Abnormal liver function tests (up to 12 to 24 weeks): 5% more people had abnormal liver function tests (meaning there was some inflammation or damage to the liver) with paracetamol (1% more to 10% more), or five more people out of 100.
• Seven out of 100 people had an abnormal liver function test with paracetamol. • Two out of 100 people had an abnormal liver function test with placebo. Quality of the evidence High-quality evidence indicated that paracetamol provided only minimal improvements in pain and function for people with hip or knee osteoarthritis, with no increased risk of adverse events overall.
- None of the studies measured quality of life.
- Due to the small number of events, we were less certain if paracetamol use increased the risk of serious side effects, increased withdrawals due to side effects, and changed the rate of abnormal liver function tests.
- However, although there may be more abnormal liver function tests with paracetamol, the clinical implications are unknown.
If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions. Authors’ conclusions: Based on high-quality evidence this review confirms that paracetamol provides only minimal improvements in pain and function for people with hip or knee osteoarthritis, with no increased risk of adverse events overall.
- Subgroup analysis indicates that the effects on pain and function do not differ according to the dose of paracetamol.
- Due to the small number of events, we are less certain if paracetamol use increases the risk of serious adverse events, withdrawals due to adverse events, and rate of abnormal liver function tests.
Current clinical guidelines consistently recommend paracetamol as the first-line analgesic medication for hip or knee osteoarthritis, given its low absolute frequency of substantive harm. However, our results call for reconsideration of these recommendations.
- Read the full abstract.
- Background: Paracetamol (acetaminophen) is vastly recommended as the first-line analgesic for osteoarthritis of the hip or knee.
- However, there has been controversy about this recommendation given recent studies have revealed small effects of paracetamol when compared with placebo.
Nonetheless, past studies have not systematically reviewed and appraised the literature to investigate the effects of this drug on specific osteoarthritis sites, that is, hip or knee, or on the dose used. Objectives: To assess the benefits and harms of paracetamol compared with placebo in the treatment of osteoarthritis of the hip or knee.
Search strategy: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, AMED, CINAHL, Web of Science, LILACS, and International Pharmaceutical Abstracts to 3 October 2017, and ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (ICTRP) portal on 20 October 2017.
Selection criteria: We included randomised controlled trials comparing paracetamol with placebo in adults with osteoarthritis of the hip or knee. Major outcomes were pain, function, quality of life, adverse events and withdrawals due to adverse events, serious adverse events, and abnormal liver function tests.
Data collection and analysis: Two review authors used standard Cochrane methods to collect data, and assess risk of bias and quality of the evidence. For pooling purposes, we converted pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function) scores to a common 0 (no pain or disability) to 100 (worst possible pain or disability) scale.
Main results: We identified 10 randomised placebo-controlled trials involving 3541 participants with hip or knee osteoarthritis. The paracetamol dose varied from 1.95 g/day to 4 g/day, and the majority of trials followed participants for three months only.
- Most trials did not clearly report randomisation and concealment methods and were at unclear risk of selection bias.
- Trials were at low risk of performance, detection, and reporting bias.
- At 3 weeks’ to 3 months’ follow-up, there was high-quality evidence that paracetamol provided no clinically important improvements in pain and physical function.
Mean reduction in pain was 23 points (0 to 100 scale, lower scores indicated less pain) with placebo and 3.23 points better (5.43 better to 1.02 better) with paracetamol, an absolute reduction of 3% (1% better to 5% better, minimal clinical important difference 9%) and relative reduction of 5% (2% better to 8% better) (seven trials, 2355 participants).
Physical function improved by 12 points on a 0 to 100 scale (lower scores indicated better function) with placebo and was 2.9 points better (0.95 better to 4.89 better) with paracetamol, an absolute improvement of 3% (1% better to 5% better, minimal clinical important difference 10%) and relative improvement of 5% (2% better to 9% better) (7 trials, 2354 participants).
High-quality evidence from eight trials indicated that the incidence of adverse events was similar between groups: 515/1586 (325 per 1000) in the placebo group versus 537/1666 (328 per 1000, range 299 to 360) in the paracetamol group (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.92 to 1.11).
There was less certainty (moderate-quality evidence) around the risk of serious adverse events, withdrawals due to adverse events, and the rate of abnormal liver function tests, due to wide CIs or small event rates, indicating imprecision. Seventeen of 1480 (11 per 1000) people treated with placebo and 28/1729 (16 per 1000, range 8 to 29) people treated with paracetamol experienced serious adverse events (RR 1.36, 95% CI 0.73 to 2.53; 6 trials).
The incidence of withdrawals due to adverse events was 65/1000 participants in with placebo and 77/1000 (range 59 to 100) participants with paracetamol (RR 1.19, 95% CI 0.91 to 1.55; 7 trials). Abnormal liver function occurred in 18/1000 participants treated with placebo and 70/1000 participants treated with paracetamol (RR 3.79, 95% CI 1.94 to 7.39), but the clinical importance of this effect was uncertain.
Should I take paracetamol for knee pain?
Paracetamol – If you have pain caused by osteroarthritis, your GP might suggest you consider taking paracetamol for short-term pain relief. You can buy paracetamol at supermarkets or pharmacies. However, many people find that it doesn’t work very well, and it is only normally tried if you can’t take other medicines.