TOP-11 strong non-steroidal anti-inflammatory substances for the treatment of joints of the legs, arms and back: list of drugs. Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of joints Contraindications to the use of NSAIDs

The whole truth about: anti-inflammatory drugs for the treatment of joints and other interesting information about treatment.

Joint pain significantly complicates life and prevents you from living fully. Painful processes do not go away on their own. Therefore, treatment is accompanied primarily by anti-inflammatory drugs. Their list is quite wide. In structure, they differ from others in the absence of steroid hormones, which allows the medicine to be taken by a wide group of patients.

Non-steroidal anti-inflammatory drugs are used to treat large and small joints, as well as ligaments. The disease is accompanied by swelling, pain and hyperthermia. At the same time, prostaglandins are formed in the body - substances that activate the production of hormones in the blood. As a result of the effect on blood vessels, body temperature rises, and inflammatory reactions intensify, which leads to arthritis, osteochondrosis and other unpleasant diseases.

The enzyme cyclooxygenase (COX) is blocked by the non-hormonal action of NSAIDs. Swelling and redness decrease, temperature returns to normal, inflammation subsides.

NSAIDs have a positive effect on diseases:

• relieve inflammation;
• have analgesic properties;
• effectively lower the temperature;
• have an antiaggregation effect - eliminate platelet aggregation.

Do not forget that immunosuppressant medications help in the treatment of rheumatism, but have a depressing effect on the immune system as a whole.

Classification of drugs

It is worth noting that COX is divided into two types. The first produces prostaglandin, which protects the mucous membrane of the stomach and intestines from damage. And the second connects prostaglandins, which increase the temperature.

Therefore, drugs are usually differentiated into two parts:

• selective (they inhibit COX2);
• non-selective.

The latter, in turn, are also grouped. Some affect both COXs equally, others affect COX1.

The first ones are prescribed for acute respiratory viral infections, after operations, for injuries, infections, others save from rheumatism and sore joints, and have anti-inflammatory properties.

Indications for the use of NSAIDs for the treatment of joints

Anti-inflammatory drugs are safe with short-term use and no contraindications.

Medicines are used for chronic and acute inflammatory processes:

• migraine;
• injuries;
• arthritis, rheumatism, ankylosing spondylitis;
• toothache;
• gout;
• renal and hepatic colic;
• inflammatory diseases of the spine, muscles, musculoskeletal system, joints and bones;
• radiculitis, sciatica, neuralgia;
• painful critical days;
• infections;
• metastases in cancer.

List of non-steroidal anti-inflammatory drugs

Acetyl salicylic acid (aspirin).

In practice for more than a hundred years. Prescribed to combat ARVI and relieve headaches. Used together with other substances for the treatment of osteoarthritis. But in case of acute inflammation, aspirin is replaced with more powerful medications.

Diclofenac.

Available in tablets, suppositories, gel and solution for injection. The popular pain reliever is absorbed within twenty minutes and relieves fever.

Ibuprofen.

Release form: suppositories, tablets. It is easy to carry and has a low price tag. Prescribed for neuralgia, bursitis, hematomas, sprains, influenza, ARVI, rheumatoid arthritis, gout, ankylosing spondylitis, osteoarthritis, febrile conditions. Ibuprofen has many analogues in different price categories.

Nimesulide.

When using it, the temperature normalizes, the body becomes mobile as a result of pain relief. The ointment is applied to the arthritic area. There may be slight redness, this is how the effect of the drug is manifested.

Indomethacin is one of the strongest drugs with an analgesic effect.

Available in the form of ointments, suppositories, tablets. Although the medicine is cheap, this does not prevent it from having an incomparable effect on arthritic and arthritic joints. Before use, consult a doctor due to the impressive list of side effects.

Meloxicam belongs to the group of NSAIDs.

Available in tablets and in solution for intramuscular administration. Pharmacological action – analgesic, anti-inflammatory with antipyretic effect. Indicated for symptomatic therapy to reduce pain and inflammation. Treats osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. It is allowed to use meloxicam under the supervision of a specialist even for several years. Long-term exposure allows you to take one tablet during the day. The substance can be purchased under various names - Movalis, Melbek, Melox, Artrosan, Mesipol, Mataren, etc.

Some drugs, under the strict supervision of a doctor, are allowed to be taken by pregnant women in case of vital need, and in no case in the third trimester.

The doctor may prescribe:

• diclofenac;
• ibuprofen;
• aspirin;
• ketorolac;
• indomethacin;
• naproxen.

Taking medications on your own is prohibited.

New generation NSAIDs for the treatment of joints

Medical technology does not stand still. Every day, hundreds of scientists are trying to develop new pills and modernize time-tested ones. Non-steroidal anti-inflammatory drugs have not been spared either. New generation drugs act more selectively and thoroughly suppress inflammation. The most important thing here is the absence of a serious effect on the gastrointestinal tract and cartilage tissue.

List of new generation non-steroidal anti-inflammatory drugs

Among the useful “potions”, the most effective was Movalis with the active ingredient in the form of meloxicam. For arthrosis, a real lifesaver. Long-term use has virtually no effect on the functioning of the stomach and intestines. Analogs work in the same area - Melbek, Mesipol, Mirlox.

The drug Xefocam has the ability to extend the effect of the panacea, so that patients do not feel pain for about twelve hours. Most importantly, Xefocam is not addictive, and its ability to relieve pain is comparable to morphine. However, the high cost does not allow everyone to purchase the drug for their first aid kit. Available with a doctor's prescription.

The antioxidant Nimesulide blocks the action of substances that break down collagen and cartilage tissue. Arthrosis of the joints is treatable, the pain subsides, and the inflammation goes away. Sold in granules for solution, tablets, and gel form.

Celecoxib was originally called Celebrex. Release form: capsules 200 and 100 mg. The pronounced fight against arthrosis and arthritis does not affect the functioning of the gastrointestinal tract, the mucous membrane remains normal.

Etoricoxib is marketed under the brand name Arcoxia. Taking up to 150 mg per day does not affect the functioning of the intestines and stomach. The average dose for arthrosis is approximately 30-60 mg per day.

The cost of medications varies. On the advice of a doctor, the patient can buy a more expensive drug or its analogue, depending on the contraindications and side effects. The products relieve unbearable pain and eliminate inflammation. After taking them, another treatment should be prescribed.

General rules of application

There is no point in taking on a medication guide on your own. Contacting a specialist will help you understand the methods and rules of treatment. To do this, you need to prepare all statements about previous or concomitant diseases and take tests so that the doctor can select the right treatment.

The tablets are taken immediately after meals with half a glass of water or low-fat milk for absorption and protection of the gastrointestinal tract from harmful effects. At the same time, bifidobacteria should be taken.

If long-term use is planned, then start with a minimum dose, gradually increasing the amount.

Side effects of non-steroidal anti-inflammatory drugs

1. Allergy.
2. Bronchospasms.
3. Dyspeptic disorders.
4. Impaired renal function (nephropathy, blood vessels narrow).
5. Ulcerogenic effect (development of erosion or stomach ulcers).
6. Increased blood activity in the liver.
7. Miscarriages.
8. In rare cases, bleeding disorders.

Contraindications to the use of NSAIDs

Any, even the most harmless medicine has contraindications. NSAIDs have several:

• pregnancy;
• individual intolerance;
• disorders of the kidneys and liver;
• peptic ulcers of the gastrointestinal tract and duodenum;
• thrombo- and leukopenia.

• General classification of drugs for joints
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Chondroprotectors
• Corticosteroids
• The use of these drugs for arthritis and arthrosis

From the first part of this article you will learn what modern drugs experts recommend for pathology of the articular apparatus. The second part describes treatment regimens for the most common joint diseases - arthrosis and arthritis.

The prescription of any medications, control over the dosage and duration of treatment is carried out by a therapist, orthopedist-traumatologist, and rheumatologist.

General classification of drugs for joints

Non-steroidal anti-inflammatory drugs

All drugs from the class of non-steroidal anti-inflammatory drugs (they are abbreviated as NSAIDs or NSAIDs) have the following effects during treatment:

• reduce inflammation in joint tissues;
• relieve pain;
• promote rapid recovery of motor function;
• reduce body temperature.

The main purpose of NSAIDs is symptomatic therapy: they quickly (within a few hours after administration) eliminate the symptoms of the disease, but only partially eliminate the causes of its occurrence. Therefore, their use is often combined with other drugs for the treatment of joint pathology (for example, glucocorticoids, chondroprotectors). According to existing international treatment protocols, NSAIDs are included in treatment regimens for all joint diseases accompanied by inflammatory or pain syndrome.

The mechanism of the anti-inflammatory action of nonsteroidal drugs is to block the enzyme cyclooxygenase (COX). It is involved in the formation of substances that support the inflammatory process (inflammatory mediators).

Non-selective NSAIDs

There are two types of cyclooxygenase enzyme in the human body: COX-1 and COX-2. The first is produced in the stomach and is responsible for protecting its mucous membrane, the second is synthesized in areas of inflammation. Non-selective NSAIDs block both types of enzyme. They are highly effective, but often cause side effects from the digestive system (gastritis, peptic ulcer).

The main representatives of non-selective NSAIDs are shown in the table. The plus sign (+) indicates existing forms of drug release.

(if the table is not completely visible, scroll to the right)

Non-selective NSAIDs

Selective NSAIDs

Drugs that selectively block the COX-2 enzyme are called selective. When treated with them, the anti-inflammatory effect is less pronounced, but the number of side effects is less compared to non-selective NSAIDs. The effect of these drugs is long-lasting – within 24 hours after administration of the medicine.

The main representatives of drugs in this group are shown in the table. Plus sign (+) – existing forms of release

(if the table is not completely visible, scroll to the right)

Selective NSAIDs

NSAIDs with a predominantly analgesic effect

Non-steroidal anti-inflammatory drugs with high analgesic properties are called non-narcotic analgesics. The main indication for use is severe joint pain with minor signs of inflammation.

The main drugs in this group are presented in the table. The plus sign (+) indicates existing forms of the drug.

(if the table is not completely visible, scroll to the right)

NSAIDs with analgesic effect

Chondroprotectors

Agents that restore damaged hyaline cartilage of joints are called chondroprotectors. When using them:

• there is no anti-inflammatory and analgesic effect in treatment;
• the therapeutic effect occurs gradually, due to the restoration of damaged areas of cartilage tissue;
• a pronounced preventive effect is observed - the destruction of articular cartilage is prevented;
• Long-term use is required (3–5 months).

The composition of chondroprotectors includes substances that form hyaline cartilage of the joint: chondroitin and glucosamine. The first is the main building material of cartilage, supporting its structure; the second is the basis for the production of intra-articular fluid.

Chondroprotectors can be single-component (contain either chondroitin or glucosamine) or combined (contain both substances). The effectiveness of combined forms is higher than that of single-component forms.

The main chondroprotectors are presented in the table. The plus sign (+) indicates existing forms of the drug.

(if the table is not completely visible, scroll to the right)

Chondroprotectors

Systemic glucocorticoid hormonal agents

In case of severe inflammatory and destructive processes in the joints, drugs with a powerful anti-inflammatory effect are needed. Such patients are administered glucocorticoids (steroid hormones of the adrenal glands). Their anti-inflammatory effect is stronger than that of NSAIDs, but the side effects are also more serious (addiction, suppression of adrenal function). Therefore, glucocorticoids, like any other drugs, should be prescribed by a doctor according to strict indications with constant dose monitoring.

(if the table is not completely visible, scroll to the right)

Glucocorticoid drugs

Medicines for intra-articular administration

If one joint hurts (for example, the knee or shoulder), it is advisable to inject drugs directly into the lesion - into the joint cavity. This achieves the maximum concentration of the drug exactly in the place where it is needed for effective treatment, reducing the risk of side effects. Such injections are performed only by an experienced orthopedic traumatologist or surgeon.

Intra-articular fluid substitutes

The most expensive drugs for the treatment of joint pathology are joint fluid substitutes. They are based on hyaluronic acid.

The main indication for use is arthrosis. Even with advanced forms of this disease, a stable therapeutic effect is achieved. The effect of hyaluronic acid on the joint is complex: cartilage is restored; reduction of inflammation; creating a liquid environment in the joint cavity, which softens the movement of rubbing surfaces.

The most commonly used hyaluronic acid products by specialists are:

• Singial,
• Hyalual,
• Noltrex,
• Gialgan.

Glucocorticoids for injection into the joint

Four mechanisms of therapeutic action of hormonal anti-inflammatory drugs on joint components:

reduction of inflammation;

improved nutrition of cartilage;

restoration of the properties of intra-articular fluid;

softening of ossified tissues and resorption of growths.

Thanks to these effects, intra-articular injections of glucocorticoids not only alleviate the condition of patients with arthrosis and various types of arthritis, but also improve the condition of articular cartilage.

The most effective drugs:

• Hydrocortisone,
• Betaspan,
• Diprospan,
• Kenalog,
• Flosteron.

Medicines for intra-articular administration

How to use medications correctly for the most common joint diseases?

The two most common joint diseases are arthrosis and arthritis. The first pathology is the destruction of cartilage tissue, the second is its inflammation.

Treatment of arthrosis with drugs

Drug treatment of arthrosis depends on the phase and stage of the disease. General tactics are presented in the table:

(if the table is not completely visible, scroll to the right)

Drug treatment for arthritis

Arthritis is any inflammation in a joint. Most often it happens:

• Reactive (response of the joint to any changes in the body: injury, infection, allergy).
• Rheumatoid (the disease is called rheumatoid arthritis).
• Psoriatic (for psoriasis).
• Gouty (with gout).

Non-steroidal anti-inflammatory drugs (Naklofen, Movalis, Nimesil). In the acute stage of the disease, intramuscular administration is more appropriate, and when inflammation decreases, you can switch to tablet administration. Drugs in this group are indicated for all arthritis, regardless of type and origin.

Systemic glucocorticoids (Methylprednisolone, Dexamethasone, Triamcinolone) have a positive result for any arthritis. In the acute period of polyarthritis, when several joints are inflamed, they are administered intramuscularly or intravenously in high doses. For rheumatoid arthritis, lifelong use of tablets (Metypred) may be indicated to prevent recurrent attacks of the disease.

Intra-articular administration of glucocorticoids (Kenalog, Diprospan) is an effective medical procedure that is indicated for inflammation of one or two joints of any origin (reactive, gouty, rheumatoid, psoriatic).

Chondroprotectors in the form of injections (Alflutop, Dona) or tablets (Movex, Teraflex). Prescribed after the elimination of inflammation in order to restore cartilage tissue, more often in rheumatoid arthritis.

Basic drugs for the treatment of rheumatoid arthritis. They directly treat the disease, as they block the mechanisms that trigger inflammation, but do not reduce the symptoms of the disease. This group includes gold derivatives (Aurotimarat, Auranofin), cytostatics (Methotrexate, Cyclophosphamide), Sulfasalazine, and special immune drugs (Infleximab, Remicade).

Antigout drugs (Colchicine, Allopurinol, Anturan). Used only for arthritis caused by gout.

Uncontrolled treatment with any drugs reduces their effectiveness, increases the risk of side effects and can worsen the course of the disease and its prognosis.

Non-steroidal anti-inflammatory drugs for the treatment of joints are used to reduce the symptoms of arthrosis, arthritis and other diseases. They are created in order to stop inflammation and get rid of pain, which strongly manifests itself at the 2-3 stage of development of the pathology.

Nonsteroidal anti-inflammatory drugs for the treatment of joints were created for specific purposes. There are only two such tasks:

• eliminate joint pain;
• reduce inflammation and prevent it from developing.

Currently, such drugs are widely used and show high effectiveness compared to other drugs. They can reduce the main manifestations of symptoms of joint diseases.

Non-steroidal anti-inflammatory drugs for the treatment of joints are not able to completely rid a person of arthrosis. Their task is to eliminate the painful symptoms of pathology. They do a great job with it. These medications provide relief from illness that other medications cannot achieve.

When arthrosis worsens, you cannot engage in physical therapy or do some physiotherapeutic procedures. Some patients are inclined to traditional medicine, but its methods work very slowly. In this situation, non-steroidal anti-inflammatory drugs for the treatment of joints can help.

Popular means

There is a varied range of non-steroidal anti-inflammatory drugs that are designed to treat diseases such as arthrosis and arthritis. When used, the disease stops developing and symptoms decrease.

The most famous drugs are:

• "Meloxicam";
• “Ketoprofen”;
• "Aspirin";
• "Naproxen";
• “Ibuprofen”;
• "Diclofenac";
• “Celecoxib”;
• “Indomethacin”;
• “Etodolac.”

Each medicine has its own characteristics: some are weaker, and some are intended to treat the disease in an acute form. You should not decide on the choice of drug on your own; it should be prescribed by a doctor.

Methods of application

Various methods of using non-steroidal anti-inflammatory drugs have been developed. Here are the existing options:

• pills;
• injections into the joint;
• candles;
• joint cream;
• ointments.

When the joint disease is severe and the condition worsens, strong medications are used that have a wide range of side effects. The doctor uses injections for the joints so as not to cause much harm to the body. Often such procedures are done for gonarthrosis and coxarthrosis. At the same time, negative substances that affect the gastric mucosa do not penetrate into the gastrointestinal tract, unlike tablets. With the help of injections, beneficial elements are delivered in large quantities when compared with other methods of application.

Non-hormonal anti-inflammatory drugs are available for oral administration. They are made in tablet form.

Precautionary measures

The use of non-steroidal anti-inflammatory drugs is required under the strict instructions of a doctor. The specialist is obliged to issue a prescription that must be followed. If you use the drug in large doses, problems and complications will appear that can even lead to the death of a person.

People who have problems with the gastrointestinal tract, kidneys, allergies, liver cirrhosis, heart and vascular diseases should be careful. The action of the components that are part of non-steroidal anti-inflammatory drugs can reduce the effectiveness of other drugs that are used. Therefore, you need to combine drugs carefully; it is best to consult a specialist.

Therapy takes a long time. Patients are prescribed about 15 injections or 7 intra-articular injections. It all depends on the stage of the disease and sensitivity to the drug.

Some important facts

In medical practice, situations have been noted when the patient, after receiving the result, feels relief, lack of pain, and quits treatment. But arthrosis or arthritis has not yet been defeated. When the symptoms have disappeared, the person needs to diligently begin to treat the underlying disease. There are the following ways to do this:

• proper nutrition;
• taking chondroprotectors;
• massage;
• swimming;
• gymnastics;
• traditional methods;

If you take nonsteroidal drugs for a long time, the production of new cells by cartilage tissue is disrupted, and this function is inhibited. But arthrosis is characterized by the destruction of cartilage. Consequently, these drugs accelerate the deformation process. They disrupt the synthesis of proteoglycans, which causes water loss. Therefore, the duration of treatment with non-steroidal drugs should also be monitored. You need to know which joint ointments to use in a particular case so as not to cause harm.

Nonsteroidal anti-inflammatory drugs are relatively safe medications. But they also have some side effects:

• worsen kidney function;
• adversely affect the activity of the gastrointestinal tract;
• may contribute to the development of heart or vascular disease;
• can cause rash, nausea, diarrhea;
• can cause miscarriage if there is a pregnancy of up to 20 weeks.

These drugs are contraindicated for people with bronchial asthma.

It is important to know

Nonsteroidal anti-inflammatory drugs show excellent results in treatment. But there are some nuances:

1. When a patient has a stomach ulcer, asthma, hypertension, serious kidney, liver, or heart disease, these drugs cannot be used.
2. Taking these medications can cause bleeding in the gastrointestinal tract. Because of this, tests are constantly taken to monitor the situation.
3. A person who takes non-steroidal drugs in any form puts himself at risk of blood clots, stroke or heart attack. They are especially dangerous for those who have problems with the cardiovascular system.
4. A person who has had coronary artery bypass surgery should stop taking these medications.

Doctor prescribing various non-steroidal drugs

Depending on the manifestation of the disease, the doctor may prescribe the following medications:

1. Ibuprofen (tablets). The instructions for use indicate an almost complete absence of side effects. This drug is particularly effective. Also available in the form of an injection solution. Included in ointments.
2. "Ketoprofen". It is available in different forms, namely: ointment, gel, tablets, injections, joint cream. Any form reduces inflammation. Most often, the drug is prescribed for arthritis of the hip joint and rheumatoid arthritis.
3. Meloxicam. Like the previous product, it is released in a variety of variations. A long course of treatment is required.
4. “Celecoxib.” The medicine is potent and comes in capsule form. It does not adversely affect the gastrointestinal tract. This can be considered a big advantage.
5. "Indomethacin". It works quickly and is quite effective. Available in the form of suppositories, tablets, gels.
6. "Nimesulide". It is a unique product. With its help, pain is eliminated, inflammation goes away, and the cartilage tissue is not destroyed in the future. It is especially often used for pathologies of the hip joints.
7. “Sulfasalazine.” It has long-lasting results, but takes about 6 weeks to be noticeable.
8. “Diclofenac” (ointment). The price of the drug is low, but it is distinguished by its power. Available in the form of a solution for injection, tablet preparations (“Diclofenac”, “Voltaren Acti”, “Ortofen”, etc.).

Rules of use

When using non-steroidal drugs, you must follow certain rules:

1. The instructions must be strictly followed.
2. When using a capsule or tablet, take it with a full glass of water. This will create some protection for the stomach; it will not be so irritated.
3. You cannot combine drugs with alcohol. This increases the risk of stomach pathologies.
4. Pregnant women are better off avoiding non-steroidal drugs.
5. After taking the capsule or tablet, half an hour should pass, after which you are allowed to lie down. The vertical position of the body promotes the rapid passage of the medicine through the esophagus; gravity affects this.
6. If, for example, anti-inflammatory ointments for joints were taken, then other non-steroidal drugs should not be taken on the same day. This does not make the effect greater, but the side effects overlap each other.
7. If the effect of any drug is not observed, you need to pay attention to the dosage. You should not increase the dose on your own; this should be agreed with your doctor. It may be necessary to change the medicine you are using to another one. This may give you the desired result.

“Ibuprofen”

Reduces fever and relieves headaches with Ibuprofen (tablets). Instructions for use include various nuances of using the drug. In large doses it is used for diseases of the joints and spine.

You should be careful as side effects often occur, such as:

• gastrointestinal disorders;
• dizziness;
• headache;
• increased blood pressure;
• insomnia.

There are other side effects and contraindications. You need to read them carefully to avoid complications. It is best to consult a doctor and then follow his instructions.

"Diclofenac"

One of the effective remedies is Diclofenac (ointment). Its price is affordable for many people. The drug has a strong analgesic effect. Doctors often recommend it for joint or back pain.

The downside of the medicine is the presence of side effects, so it cannot be used for a long time. Diclofenac can cause dizziness, headache, and tinnitus. In this case, the activity of the liver is disrupted. It should not be used if you have asthma, pregnancy or breastfeeding.

Diclofenac with paracetamol

“Panoxen” is an effective remedy that contains two powerful components. The drug reduces pain with:

• osteoarthritis;
• arthritis;
• arthrosis;
• osteochondrosis;
• neuralgia;
• lumbago and other pathologies.

Side effects do not differ from those of diclofenac. Has the following contraindications:

• renal, liver and heart failure;
• intestinal diseases;
• recent coronary artery bypass surgery;
• active, progressive kidney and liver diseases;
• pregnancy, childhood.

"Indomethacin"

Just like diclofenac, indomethacin relieves inflammation and relieves pain. But this drug is considered outdated, as it has a number of side effects and contraindications. This product should not be used by children under 14 years of age.

There are various anti-inflammatory ointments for joints, creams, tablets, injections, suppositories that do not contain hormones. They show themselves effectively in the treatment of arthrosis, arthritis and other diseases. Such drugs will not be able to completely get rid of the disease, but will only suppress the symptoms. Non-steroidal anti-inflammatory drugs are relatively harmless when compared with hormonal ones. They perfectly relieve signs of the disease, relieve pain, after which the patient can begin comprehensive treatment.

Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of joints

A medical summary of the last few decades shows that diseases of the musculoskeletal system, ligaments and joints, in particular, are in the ranking of the most popular diseases after diseases of the cardiovascular system and neurological disorders. In addition, the age threshold of patients has also decreased; an increasing number of people under forty years of age are turning to orthopedists with complaints of pain in joints and ligaments.

After consulting a doctor and determining the diagnosis, treatment is prescribed, which necessarily and primarily includes non-steroidal anti-inflammatory drugs.

General information

Nonsteroidal anti-inflammatory drugs are a pharmaceutical group of drugs that are used in the treatment and prevention of inflammation in the area:

1. Large and small joints.
2. Bundles.

The main action of NSAIDs is aimed at removing:

• Pain;
• Inflammation;
• Heat.

The development of this group of drugs was preceded by the discovery of salicylic acid, obtained from broom bark in 1829. Since then, nonsteroidal drugs have been one of the most indispensable groups of drugs in pharmacology, and their list is replenished every year with more and more new types of nonsteroidal drugs.

The purpose of treating joints and ligaments with non-steroidal anti-inflammatory drugs is based on suppressing the production of prostaglandins due to cyclooxygenase.

The chemical structure of non-steroidal drugs divides them into 2 large groups:

1. Acidic - the most common group containing acid (salicylic), the targeted action of which effectively relieves fever and anesthetizes. These drugs include Ibuprofen, Indomethacin, Meloxicam.
2. Non-acidic - anti-inflammatory drugs that direct their action to suppress inflammation and pain. Such drugs traditionally include Ortofen, Diclofenac, Ketoprofen and their analogues.

Side effects and contraindications

In medicine, there are no other ways to treat joints and ligaments other than prescribing non-steroidal anti-inflammatory drugs. However, despite their powerful effect in relieving inflammation, these drugs have a long list of side effects on many systems of the human body. The most common are:

• Stomach upsets;
• Nausea and vomiting;
• Loss of vision and hearing;
• Dry mouth;
• Cardiopalmus;
• Hematopoietic disorder;
• Allergies;

• Darkening of the eyes and noise in the ears;
• Pain in various organs;
• Drowsiness.

Due to serious side effects, non-steroidal drugs are contraindicated in persons who have:

1. Ulcerative colitis.
2. Gastritis, erosions, stomach ulcers.
3. Children's age up to 12 years.
4. Pregnancy, breastfeeding period.
5. Hypersensitivity to the components of the drug.
6. Liver and kidney failure.

Nonsteroidal anti-inflammatory drugs are available in various forms. Each patient can choose the one that is most convenient for him. However, there are certain advantages of one form over the other. Sometimes the prescription of a specific form for the treatment of joints and ligaments is fundamentally important. Nonsteroidal anti-inflammatory drugs for the treatment of joints have the following release forms:

1. Injections (shots).
2. Ointments for the treatment of joints (gels, creams).
3. Pills.
4. Plasters.
5. Suppositories.
6. Suspensions.
7. Capsules.

Advantages and disadvantages

Each form of release has its advantages and disadvantages. Depending on the type of disease, its severity, duration and form, one or another type of drug and its specific form are prescribed. Sometimes several forms may be prescribed for treatment at once. For example, injections (shots) and tablets at the same time, or tablets and ointments, gels at once.

Injections (shots) are prescribed by a doctor for the treatment of joints and ligaments when the disease is in an acute stage, and inflammation and pain need to be relieved as soon as possible in order to alleviate the patient’s suffering and prevent the disease from spreading to new areas. Injections can be administered intravenously or intramuscularly, most often intramuscularly for a course of 7 to 10 days twice a day. Injections are first on the list in terms of frequency of prescription to patients for pain in joints and ligaments.

More details

Advantages of injections:

• Speed ​​of action;
• Minimal risk of damage to the gastric mucosa;
• No additional time is required for the medication to be absorbed into the walls of the stomach.

Disadvantages of injections:

1. Painful insertion.
2. Inconvenience (a second person is needed to administer the drug).

Tablets, like injections, are popular for treating joints and ligaments. Very often prescribed after injections to continue treatment and consolidate the result.

Advantages of tablets:

• Can be taken for a long time (much longer than injections);
• Painless administration;
• No help from other people is required;

Disadvantages of the tablet form:

1. It takes additional time for the drug to be absorbed into the walls of the stomach and enter the bloodstream.
2. Tablets entering the stomach can injure it, cause erosion, ulcers and gastritis.

Ointments, gels, and creams are usually prescribed by doctors in combination with tablets or injections to achieve the best result.

Advantages of gels and ointments, creams:

• Effect on the affected area (joint or ligaments);
• Ease of use;
• Enhancing the effect of other non-steroidal anti-inflammatory drugs;
• Does not injure the walls of the stomach or liver;
• Has a pronounced analgesic (and sometimes cooling) effect;
• It has far fewer contraindications and side effects than the first two forms of release.

Disadvantages of ointments, gels, creams:

1. It takes time for the product to absorb.
2. Valid for a short period of time.
3. May leave difficult to remove stains on clothing.
4. Leaves a sticky feeling on the skin.

Patches, like ointments (gels, creams), are prescribed in combination with other non-steroidal drugs to enhance the anti-inflammatory and analgesic effect.

Advantages of patches:

• They have a pronounced analgesic and warming effect;
• Easy to use;
• Do not injure the stomach, kidneys and liver;
• Have virtually no side effects;
• They last longer than ointments, gels and creams.

Disadvantages of patches:

1. Visible under clothes.
2. May come off when sweating or moving quickly.
3. They leave traces of glue.

Suppositories, or suppositories as they are also called, are prescribed as an alternative to injections and tablets. Method of administration: rectally.

Advantages:

• Rapid absorption into the blood (the speed is equal to injections);
• Does not injure the liver, kidneys and stomach;
• Ease of use.

Disadvantages of suppositories:

1. Short shelf life.
2. Strict rules for wounding (in the refrigerator), which prevents you from taking the drug with you on the road.

Treatment with non-steroidal anti-inflammatory drugs

Damaged joints and ligaments cannot be restored completely; you can only stop the process that has begun and prevent complications from arising.

Anti-inflammatory nonsteroidal drugs are the main drugs used to treat joints and ligaments. The form of the drug, duration of use and dosage are determined only by the doctor in accordance with the patient’s age, diagnosis and degree of advanced disease. Painkillers, anti-inflammatory drugs quickly relieve pain, swelling, and redness of the joint.

After examining a patient complaining of pain in the joints and ligaments, the doctor comes to a decision on which anti-inflammatory drug to prescribe. The following types of non-steroidal anti-inflammatory drugs are usually prescribed:

Diclofenac is a non-acid derivative prescribed for severe pain in the joints and ligaments. Despite its popularity, it has a large list of contraindications and is strictly prohibited:

• Pregnant and lactating women;
• Children under 12 years old;
• Patients with problems with the cardiovascular, excretory systems, and gastrointestinal tract.

Diclofenac and its more expensive analogues have several forms of release (injections, ointments, gels, patches, tablets).

Ibuprofen is an acid derivative drug with antipyretic and analgesic effects, one of the few drugs that is approved:

1. Children over 3 months.
2. Pregnant women.
3. For nursing mothers.

It has several release forms:

• Suspension;
• Pills;
• Ointments;
• Suppositories;
• Gels.

Indomethacin is a widely used drug for relieving inflammation and pain and belongs to the group of non-acid derivatives. It has several release forms:

1. Pills.
2. Ointment.
3. Candles.
4. Gel.
5. Capsules.

Painkillers of the indomethacin group are prescribed for the treatment of joints and ligaments in adults and children.

Nimesulide is a relatively recently developed drug prescribed for the treatment of degenerative processes in joints and tissues. The advantages of nimesulide include a small list of contraindications and side effects. This drug is available in the form:

• Tablets;
• injections;
• Ointments;
• Candles.

Ketoprofen is one of the most powerful anti-inflammatory non-steroidal drugs with a powerful analgesic effect. Widely used by orthopedists to treat diseases:

Treatment of joints Read more >>

1. Joints.
2. Backs.
3. Bundles.

Ketoprofen and its analogues have the following release forms:

• Pills;
• Injections;
• Gels.

Conclusion

Thus, drugs prescribed for the treatment and elimination of problems of the musculoskeletal system, in particular joints and ligaments, have analgesic, antipyretic and anti-inflammatory effects.

Nonsteroidal drugs are mandatory means for getting rid of diseases of the musculoskeletal system. Each pharmacological form of release (tablets, injections, gels, ointments, creams, suppositories, patches, suspensions) has its own advantages and disadvantages, and the choice of a specific form depends on the patient’s age, type of disease and general health.

Painkillers direct their action to suppress the production of prostaglandins, which influence the occurrence of inflammation.

Diseases of the joints and ligaments are a frequent phenomenon and cause a lot of trouble for those who suffer from them. In addition, it requires immediate consultation with a doctor and high-quality treatment, after which you will have to change your lifestyle completely in order to avoid relapse of the disease.

Anti-inflammatory and pain-relieving injections: what means to inject

When severe pain appears in the joints of the arms and legs, the primary task of the doctor is to determine the nature of their occurrence. Pain syndrome can be caused by gonarthrosis (arthrosis of the knee joint), coxarthrosis (arthrosis of the hip joint), tendonitis, dislocation or sprain of the ankle, injury or bursitis of the elbow.

Whatever the cause of pain in the extremities, the patient must be examined by a neurologist, osteopath, traumatologist, orthopedist, perhaps even a gynecologist, urologist and gastroenterologist. After all, joint diseases are often associated with pathologies of internal organs.

For example, gouty arthritis is a pathology in which purines (uric acid) accumulate in the body, and various kidney diseases can cause such an imbalance.

Rheumatoid arthritis and osteoporosis often occur in women during menopause. Many joint diseases provoke metabolic disorders.

That is why the examination must be comprehensive. After diagnosing and determining the cause of joint pain, the doctor may prescribe the patient anti-inflammatory, non-steroidal painkillers - NSAIDs and B vitamins.

How to treat the musculoskeletal system

Modern medicine has a huge arsenal of drugs that are effective for various joint pathologies.

If an inflammatory process develops in the joints, the doctor places the main therapeutic emphasis on NSAIDs, which can suppress pain, eliminate the source of inflammation and reduce high body temperature.

After the acute period of the disease has passed, non-traditional treatment methods are added to treatment with medications:

• massage;
• physiotherapeutic procedures;
• manual therapy;
• exercise therapy course.

The patient should move as much as possible and perform daily gymnastic exercises aimed at restoring mobility in the damaged joint and strengthening the ligamentous apparatus.

Returning to the topic of medications, it should be noted that the treatment of diseases of the joints (elbow, knee, shoulder, ankle) requires the administration of combined vitamin complexes, which also provide moderate pain relief and, most importantly, supply cartilage and bone tissue with the necessary microelements.

It is generally accepted that the greatest effect in terms of pain relief can be achieved by taking vitamin B12. This drug has recently become considered in medical practice as a moderate analgesic, since it has the following properties:

1. normalizes muscle innervation;
2. participates in the transmission of excitation impulses;
3. stimulates metabolic processes;
4. normalizes the functioning of the nervous system;
5. restores damaged nerve tissue.

Numerous clinical studies have proven that the use of vitamin B for the treatment of joint diseases in most cases led to a significant reduction in pain during exacerbation of inflammation.

If oral medication does not eliminate pain in muscle tissue, the patient may be offered injections for inflammation in combination with a stretching method. The essence of this technique is as follows:

• The patient is asked to lie on his back or stomach (depending on the location of the pain).
• The doctor finds lumps or points on the patient’s body where the pain is most severe.
• An injection is made exactly perpendicularly to this place with a solution of novocaine.

Immediately after the procedure, it is necessary to perform passive stretching of the muscle. Next, a hot compress is applied to the sore spot. After removing the compress, the patient should use the sore muscle as much as possible with active movements.

The main purpose of the novocaine blockade is to “switch off” the nerve. Therefore, injections for inflammation should be as close as possible to the exit points of nerve endings

Drugs for the treatment of joint diseases

B vitamins are also available in tablet form for oral use. However, intramuscular injections for joint and muscle pain are most effective.

It is these that are worth dwelling on in more detail: find out their composition, pharmacological action, indications and contraindications, storage conditions and approximate cost. The composition of all the drugs listed below is the same: Pyridoxine, Lidocaine, Thiamine, Cyanocobalamin.

Milgamma injection drug.

• 5 ampoules – 220 rub.
• 10 ampoules – 400 rub.
• 25 ampoules – 900 rub.

Indications for use: Milgamma is prescribed in complex therapy for neurological disorders and diseases of the nervous system:

1. paresis of the facial nerve, neuritis, trigeminal neuralgia;
2. if joints and muscles hurt, there is pain in the spine caused by neurological manifestations and degenerative changes in tissues;
3. alcoholic, diabetic polyneuropathy;
4. night muscle cramps;
5. shingles.

Combilipen

• 5 ampoules – 120 rub.
• 10 ampoules – 200 rub.

The drug has the following contraindications:

1. acute forms of heart failure;
2. pregnancy and lactation;
3. high sensitivity of the body to the components of the drug;
4. the medicine is not prescribed to children due to the lack of research in this area.

Neurobion

Price: 3 ampoules – 220 rub. A distinctive feature of Neurobion is that it does not contain Lidocaine.

Negative manifestations during treatment:

• increased sweating;
• tachycardia;
• skin rashes (extremely rare);
• anaphylactic shock;
• labored breathing.

In case of overdose:

1. symptoms of intoxication – nausea, vomiting;
2. tachycardia;
3. dizziness.

Trigamma

Price: 5 ampoules – 100 rub.

All of the drugs listed above are injected deep into muscle tissue.

Anti-inflammatory, analgesic non-steroidal drugs

Non-steroidal anti-inflammatory drugs in the treatment of joint diseases are prescribed only as symptomatic treatment. They are able to eliminate pain in joints and muscles, but cannot affect the cause of the inflammatory process.

Unfortunately, half of patients treated with NSAIDs experience side effects, sometimes severe. If this happens, you should stop taking the medications and consult a doctor who will prescribe another treatment.

Medical scientists have conducted a huge amount of research, the purpose of which was to identify the best pain reliever. During these activities, it was found that non-steroidal anti-inflammatory drugs in this regard are not highly effective. However, some of these medications are not cheap.

When choosing an analgesic, doctors advise their patients to pay attention to the fact that some analogues are significantly inferior in effectiveness to the original drugs. An example is the domestic drug Diclofenac, which cannot be compared with the European original.

Studies have found that Ibuprofen is the least toxic of all NSAIDs and has minimal side effects.

The manufacturers of the new COX-2 inhibitor, Celebrex, claimed that the drug had virtually no negative side effects, but additional study of the drug proved that this fact has no evidence.

Therefore, when going to the pharmacy to buy anti-inflammatory painkillers, the patient should know that they are all anesthetics and have side effects, but different frequency, severity and intensity of negative manifestations. The price range between one NSAID and another can be very wide.

For example, Indomethacin has pronounced analgesic and anti-inflammatory properties, but it has a destructive effect on cartilage tissue. Therefore, doctors prescribe this drug very rarely.

For some advanced joint pathologies, anti-inflammatory painkillers have low effectiveness, and increasing the dose does not eliminate pain and inflammation.

In this case, replacing one drug with another does not make sense; you need to look for other methods of treatment.

How to choose a painkiller

If pain in the joints of the limbs is chronic, the doctor must first determine its cause and intensity. Based on this, the doctor can prescribe adequate treatment.

In case of acute pain, the risk of side effects of prescribed drugs on the gastrointestinal tract must be determined. If this risk is low and there is no dyspepsia, the patient can be prescribed any non-steroidal anti-inflammatory drugs.

If you have dyspepsia, you should prescribe one of these drugs:

• Ibuprofen.
• Naproxen.
• Diclofenac.
• Miloxicam.
• Nimesulide.

If there is a high probability of developing cardiovascular complications, the use of NSAIDs should be avoided and one should be content with Paracetamol. At moderate risk, you can take Nimesulide.

If there is a possibility of gastrointestinal bleeding, proton pump inhibitors must be added to NSAIDs. It is believed that even a single dose of NSAIDs poses a certain risk to the body, so taking drugs from this group (regardless of the likelihood of gastroduodenal bleeding) implies the prescription of proton pump blockers.

Even if the pain subsides within a few days, treatment cannot be stopped. The medication should be continued until the pain is completely relieved. If the pain does not subside within seven days, the patient is prescribed muscle relaxants and external anesthetics.

Local injections of corticosteroids are possible in the absence of tuberculosis of the spine or joints. In case of intense, ongoing pain, you need to make sure that the nature of the disease is non-infectious. The patient should be examined at an anti-tuberculosis and venereology clinic.

Nonsteroidal anti-inflammatory drugs for the treatment of joints

The main purpose of non-steroidal anti-inflammatory drugs is to relieve unpleasant symptoms that arise from joint diseases - primarily arthrosis, arthritis and others. Most often, specialist doctors prescribe them to combat inflammation and pain, which become especially acute in the second or third stage of pathology development.

• Challenges for non-steroidal anti-inflammatory drugs
• Popular means
• Methods of application
• Precautionary measures
• Some important facts
• Side effects, contraindications
• It is important to know
• Rules of use
  • Ibuprofen
  • Diclofenac
• Conclusion

Challenges for non-steroidal anti-inflammatory drugs

Having set out on the idea of ​​creating non-steroidal anti-inflammatory drugs for the treatment of joints, pharmacists hoped to solve a number of problems with their help:

• Remove joint pain;
• Reduce inflammation by completely stopping this process.

Today, these drugs are among the most widely used, which are superior in effectiveness to many other drugs. With their help, you can significantly reduce pain symptoms in various joint diseases.

But it should be understood that when carrying out long-term treatment with non-steroidal anti-inflammatory drugs, you should not expect that they can cure arthrosis. They are designed primarily to relieve painful manifestations of pathology. Therefore, they are recommended to alleviate the condition of a disease that previously prescribed drugs cannot provide.

During periods of exacerbation of arthrosis, patients are contraindicated in physical therapy, as well as certain physiotherapeutic procedures. Often patients have a desire to use traditional medicine, but they have to wait quite a long time for the effect. Non-steroidal anti-inflammatory drugs for the treatment of joints can be a solution in such a situation.

Popular means

Pharmacy chains offer a wide variety of non-steroidal anti-inflammatory drugs, which are initially intended for the treatment of such common joint diseases as arthritis and arthrosis. Regular use of these remedies allows you to completely stop the disease, as well as reduce the manifestation of symptoms.

Among this group of funds, the most common are:

• "Meloxicam";
• "Naproxen";
• "Ibuprofen";
• "Diclofenac";
• "Indomethacin";
• "Etodolac."

Moreover, all these remedies differ from each other in their properties: some have a less pronounced effect, others show themselves to be excellent in suppressing acute attacks of the disease. When treating with these drugs, it is important that they are prescribed by a doctor, otherwise you can not only lose valuable time, but also face the side effects of an incorrectly selected non-steroidal drug.

Methods of application

Nonsteroidal anti-inflammatory drugs available in pharmacies today come in several forms:

• pills;
• intramuscular injections for joints;
• injections into the joint;
• candles;
• joint cream;
• ointments.

In case of exacerbation of joint disease, which is accompanied by deterioration of the patient’s condition, it is necessary to use potent medications, which, unfortunately, have many adverse reactions. To minimize harm to the body, doctors prescribe injections for the joints. In most cases, a similar measure is resorted to in the treatment of gonarthrosis and coxarthrosis. Compared to tablets, the active substances entering the body after injections do not penetrate the gastrointestinal tract, thereby eliminating the negative impact on the gastric mucosa. Injections make it possible to provide the body with useful elements in increased quantities, which is often impossible to achieve using other methods of application.

The pharmaceutical industry today offers non-hormonal anti-inflammatory drugs designed for oral administration. They are available in tablet form.

Precautionary measures

In order for the nonsteroidal anti-inflammatory drugs used to bring relief to the patient while minimizing the harm from them, they must be used strictly in accordance with the doctor’s recommendations. When visiting a specialist, the patient must receive a prescription that he needs to follow. Trying to exceed the dosage of medication to speed up recovery will not be beneficial. On the contrary, it can cause a number of complications that can be very serious, sometimes even fatal.

Extreme caution should be used in the category of patients who suffer from diseases of the gastrointestinal tract, kidneys, severe allergies, cirrhosis of the liver, heart and vascular diseases. It is also necessary to take into account that non-steroidal anti-inflammatory drugs contain special components that can make other drugs less effective when used together. This requires the patient to correctly combine medications. Therefore, before starting a course of treatment with one or another drug, it is necessary to discuss this issue with a specialist.

Treatment of joints with non-steroidal anti-inflammatory drugs is a rather lengthy process. The required therapeutic effect can be achieved after the entire course has been completed, including approximately 15 injections or 7 intra-articular injections. The exact number of sessions is determined taking into account the stage of the disease and the body’s response to the drug.

Some important facts

Based on medical practice, one can cite many cases where prescribed NSAIDs brought relief to the patient, relieving him of pain, and after that he refused to continue treatment. However, the absence of symptoms is not a sign that arthrosis or arthritis has been cured. Having removed the symptoms, the patient must devote all his efforts to treating the underlying disease. You can solve this problem using the following methods:

• proper nutrition;
• taking chondroprotectors;
• massage;
• swimming;
• gymnastics;
• traditional methods;
• stay in medical sanatoriums.

With a long course of treatment with NSAIDs, cartilage tissue is no longer able to synthesize new cells, and this function stops. One of the main signs of arthrosis is the destruction of cartilage. Therefore, when taking these drugs, you can speed up the deformation process. As a result of their intake, the production of proteoglycans deteriorates, and this leads to water loss. Thus, long-term use of NSAIDs requires constant monitoring by a specialist. The patient should have an idea of ​​what ointments he is allowed to use in his case in order to minimize possible harm.

Side effects, contraindications

There are few known cases where non-steroidal anti-inflammatory drugs were harmful, worsening the patient's condition. But we must not forget that these medications have a number of side effects:

• Negatively affect kidney function;
• Have a negative effect on the activity of the gastrointestinal tract;
• With long-term use, conditions may arise for the development of heart or vascular diseases;
• May cause symptoms such as rash, nausea and diarrhea;
• If taken by women during pregnancy up to 20 weeks, there is a risk of miscarriage.

An absolute contraindication to the use of these drugs is the presence of bronchial asthma.

It is important to know

Statistics show that, unlike steroid drugs, non-steroidal anti-inflammatory drugs can quickly achieve stable remission. However, it is necessary to remember important points:

• Patients diagnosed with stomach ulcers, asthma, hypertension, as well as severe forms of kidney, liver and heart diseases are prohibited from taking medications.
• If you take these drugs, there is a risk of bleeding in the gastrointestinal tract. To avoid this, the patient should undergo regular testing to avoid such complications.
• Regardless of the form in which non-steroidal drugs are taken, there is a risk of blood clots, stroke or heart attack. People with cardiovascular diseases need to be careful with these drugs.
• Patients who have recently undergone coronary artery bypass surgery should not take non-steroidal anti-inflammatory drugs.

Rules of use

When taking non-steroidal anti-inflammatory drugs, as well as when treating with steroid drugs, the patient must strictly follow certain rules.

1. You can use medications only in accordance with the instructions in the instructions.
2. When taking the drug in capsule or tablet form, take it with a full glass of water. This can help the stomach avoid significant irritation.
3. During the course of treatment with non-steroidal drugs, it is unacceptable to drink alcohol. In this case, there is a possibility of developing stomach pathology.
4. It is strongly recommended that women not take non-steroidal drugs during pregnancy.
5. After drinking the drug in the form of a capsule or tablet, you need to wait 30 minutes, and then you can lie down. When a person is in an upright position, it speeds up the passage of the drug through the esophagus due to the effect of gravity.
6. Patients undergoing treatment with anti-inflammatory ointments for joints should choose separate days to use non-steroidal drugs. Combining medications will increase the side effects, but will not bring much benefit.
7. Sometimes it is difficult to achieve the desired effect when taking certain medications. In this case, it is necessary to reconsider the dosage. You should not make changes to the treatment regimen yourself. You must obtain permission from your attending physician. It is possible that the medication may need to be changed.

Ibuprofen

This anti-inflammatory non-steroidal drug is available in tablet form and can reduce fever and relieve headaches. It must be taken, like all steroid medications, strictly in accordance with the instructions, which contain certain nuances of use. It is indicated for use in increased doses for the treatment of diseases of the joints and spine.

Take this drug strictly in accordance with the instructions, since non-compliance will lead to side effects:

• Problems with the gastrointestinal tract;
• Dizziness;
• Headache;
• High blood pressure;
• Sleep disturbance.

This drug also has other side effects. Therefore, before you start taking medicine, you need to carefully study them to avoid complications. It is advisable to consult a specialist on this issue before starting treatment and follow his instructions exactly.

Diclofenac

Doctors often prescribe Diclofenac ointment to eliminate symptoms. This is a very affordable drug that quickly relieves pain. The medicine has proven itself in the treatment of joints and back.

But this drug also has its drawbacks - adverse reactions that occur with long-term use. Failure to follow this recommendation may lead to unpleasant symptoms such as dizziness, headaches, and tinnitus. At the same time, problems with liver function are observed. People with asthma, pregnancy and breastfeeding should also avoid using it.

Home » Joints » Nonsteroidal anti-inflammatory drugs for the treatment of joints

Nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of joints

In addition, ostenil penetrates deep into the cartilage, improving its firmness and elasticity. Thanks to ostenil, cartilage that has dried out and become thinner due to arthrosis restores its shock-absorbing properties. As a result of weakening the mechanical overload, pain in the diseased joint decreases and its mobility increases. It is most advisable to inject ostenil into the supporting joints, which primarily suffer from arthrosis - the knee, hip, and shoulder joints.​

Mechanism of action

​Dimexide​

Classification

​But vasodilator drugs improve the well-being of patients during the recovery period after a heart attack or stroke, help with poor patency of blood vessels in the legs, with obliterating endarteritis and diabetes mellitus, and bring relief to hypertensive patients when the pressure is moderately elevated.​

1. ​Glucosamine and chondroitin sulfate belong to the group of chondroprotectors - substances that nourish cartilage tissue and restore the structure of damaged joint cartilage.​
2. ​gold preparations​

Contraindications

​arcoxia;​

• "Chondroitin sulfate."
• ​"Dona".​
• "Diclofenac."
• ​Since a medicine in this group can have a pronounced negative effect on the cardiovascular system, constant blood pressure checks should be carried out in the first days and weeks of taking this medicine.
• ​7. Be careful not to take two or even three different NSAIDs at the same time. The medicinal effect of this is unlikely to increase, but the number of side effects can easily multiply.​

For joint pathologies accompanied by pain and accompanying signs of inflammation (swelling, hyperemia), drugs from the group of anti-inflammatory nonsteroids must be prescribed. They have anti-inflammatory, analgesic and antipyretic effects.​

NSAIDs used in the treatment of joint diseases

Aspirin

- a chemical substance, a liquid with colorless crystals, has a good anti-inflammatory and analgesic effect. Moreover, unlike many other substances for external use, dimexide is actually able to penetrate skin barriers. That is, dimexide applied to the skin is actually absorbed by the body and works within it, reducing inflammation at the site of the disease. In addition, dimexide has a resolving property and improves metabolism in the area of ​​application, which makes it most useful in the treatment of arthrosis that occurs with the presence of synovitis, primarily of the knee and ankle joints.​

Diclofenac

However, those suffering from hypertension should keep in mind that while using vasodilators, it is necessary to reduce the dose of other drugs used to reduce high blood pressure. Otherwise, the effect of two different medications is additive and can lead to an excessively sharp drop in pressure, causing fainting or collapse.​

This is the most useful group of drugs for the treatment of arthrosis of the joints. Unlike NSAIDs, chondroprotectors do not so much eliminate the symptoms of arthrosis as they affect the “base” of the disease, although glucosamine and chondroitin sulfate work differently and each performs its own special task.​

Indomethacin

​cyclophosphamide,​

Ibuprofen (Nurofen)

​nimesulide (aponil, nise, koxtral, nymphast);​

Ketoprofen

​The drug also brings favorable results for connective tissues and joints.​

New generation drugs from the NSAID group

​"Arthra".​

Movalis (Mirlox, Artrosan, etc.)

"Flurbiprofen."

Celecoxib

​And, of course, this drug should be taken only on the recommendation of a doctor and under his supervision.​

Arcoxia

​When taking NSAIDs, it is important to avoid alcohol

Nimesulide

​The majority of drugs from this group inhibit the production of the enzyme cyclooxygenase, which is represented by two isomers: COX-1 and COX-2. The presence of a focus of inflammation in the body stimulates the production of COX-2, which is not present in a healthy body. Inhibition of COX-1 is an undesirable reaction, since this enzyme is present in humans and is “responsible” for the synthesis of prostaglandins that protect the gastrointestinal mucosa, regulate renal blood flow and the normal functioning of platelets.​

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Anti-inflammatory drugs for arthrosis and arthritis of the joints

​Bishofite​

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​MISSION RELAXANTS - DRUGS USED TO ELIMINATE MUSCLE SPASMS IN THE TREATMENT OF JOINT ARTHROSIS.​
​For example, glucosamine stimulates the activity of chondrocyte cells and serves as raw material for the synthesis of proteoglycan molecules. When there is a large amount of glucosamine in the cartilage, more proteoglycans are produced, and they, in turn, retain more water in the cartilage tissue, which makes the cartilage moist and elastic. That is, glucosamine “starts” the production of key elements of cartilage and subsequently protects them from destruction, stimulating the action of the natural mechanisms of joint tissue restoration
​methotrexate.​

meloxicam (melox, arthrozan, movalis, lem);

​"Collagen".​

​"Teraflex".​

What is important for a patient to know before using NSAIDs?

"Indomethacin."

​Please note: even if you are using the newest and highest quality non-steroidal anti-inflammatory drugs, remember that these drugs DO NOT TREAT arthritis and arthrosis of the joints: they are only needed to reduce inflammation and relieve pain, after which physical therapy procedures and apply other treatment methods.​

Non-steroidal anti-inflammatory drugs for the treatment of joints are divided into two groups:

​- petroleum derivative, brine obtained during oil drilling. It gained its fame thanks to drillers who were the first to pay attention to its therapeutic effect on arthrosis of the fingers. While working in oil wells, drillers experienced resorption of arthrosis nodules on their hands due to constant contact with oil brine. Later it turned out that bischofite has a moderate anti-inflammatory and analgesic effect, and also has a warming effect, causing a feeling of pleasant warmth.​

Of the drugs in this group, they are most often used for arthrosis.

Chondroitin sulfate also promotes the saturation of cartilage tissue with water, but, unlike glucosamine, it does not increase the production of proteoglycans, but increases their ability to capture and retain water. In addition, chondroitin sulfate neutralizes the action of some enzymes that “eat away” cartilage tissue, and also stimulates the formation of collagen protein, which is part of the collagen fibers of cartilage.​

​Medicines are prescribed for rheumatoid, psoriatic, reactive arthritis and other autoimmune pathologies of the musculoskeletal system in long courses from 6 months to several years.​

​celecoxib (rancelex, flogoxib).​

The product effectively strengthens joints, bones, and helps improve the functioning of ligaments. In addition, it has a beneficial effect on the properties of the skin.​

​Such medications imitate the action of the hormone cortisol in the body, which is produced naturally by the adrenal glands. It is able to have a beneficial effect on many systems. In addition, the hormone perfectly controls inflammatory processes. The medicine is available in various forms: mixtures, tablets, injections, sprays, ointments, drops.​

List of NSAIDs for joint diseases

​Medicines that are best able to eliminate pain syndrome:

Aspirin or acetylsalicylic acid

​In order to stop the development of the disease and generally be treated correctly, you need to see a doctor and take comprehensive treatment, which includes taking medications from other groups, including chondroprotectors!​

​9. It is recommended to refrain from drinking alcohol while taking medications from the NSAID group, as this greatly increases the negative effect on the gastric mucosa.​

​Non-selective - suppress the production of COX-1 and COX-2.​

Diclofenac

​Bishofite is most useful for the treatment of arthrosis of the knee, ankle, shoulder, elbow and big toe joints - with moderate deformities and provided that the disease occurs without symptoms of synovitis.​

​mydocalm​

Thus, the use of glucosamine and chondroitin sulfate helps restore the cartilage surfaces of the joint, improve the production of joint fluid and normalize its “lubricating” properties. Such a complex effect of chondroprotectors on the joint makes them indispensable in the treatment of the initial stage of arthrosis.​

​To treat and strengthen joints, in addition to the main groups of drugs, medications are used that increase the effectiveness of the therapy. Vasodilators (trental) improve blood flow in the joints, the flow of nutrients and drugs into the joint.

Movalis is an effective anti-inflammatory drug with selective action

​Vitamin D, calcium.​

Indomethacin

​This group includes the following drugs:​

"Ketorolac."

​High loads on joints and ligaments lead to pain and degenerative processes. There are many treatment methods. The most important way to combat pathology is therapeutic therapy. It helps eliminate inflammation, alleviate symptoms, and restore the functioning of joints. What joint medications are recommended for use? What are their pros and cons?​

​10. And finally, the most important advice: try not to self-medicate and take medications to treat joints, including these, only as prescribed by a doctor and under his supervision! This will allow you to avoid many complications when taking these medications and at the same time achieve the maximum therapeutic effect.​

Ketoprofen

​Selective - have a predominant (selective) inhibitory effect on COX-2.​

​Medical bile​

COX-2 inhibitors: new generation NSAIDs

​However, there is no need to exaggerate the capabilities of these drugs. Chondroprotectors are ineffective in treating the third stage of any arthrosis, when the cartilage is almost completely destroyed. After all, it is impossible to influence bone deformations or grow new cartilage tissue with the help of glucosamine and chondroitin sulfate. And even in the first and second stages of arthrosis, chondroprotectors act very slowly and do not immediately improve the patient’s condition. To get a real result, you need to undergo at least 2-3 courses of treatment with these drugs, which usually takes a year and a half, although advertising for glucosamine and chondroitin sulfate usually promises recovery in a shorter time.​

​Muscle relaxants (mydocalm) relieve muscle spasm in the area of ​​inflammation, thereby providing an analgesic effect. Local application of ointments, gels, solutions with irritating components (finalgon, apisatron, dimexide) reflexively improves trophism and metabolism, affecting the nerve receptors of the skin. The main condition for recovery is complex therapy under the supervision of a doctor. In advanced cases, it is necessary to resort to surgery, which often requires joint replacement, leads to disability, and limits freedom of movement.​

Meloxicam

​Selective drugs can be prescribed for several months under the supervision of a physician. It must be taken into account that repeated courses of treatment with NSAIDs worsen metabolic processes in cartilage and should be used with caution in case of arthrosis of the joints. The pharmacological industry produces NSAIDs in tablets, injections, rectal suppositories and ointments.​

​Such components must be consumed simultaneously. They help strengthen the skeletal system. A lack of vitamin D can cause inflammation of joints and ligaments.​

"Prednisolone."

"Diclofenac."

Celecoxib

​As the name suggests, these are drugs for joint pain. All analgesics are divided into several types:

​All NSAIDs are divided into 2 large groups: cyclooxygenase inhibitors of type 1 and type 2, abbreviated as COX-1 and COX-2.​

Nimesulide

​NSAIDs cannot be used for a number of pathological conditions, including:​

- natural bile extracted from the gall bladders of cows or pigs. Bile has a resolving and warming effect and is used in the same cases as bischofite, but has some contraindications: it cannot be used for pustular skin diseases, inflammatory diseases of the lymph nodes and ducts, febrile conditions with increased body temperature.​

​sirdalud​

Etoricoxib

​Currently, on our pharmacological market, chondroprotectors are most widely represented by the following drugs:​

​NON-STEROID ANTI-INFLAMMATORY DRUGS (NSAIDS) IN THE TREATMENT OF JOINT ARTHROSIS: DICLOFENAC, PIROXICAM, KETOPROFEN, INDOMETHACIN, BUTADIONE AND THEIR DERIVATIVES.​

Steroid hormones are used to treat arthritis, which is accompanied by an inflammatory reaction and pain of high intensity. They are prescribed in tablets (prednisolone, hydrocortisone), intra-articular injections and are substances synthesized by the adrenal cortex. Hormonal therapy is usually used in cases where NSAIDs do not provide the required clinical effect. In addition, drugs are recommended for the occurrence of synoviitis - inflammation of the periarticular soft tissues (ligaments, tendons, muscles). For the treatment of diseases of the musculoskeletal system, intra-articular injections are recommended:

"Methylsulfonylmethane."

​"Celeston".​

"Ketoprofen."

​Medicines that contain acetaminophen. These drugs are sold without a prescription in pharmacies. A representative of this class is the drug Tylenol. These medications can eliminate moderate pain.​

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Effective preparations for joints. Medicines for joint pain

​This is not only the very first discovered drug from this group of drugs, but also one of the oldest medical drugs: it continues to be used and prescribed, despite the fact that it has existed for more than a hundred years, and now there are many other synthesized and more effective drugs . Treatment of osteoarthritis often begins with aspirin.​

Effective analgesics

​anemia;​

1. ​INTRA-ARTICULAR INJECTIONS (INJECTIONS INTO THE JOINT) FOR TREATMENT OF ARTHROSIS.​
2. ​Arthra​

​Non-steroidal, that is, non-hormonal, anti-inflammatory drugs are widely used to suppress inflammatory reactions in the body. One of the first drugs in this group, which appeared in 1899 and became widely known, was aspirin, or acetylsalicylic acid, which is still used today. In the 20th century Nonsteroidal anti-inflammatory drugs have become popular among doctors of almost all specialties due to their antipyretic, analgesic, and antirheumatic properties.​

• ​kenalog,​
• ​This compound helps relieve pain and can suppress inflammation. However, it is characterized as a means of average effectiveness, since it does not contribute to the restoration of connective tissues.​
• ​"Metypred".​
• "Indomethacin."
• ​Opioid analgesics. They can only be purchased with a doctor's prescription.​
• ​Despite the fact that this remedy is effective in many areas of medicine, it is usually rather weak for the treatment of arthrosis and arthritis, and, as a rule, it is quickly replaced with other medications, or even treatment is started with other medications.​

​stomach and duodenal ulcer;​

​Intra-articular injections are often used to provide emergency treatment for joint diseases. In many cases, an intra-articular injection can actually alleviate the patient's condition.​

​Muscle relaxants are prescribed to eliminate painful muscle spasms that often accompany arthrosis of large joints - primarily the hip and shoulder. These drugs really do a good job of eliminating muscle pain and, in addition, somewhat improving blood circulation in the area of ​​the affected joint.​

​, made in the USA. Release form: tablets containing 500 mg of chondroitin sulfate and 500 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 2 tablets per day.​

• For the treatment of joint diseases (and arthrosis in particular), those NSAIDs that have a more pronounced analgesic and anti-inflammatory effect and a less pronounced antipyretic effect are used primarily. These are butadione, ibuprofen, diclofenac, indomethacin, piroxicam, ketoprofen and their derivatives. For arthrosis, non-steroidal, that is, non-hormonal, anti-inflammatory drugs are traditionally used to eliminate pain and inflammation of the joint, since against the background of severe pain it is impossible to begin normal treatment. Only by eliminating acute pain with anti-inflammatory drugs can you subsequently move on, for example, to massage, gymnastics and those physiotherapeutic procedures that would be intolerable due to pain.​
• ​metipred,​
• ​Let's look at some medications that are in demand in the treatment of joints.​
• ​"Diprospan".​
• ​At the same time, medications are the most aggressive in relation to the gastrointestinal tract;​
• ​Combined drugs. The medications contain: opioid, acetaminophen.​
• ​Aspirin should be taken with caution if you have blood diseases, as it slows down blood clotting.​
• ​increased blood pressure;​
• Most often, corticosteroid hormones are injected into the joint:
• However, their use requires some caution. The fact is that muscle spasm is often a protective reaction of the body, protecting the joint from further destruction. And if we simply relieve the protective tension of the muscles, but do not take measures to save the joint from excessive pressure, subsequently the damaged joint will begin to deteriorate at an accelerated pace. That is, it makes sense to use muscle relaxants only in combination, in combination with chondroprotectors and joint traction. And it is absolutely pointless to use them separately as an independent method of treatment.​
• ​Arthroflex​
• ​However, it is undesirable to use drugs from this group for a long time, as they can “mask” the manifestations of the disease. After all, when the pain decreases, a deceptive impression is created that healing has begun. Arthrosis, meanwhile, continues to progress: NSAIDs only eliminate individual symptoms of the disease, but do not cure it.​
• ​phlosterone,​
• ​Effective combination product. The drug contains two active ingredients:

​If we compare them with NSAIDs, corticosteroids have a stronger anti-inflammatory effect. However, when using them, the body becomes highly vulnerable to infections.​

​"Piroxicam".​

• ​Mixed and opioid drugs for joints:​
• ​Perhaps one of the most popular NSAIDs, created back in the 60s. Available in both tablet and ointment form. This remedy for the treatment of arthrosis combines both high anti-pain activity and good anti-inflammatory properties.​
• ​diseases of the cardiovascular system, liver, kidneys;​

​kenalog​

• ​When using muscle relaxants, certain rules must be followed: all drugs in this group are initially prescribed in a minimum dose, and it must be increased gradually. In the same way, it is necessary to gradually discontinue the drug - it is undesirable to stop taking the medication immediately, on one day, since the decisive withdrawal of muscle relaxants changes the body’s tone too dramatically.​
• ​, made in Romania. Release form: tablets containing 265 mg of chondroitin sulfate and 375 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 3-4 tablets per day.​
• ​In addition to the fact that non-steroidal anti-inflammatory drugs mask the manifestations of the disease, they also, apparently, do not have the best effect on joint cartilage. In recent years, data have been obtained indicating the harmful effects of long-term use of non-steroidal anti-inflammatory drugs on the synthesis of proteoglycans.​
• ​depo-medrol,​

​chondroitin sulfate;​

• ​It is strictly forbidden to use them yourself, reduce the dosage or completely abandon these medications. This can lead to the inability of the adrenal glands to adapt to the changes undertaken. As a result, the hormone cortisol can decrease to extremely dangerous levels.​
• "Ketoprofen."
• "Oxycodone."

​Produced under the names Voltaren, Naklofen, Ortofen, Diklak, Diclonac P, Vurdon, Olfen, Dolex, Dikloberl, Clodifen and others.​

• ​disturbances in the blood clotting system (frequent bleeding).​
• In conclusion, I think it is necessary to talk about the side effects of muscle relaxants. Almost all drugs in this group can cause a feeling of mild intoxication, changes in gait, headache and sleep disturbances (insomnia at night and drowsiness during the daytime). In connection with this feature of muscle relaxants, they should be used with caution by those people whose work requires a quick mental and physical reaction - vehicle drivers, air traffic controllers, machinists, etc.

Use of disease-modifying antirheumatic drugs (DMARDs)

​Proteoglycan molecules are responsible for the entry of water into cartilage, and disruption of their function leads to dehydration of cartilage tissue. As a result, cartilage already affected by arthrosis begins to deteriorate even faster. Thus, the pills that the patient takes to reduce pain in the joint may slightly accelerate the destruction of this joint.​

​diprospan,​

• ​Glucosamine hydrochloride.​
• ​If the patient has severe discomfort, the doctor may prescribe medications for joint pain, injected directly into their cavity.​
• "Indomethacin."
• "Tramadol."
• ​Read also the article about the “distant relative” of diclofenac - the drug Aceclofenac (Aertal).​

​NSAIDs are prescribed to pregnant patients with caution, so as not to provoke premature birth, pathologies of the kidneys and heart of the fetus.​

​diprospan​

​MEDICAL OINTMENTS AND CREAMS FOR TREATMENT OF JOINT ARTHROSIS.​

Chondroprotective drugs

​, made in Italy. A monotherapy containing only glucosamine. Release form: powder, packaged with 1500 mg of glucosamine in 1 sachet; You need to take 1 sachet of the drug per day; or capsules containing 250 mg glucosamine; You need to take 4-6 capsules of the drug per day.​

In addition, when using non-steroidal anti-inflammatory drugs, it is necessary to remember that they all have serious contraindications and can cause significant side effects with long-term use. They cannot be used (at least in the form of tablets and injections) for gastric and duodenal ulcers, ulcerative colitis and gastritis. In cases of extreme necessity, it is possible to recommend the use of NSAIDs for such diseases of the stomach and intestines only in the form of rectal suppositories. Absorbed in the rectum, non-steroidal anti-inflammatory drugs in the form of suppositories have less effect on the stomach and small intestine than tablets and injection solutions. But suppositories are contraindicated for those people who have diseases of the rectum: hemorrhoids, fissures or polyps.​

​celeston.​

​The medicine can stimulate cartilage regeneration, reduce pain, relieve inflammation, and improve joint mobility. The use of Arthra allows the patient to completely stop using NSAIDs.​

The following glucocorticosteroids can help eliminate the unpleasant symptoms of inflammation:

• ​Patients diagnosed with gastritis, ulcers, or high acidity are often prescribed selective medications:​
• "Morphine."
• ​Ibuprofen is good for joint diseases
• Acetylsalicylic acid has a good antipyretic and analgesic effect. As an anti-inflammatory drug, aspirin is inferior to indomethacin and diclofenac. Long-term use causes a number of side effects from the gastrointestinal tract.​
• ​Therapeutic ointments and creams are often advertised as guaranteeing cure for joint diseases. Unfortunately this is far from the case. But this does not mean that ointments are useless. Although ointments and creams cannot cure advanced arthrosis, their use sometimes significantly alleviates the patient’s condition. For example, for arthrosis of large joints that occurs without symptoms of synovitis, ointments that warm or irritate the skin are useful in order to improve blood circulation in the joint. Menovazin, Gevkamen, Espol, Finalgon, Nicoflex or other similar ointments are prescribed with this.
• ​Kondro (Kondronova)​

Prescribing corticosteroids

​Caution when using NSAIDs should be observed for those people who have suffered serious liver and kidney diseases (or are currently suffering from them). All of the listed contraindications are common to all NSAIDs, but there are also individual contraindications for each drug, which can be found in reference books or the package insert included with the medicine.​

Kenalog is used for injection into the joint cavity

• The medicine is not prescribed to patients who have severe kidney damage. It is not recommended for use by pregnant or lactating women.
• ​"Diprospan".​
• "Celecoxib."
• "Methadone."

​This drug for treating joints is slightly inferior in its anti-inflammatory and analgesic effect to other medications, including, for example, indomethacin, but is quite well tolerated.​

​(naklofen, ortofen, arthrozan, voltaren, etc.)​

Medicines injected into the joint

​hydrocortisone​

It has been proven that the irritation of skin receptors that occurs when rubbing these ointments leads to the production of endorphins - our internal painkillers “drugs”, thanks to which pain is reduced and painful spasm of the periarticular muscles is partially eliminated; In addition, warming ointments help increase blood circulation in the affected joints.​

• ​, made in India. Release form: capsules containing 200 mg of chondroitin sulfate and 250 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 4 tablets per day.​
• ​This, of course, does not mean that such adverse reactions will occur immediately and necessarily in everyone. There are a lot of people who take NSAIDs for years, and they do not experience any negative feelings, but the risk of developing side effects and complications with long-term use of NSAIDs is still quite high.​
• The therapeutic course consists of 1-3 injections, which are carried out at intervals of 5-10 days. Hormonal therapy is prescribed during the acute period of the disease under the strict supervision of the attending physician. The introduction of steroid drugs into the joint is associated with the risk of complications (infection, blocking of the joint, injury to soft tissue structures) and requires a highly qualified approach. Therapy is recommended for inflammation of the elbow, hip, and knee joints when persistent pain occurs that cannot be relieved by other methods.​
• The medicine is an active NSAID. This remedy is widely in demand in the treatment of joint diseases and inflammatory pathologies of connective tissues. It perfectly eliminates pain discomfort.​

​"Hydrocortisone".​

• "Meloxicam."
• ​"Oxycontrine."​
• This product is produced under the names Ibuprom, Advil, Reumafen, Nurofen, Faspik, MIG-400, Bonifen, Brufen, Ibalgin, Solpaflex, Burana, Dolgit, Bolinet, etc.
• ​Has a fast and long-lasting effect. Available in tablets, rectal suppositories, solution for intramuscular administration, gel (for topical use).​

Local agents

​Ointments based on bee venom (​

• ​The most commonly used trade names for the main non-steroidal anti-inflammatory drugs in the drug treatment of arthrosis.​
• Chondroprotectors are prescribed for degenerative-dystrophic diseases of the joints - arthrosis, which are accompanied by the destruction of intra-articular cartilage. Preparations in this group contain two main components, chondroitin sulfate and glycasamine. They help restore the normal structure of cartilage tissue, block the work of enzymes involved in inflammation, and reduce the intensity of pain.​
• However, despite the high effectiveness of the drug, it has many contraindications. Therefore, before using this product, you should definitely consult your doctor.​
• ​"Celeston".​
• "Nimesulide."

"Vicodin."

Preparations for ligaments and joints

In terms of its effect on inflammation, this is one of the most powerful; the analgesic effect of its use is also quite high.​

​This drug has proven itself as a good analgesic and anti-inflammatory agent in the treatment of ankylosing spondylitis, in the treatment of gout attacks. Along with aspirin, it has gastrotoxicity, so it is used with caution in the elderly, patients with a predisposition to stomach ulcers, as well as in those who smoke and abuse alcohol. Available in tablets (for oral administration), in the form of rectal suppositories, as well as ointments (for external use).​

​phlosterone​

The drug "Arthra"

• ​Teraflex​
• ​sold under the names ortofen, voltaren, diclofen, diclonac, diclonate, dicloran, diclobene, rapten, naklofen, feloran, betaren, arthrozan, etc.

This drug is a representative of the group of chondroprotectors. The active ingredient of the drug is chondroitin sulfate. Thanks to it, the product is able to positively influence metabolic processes in cartilage, protect them from degeneration, and reduce calcium loss. As a result, restoration processes in bone tissue are significantly accelerated.​

The drug "Indomethacin"

​The introduction of chondroprotectors, which are a “liquid prosthesis,” is considered optimal. Effective drugs for joint restoration:​

​These drugs are included in drug treatment (for the diagnosis of “arthrosis of the knee joint”). The drugs have different principles of action. However, the effect is always the same - the progressive disease slows down or stops.​

​The main advantage of this group is the absence of unpleasant effects on the gastrointestinal tract and high efficiency in eliminating pain discomfort.​

Means "Structum"

​It has a fairly decent list of side effects, but is considered a highly effective drug for arthritis and arthrosis of the joints, and in addition, it is quite cheap (the cost of the tablet form, depending on the number of tablets, ranges from 15 to 50 rubles per pack).​

Penetrates well through the skin, provides rapid pain relief, which makes it effective in the form of an external agent - a gel. It is also available in capsules, tablets, suppositories and solution for injection.​

celeston

Conclusion

​ungapiven​

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Preparations for the treatment of joints

​, made in Great Britain. Release form: capsules containing 400 mg of chondroitin sulfate and 500 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 2 tablets per day.​

​Indomethacin​

​Injections for joint pain​

Nonsteroidal anti-inflammatory drugs (NSAIDs)

​The drug "Structum" effectively reduces pain and restores the mobility of damaged joints. The positive effect of therapy lasts for a long time in the patient.

​"Duralan".​

​This group includes the following medications:​

The group of medications discussed above eliminates pain exclusively. Non-steroidal drugs for joints affect the body somewhat differently. They allow you to get rid of two unpleasant symptoms of the disease: inflammation, pain.​

• ​This active substance can be supplied by various pharmaceutical companies under the names Metindol, Indovis EC, Indotard, Indocollir, Indovazin, etc.​
• ​These drugs are more effective than their predecessors. When taken, the gastrointestinal tract is not affected and cartilage tissue is not destroyed.​
• ​) and snake venom (​
• ​Chondro​
• ​sold under the names methindol, indomin, indotard, indobene, rheumatin, inteban, etc.​

The pharmacological industry produces chondroprotectors containing only glycasamine or chondroitin sulfate, as well as combination agents that are considered more effective in the treatment of arthrosis. The most popular medications in medical practice are:

The drug is completely non-toxic. Therefore, it has practically no contraindications. The drug is not prescribed for small children, pregnant women or during lactation.​

• ​"Synvisk".​
• ​"Arava".​
• ​Common representatives of this class are:​
• In addition to the drugs listed above, the group of drugs of the first type, non-selective NSAIDs, i.e. COX-1, includes a drug such as ketoprofen. In terms of the strength of its action, it is close to ibuprofen, and is available in the form of tablets, gel, aerosol, cream, solutions for external use and for injection, rectal suppositories (suppositories).​

The absence of undesirable effects makes it possible to use this remedy for a long time. Self-medication is unacceptable. The dose and frequency of administration are prescribed by the doctor. Available in suppositories, tablets, injection solutions (for intramuscular administration).​

​metipred​

Hormonal agents

​viprosal​

• ​, made in India. Release form: capsules containing 200 mg of chondroitin sulfate and 250 mg of glucosamine. To achieve a full therapeutic effect, you must take at least 4 tablets per day
• ​preparations with chondroitin sulfate (mucosate, structum, chondrolone, chondroxide);​
• ​Today, any drugs for the knee joint or other joints are available. There are a great many of them. And each of them has its own therapeutic purpose, side effects and contraindications. To choose the most suitable and effective medicine, it is recommended to listen to the advice of a professional doctor.​
• ​"Ostenil."​
• "Plaquenil."

"Aspirin."

​You can buy this product under the trade names Artrum, Febrofid, Ketonal, OKI, Artrosilen, Fastum, Bystrum, Flamax, Flexen and others.​

Chondroprotectors

​Used in the treatment of osteochondrosis, arthritis and arthrosis. Has a strong analgesic and anti-inflammatory effect.​

​) also have an irritating and distracting effect, but, in addition, being absorbed in small quantities through the skin, they improve the elasticity of ligaments and muscles, as well as blood microcirculation. However, there are more side effects from their use: such ointments quite often cause allergies and inflammation of the skin at the sites of their application. You should also know that they are contraindicated for women during menstruation and for children.​ ​Chondroitin AKOS​

​included in the drugs Nurofen, Brufen, Bolinet, Buran, Motrin, Reumafen, and butadione - in the composition of Reopirin and Pirabutol.​

• ​preparations with glycazamine (Elbona, Ultron-flex, Dona, Yunium);​
• ​In recent decades, the incidence of musculoskeletal diseases has increased among the population of many countries around the world. Arthrosis and arthritis affect young people and tend to be chronic and progressive. The progression of the disease can be stopped by consulting a doctor in a timely manner. Otherwise, there is a high risk of irreversible changes, loss of ability to work and decreased quality of life.​
• ​"Fermatron".​

​"Imuran".​

"Diclofenac."

This group of NSAIDs has a more selective effect on the body, due to which there are much fewer side effects on the gastrointestinal tract, and the tolerability of these drugs increases. In addition, it is generally accepted that some COX-1 drugs can negatively affect the condition of cartilage tissue. Medicines from the COX-2 group do not have this feature, and they are considered to be good drugs for arthrosis.​

• The action of the drug is similar to celecoxib. When treated with doses prescribed by a doctor, it does not have a negative effect on the gastrointestinal mucosa.​
• ​depo-medrol​
• ​Ointments based on non-steroidal anti-inflammatory substances (​

​, made in Russia. A monopreparation containing only chondroitin sulfate. Release form: capsules containing 250 mg of chondroitin sulfate. To achieve a full therapeutic effect, you must take at least 4 capsules per day.​

​Piroxicam​

Basic funds

​combined products containing glycosamine and chondroitin sulfate (Honda, artroflex, arthron-complex, teraflex, chondro, arthra).​

• ​The main role in the treatment of joint diseases is played by medications, the dosage and duration of use of which is established by a specialist after a diagnostic examination and determination of the severity of the pathology.​
• ​These drugs for the treatment of the knee joint allow you to replace the necessary fluid and improve the nutrition of cartilage. The disadvantage of such medications is their high cost.​
• ​"Cytoxan".​
• "Indomethacin."
• ​However, not everything is so rosy: many of the drugs in this group, without affecting the stomach, can negatively affect the cardiovascular system.​
• ​It has the additional property of inhibiting active substances that destroy collagen and cartilage tissue. Release forms: granules, tablets, gel.​
• ​. Corticosteroids are good because they quickly and effectively suppress pain and inflammation associated with synovitis (swelling and swelling of the joint). It is the speed with which the therapeutic effect is achieved that is the reason why corticosteroid injections have gained particular popularity among doctors.​

​indomethacin​

​Chondrolone​

​is produced in the form of drugs pirocam, toldin, roxicam, pirox, erazon, and lornoxicam is sold under the name xefocam.​

MoyaSpina.ru

DRUG TREATMENT OF ARTHROSIS

In addition, chondroprotectors can be taken as part of dietary supplements (BAA). They contain not only the main components for cartilage restoration, but also additional ingredients that improve the regenerative and protective properties of joint tissues. The most effective for the health of the musculoskeletal system are Methylsulfanylmethane (contains sulfur) and Celadrin (includes a complex of fatty acids). They are included in Glucasamine Chondroitin Super Formula, Chondroitin Glucasamine MSM, Millennium Neo, Celadrin 525, New Celadrin&MSM, Agel FLX, which are considered the best homeopathic remedies for cartilage restoration. It should be remembered that chondroprotectors contained in medications and dietary supplements slowly accumulate in the body, so they are prescribed in repeated courses of 4-6 months over several years.​

​The main goal of conservative therapy is to eliminate pain, reduce the inflammatory response, and restore normal volume and range of motion. Some medications affect the symptoms of the disease, others can eliminate its cause. An integrated approach increases the effectiveness of treatment and helps achieve lasting positive results.​

This type of therapy is very popular. The following drugs are widely in demand for joint arthrosis:

​"Neoral".​

"Ibuprofen."

​Drugs in this group include medications such as meloxicam, nimesulide, celecoxib, etoricoxib (Arcoxia) and others.​

​What are the most effective anti-inflammatory drugs for joint diseases? What are their benefits, and are they harmful? How do these medications affect the disease and condition of the joints, as well as the body as a whole? This is what we will talk about in this article.​

However, the problem is that it is arthrosis itself that corticosteroids do not and cannot treat. This means they cannot prevent the development of arthrosis! Corticosteroids do not improve the condition of articular cartilage, strengthen bone tissue, or restore normal blood circulation. All they can do is reduce the body’s inflammatory response to this or that damage in the joint cavity. Therefore, it is pointless to use intra-articular injections of hormonal drugs as an independent method of treatment: they should be used only in the complex therapy of arthrosis.​

​, made in Russia. A monopreparation containing only chondroitin sulfate. Release form: ampoules containing 100 mg of chondroitin sulfate. To achieve a full therapeutic effect, it is necessary to carry out a course of 20-25 intramuscular injections.​ ​Ketoprofen​ Structum is a single drug with a chondroprotective effect. NSAIDs are drugs that have an antipyretic, analgesic, and anti-inflammatory effect on the body. They are prescribed as a symptomatic medicine for arthrosis of the joints and arthritis. Medicines in this group relieve signs of inflammation in pathologies of the musculoskeletal system of any nature and are prescribed during the acute period of the disease. Non-steroidal drugs are of non-hormonal origin, but have a pronounced analgesic effect. They are divided into two main groups, which differ in the selectivity of their effect on inflammatory mediators. “Fastum gel.” These medications are prescribed to patients who have a high risk of irreversible joint destruction. They are in demand in the fight against psoriatic, rheumatoid, idiopathic, and juvenile arthritis. Such drugs, even in case of long-term use, have virtually no side effects on the body and do not provoke addiction to them. “Diflunisal.” Movalis is the drug of choice for joint arthrosis​What is important for a patient to know before using anti-inflammatory drugs​ It is more useful to inject chondroprotectors into a joint affected by arthrosis (​​butadione​ ​Unium​​sold under the names ketonal, flexen, artrosilene, oruvel, profenid, knavon

​The achievements of modern medicine have made it possible to introduce “articular fluid prostheses” into the joint, which are hyaluronic acid preparations:​

​Non-selective NSAIDs inhibit the production of the enzymes COX-1 and COX-2, which causes side effects from the digestive tract. The enzyme cyclooxygenase is involved in the synthesis of inflammatory mediators called prostaglandins. At the same time, COX-1 has protective functions for the gastric mucosa, and COX-2 is released during inflammation of the joints. Inhibition of the production of two fractions of the enzyme leads to a good anti-inflammatory effect and persistent pain relief. However, it often causes side effects associated with the formation of ulcers in the digestive tract mucosa and bleeding. Therefore, drugs are prescribed in short courses of 10-14 days while taking drugs to protect the gastric mucosa, for example, omeprozole.​

​Indomethacin ointment.​

​The big disadvantage of this group is its extremely slow action. It takes weeks and sometimes months of regular treatment to see results. Therefore, they are prescribed by a doctor in combination with medications that have a quick action - corticosteroids, NSAIDs.​

​"Nimesulide";.​​One of the most well-known remedies with this active ingredient is movalis. The main advantage of this drug is that, unlike diclofenac or indomethacin, it can be taken for a long time - many months and even years (of course, under regular medical supervision).​ ​List of non-steroidal anti-inflammatory drugs​

​alflutop​

​, made in the USA. A monotherapy containing only glucosamine. Release form: tablets containing 750 mg of glucosamine. To achieve a full therapeutic effect, you need to take 2 tablets of the drug per day.​

​Ketorolac​

​durolan​

​Ibuprofen-based drugs are non-selective NSAIDs​

​"Menovazin";​

​These drugs for joints are not allowed to be used by patients with pathologies of the kidneys, liver, with a diagnosis of hypertension, or after vaccination.​ ​"Lysine monoacetylsalicylate."​ Meloxicam is available in the form of tablets, rectal suppositories, ointment and solution for intramuscular administration. Meloxicam (Movalis) tablets are good because they act for a long time, and it is enough to take just one tablet throughout the day - in the morning, or, for example, at night.​ ​COX-2 inhibitors - new generation NSAIDs​​,​​takes a long time​Vasodilator drugs for the treatment of joint arthrosis.​ ​is available in the form of drugs ketorol, ketalgin, dolac, adolor.​​stunned,​ ​Non-selective NSAIDs:​​Butadione ointment.​​These products can protect the cartilage of the joints from destruction. And, as you know, this is a necessary treatment for the diagnosis of “arthrosis of the knee joint.” “Aceclofenac.” Other trade names of this active substance are Artrosan, Movasin, Mesipol, Amelotex, Melox, Meloflam, Mirlox, Bi-xicam, Mixol -od, Lem, Melbek and Melbek-forte, Mataren, and, of course, the most famous in our country, Movalis. Warning: self-medication can harm your body! Take only medications prescribed by your doctor. Before using any medications, be sure to consult your doctor!​ ​chondrolone​​,​​Vasodilator drugs such as​​SELECTIVE ANTI-INFLAMMATORY DRUGS (MOVALIS) FOR TREATMENT OF JOINT ARTHROSIS.​ ​pharmatron.​ Diclofenac (Voltaren, Diclovit, Ortofen, Naproxen);

"Voltaren gel."

​The drugs can achieve several positive results. When using chondroprotectors, the dosage of NSAIDs is significantly reduced, since these drugs have anti-inflammatory properties. At the same time, they are much better tolerated. ​"Sulindak".​​The drug was originally developed by the pharmaceutical company Pfizer under the name Celebrex.​​Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most important groups of drugs for the treatment of diseases such as arthritis and osteoarthritis. The main function of these drugs is to reduce the level of inflammation in the joints, as well as reduce painful symptoms.​ ​or​

​voltaren-gel​

​trental​

Over the past two decades, several pharmacological companies have been developing non-steroidal anti-inflammatory drugs that, while eliminating inflammation and pain, would have a minimum of side effects. The result was a group of drugs called selective anti-inflammatory drugs. They are also called COX-2 inhibitors (cyclooxygenase-2 inhibitors).

​They prevent friction of the articular surfaces of bones, forming a protective film on the cartilage. This helps eliminate pain, activate metabolism in the area of ​​pathology, and normalize motor activity of the joints. The course of treatment requires 5-10 injections depending on the severity of the disease. In addition, chondroprotectors are injected into the joint, such as chondrolone, aflutop, goal T. The price of therapy with drugs in this group is quite high, but they affect not only the symptoms, but also the cause of arthrosis, which helps eliminate the pathological process.​

​Ibuprofen (Bolinet, Advil, Dolitol, Motrin);​

​Diclofenac ointment.​

Chondroprotectors prevent the progression of pathology. This is shown by X-rays after long-term medication use.​ "Etodolac."​It has a fairly powerful anti-inflammatory and analgesic effect on arthritis and arthrosis, while giving virtually no side effects on the gastric mucosa and the gastrointestinal tract as a whole. The medicine is available in capsules of 100 and 200 mg.​​Unlike hormonal anti-inflammatory medications (corticosteroids), NSAIDs do not contain hormones and have much fewer side effects on the body as a whole.​ ​homeopathic Purpose T​

​(aka agapurin, pentoxifylline) and​

​Selective agents are much less likely to produce unpleasant side effects, cause almost no complications and do not have a negative effect on the structure of articular cartilage. They can be taken for a long time, even in courses from several weeks to several years (of course, only under the supervision of a doctor)​

​Remicade effectively eliminates inflammation of the joints of an autoimmune nature​

​indomethacin (indobene, indocid, movimed, methindol);​

​Therapeutic compresses using these drugs, which in most cases contain the active substance NSAIDs, must be included in complex therapy. Using only local influence will not provide a high effect.​

​However, results should be expected only after six months of regular therapy. At the same time, these medications provide the best effect in the initial stages (1,2) of arthrosis.​

​"Ketoprofen".​​In addition to the fact that nimesulide has sufficient anti-pain and anti-inflammatory effects for the treatment of joint arthrosis, it has antioxidant properties and slows down the action of substances that destroy cartilage tissue, collagen fibers and proteoglycans.​ ​1. Despite their relative safety, most NSAIDs cannot be taken in long courses, since they have significant side effects and are contraindicated in many diseases of the gastrointestinal tract, liver, kidneys, and cardiovascular system. These drugs are used in courses over 2-3 years. During a course of treatment, from 5 to 15 injections of chondroprotectors are performed into one joint; on average, 2-3 such courses are carried out per year. The advantage of these drugs is their ability to affect the cause of the disease: they improve the condition of cartilage tissue and normalize metabolism in the joint. That is, unlike corticosteroids, chondroprotectors not only eliminate the symptoms of the disease, but also treat arthrosis. The question arises: why is intra-articular administration of chondroprotectors less commonly used by doctors? The thing is that these drugs help only 50-70% of patients, and it is impossible to predict in advance whether their use will have an effect or not. In addition, it is necessary to carry out quite a lot of injections into the joint, which, as we said, increases the risk of injury to the joint with a needle and increases the risk of complications.​ ​fastum​ ​teonicol​ One of the most prominent representatives of selective anti-inflammatory drugs is the drug movalis. Movalis acts more mildly than “classical” anti-inflammatory drugs, has fewer contraindications and is much less likely to cause unpleasant reactions from the gastrointestinal tract.

For autoimmune diseases of the musculoskeletal system, basic medications are used. They are aimed at eliminating the inflammatory reaction of connective tissue, which is caused by the damaging effect of antibodies when the normal functioning of the immune system is disrupted. These drugs affect the cause of the pathological process and are prescribed in combination with NSAIDs and steroid hormones in the acute phase of the disease. Basic therapy is represented by the following means:​ ​ketoprofen (artrosylene, ketonal);​ It's not just the joints that need treatment. Often the ligaments are also affected. Today, many medications and supplements have been developed to strengthen and treat joints and connective tissues. But, unfortunately, most of them are not effective enough. And some of these drugs do not even meet accepted quality standards.​ ​The most common drugs for joint restoration:​​"Lornoxicam".​​This medication has many different forms: gel for external use, tablets for oral administration and lozenges, granules for preparing a solution, etc.​ ​2. Anti-inflammatory drugs should not be used if the patient currently or in the past has had diseases such as gastritis, gastric and duodenal ulcers, and colitis. Unfortunately, this group of drugs has an extremely negative effect on the mucous membranes, causing inflammation and even the formation of ulcers. In addition, the effect of these drugs, unlike hormones, develops slowly, and, therefore, chondroprotectors make less of an impression on the patient. etc.) are used in cases where the course of arthrosis is aggravated by symptoms of synovitis. Unfortunately, they do not act as effectively as we would like - after all, the skin allows no more than 5-7% of the active substance to pass through, and this is clearly not enough to develop a full anti-inflammatory effect. However, these ointments extremely rarely cause the side effects that occur from the internal use of non-steroidal anti-inflammatory drugs (xanthine nicotinate), very useful for the treatment of arthrosis. They help restore the joint by improving articular blood flow and relieving spasm of small vessels. Thus, vasodilator drugs eliminate stagnation of blood circulation, which almost always accompanies arthrosis or arthritis. As a result, the affected joint receives more nutrients and recovers faster. Movalis is best used in cases where we need to treat inflammation and pain for a long time. As a rule, such a need arises in the treatment of arthrosis of the knee or hip joints, ankylosing spondylitis, psoriatic and rheumatoid arthritis.​

​azathioprine,​

​lornoxicam (xefocam);​

​The greatest effect will be brought by those medications for ligaments and joints that are prescribed by the doctor. After all, the doctor will select a medicine that will not just eliminate symptoms temporarily, but a medicine that will help restore connective tissues and cartilage.​ ​"Chondrolone".​​"Flurbiprofen".​​Nimesulide is produced under the trade names Aulin, Rimesid, Nise, Mesulide, Nimegesic, Aktasulide, Nimika, Flolid, Aponin, Koxtral, Nimid, Prolide, etc.​ ​3. These medications should also be taken with great caution if you have kidney or liver diseases. NSAIDs have a strong effect on renal blood flow, causing water and sodium retention, which can provoke not only an increase in blood pressure, but also serious disruption of the renal apparatus, as well as the liver.​

​The derivatives of hyaluronic acid, the drug Ostenil, which appeared about 5 years ago, act much more reliably, and most importantly, faster than chondroprotectors. ​MEANS FOR COMPRESSES IN THE TREATMENT OF JOINT ARTHROSIS.​ In addition, the use of vasodilators helps eliminate nighttime “vascular” pain in damaged joints. To achieve the maximum therapeutic effect, it is advisable to combine the use of vasodilating drugs with the use of chondroprotectors. In this case, chondroprotective nutrients penetrate the joint more easily and in greater quantities, and also circulate more actively in it.​

​arava,​

​Piroxicam (Pirocam, Toldin, Erazon, Pirox).​Based on modern research, the following drugs have been identified as having the greatest effectiveness:​ ​Structum.​ ​"Nabumeton".​​The best known form in our country is under the brand name Arcoxia. If the drug is taken in suitable, not very high dosages (up to 150 mg per day), then the effect on the gastric mucosa of this drug is very small - like other representatives of COX-2. For arthrosis of the joints, Arcoxia is usually prescribed at a dose of 30-60 mg per day.​​4. Sometimes some people may experience individual reactions of intolerance or hypersensitivity to anti-inflammatory drugs, so even in the absence of the diseases listed above, you should start taking them very carefully and in small doses, gradually. Ostenil Compress products have a slightly greater therapeutic effect compared to ointments.​The advantages of vasodilators include their “harmlessness” - when used correctly, they have few contraindications. But these medications should not be used in acute cases of myocardial infarction and “fresh” hemorrhagic strokes, when the effect of vasodilators can increase bleeding from burst cerebral vessels.​​available in tablets of 7.5 and 15 mg (0.0075 and 0.015 g) , in suppositories of 15 mg and in ampoules for intramuscular administration of 15 mg. Movalis is easy to use: one tablet or suppository of the drug is enough for the whole day, that is, it needs to be taken once a day - in the morning or at night. And for the most acute cases, an injection form of movalis has been developed for intramuscular administration. In situations where we need to quickly stop an attack of intense pain in a joint, we can use movalis in injection form for the first 5-7 days, and then switch to taking similar tablets, which the patient will then take for the required time.​ ​sulfasalazine, ​​​Selective NSAIDs belong to the new generation of drugs. They block the synthesis of only COX-2, thereby selectively acting on the source of inflammation in the affected joint. At the same time, they have a slightly less analgesic effect, but do not cause irritation of the mucous membrane of the stomach and intestines.​ ​"Glucosamine sulfate."​ ​"Chondroitin AKOS".​​NSAIDs block prostaglandins, which provoke the inflammatory process, but are also a protective factor for the stomach. That is why most of these drugs have a very negative effect on the gastrointestinal tract.

You can buy the drug Arcoxia, for example,

​5. Before taking the product, read all the instructions for it very carefully and act only in accordance with it. - 1% sodium hyaluronate solution - also called “liquid prosthesis” or “liquid implant”. Injected into a diseased joint, it gradually restores the characteristics of synovial fluid - the natural “lubricant” of the joint - to normal. Ostenil also forms a protective film on damaged cartilage, protecting its tissue from further destruction and improving the sliding of contacting cartilage surfaces. Of the topical agents used in our time, three drugs deserve the greatest attention: dimexide, bischofite and medical bile. It is also undesirable to use vasodilators for low blood pressure, because they slightly reduce pressure, and with a tendency to bleeding: nasal, uterine, hemorrhoidal.​ ​CHONDROPROTECTORS (GLUCOSAMINE AND CHONDROITIN SULPHATE) - DRUGS FOR RESTORATION OF CARTILAGE TISSUE IN THE TREATMENT OF JOINT ARTHROSIS.​ ​remicade,​​Selective NSAIDs:​

​The medicine helps strengthen ligaments and joints.​

​"Elbona".​ ​The drugs for joints have the best anti-inflammatory effects:​​or​

​6. In order to reduce the negative effect of NSAIDs on the gastric mucosa, take the tablets with as much liquid as possible - preferably a whole glass of water. For drinking, try to use only water, because other liquids may affect the absorption of the medicine.​

Non-steroidal anti-inflammatory drugs are included in the international standards for the treatment of inflamed joints and degenerative diseases (spondylosis, osteochondrosis, deforming arthrosis, ankylosing spondylitis).

Nonsteroidal anti-inflammatory drugs is a proven and clinically effective treatment method. Medicines eliminate inflammation and pain in a relatively short period. The visible effect occurs within 3–5 days after use. Many NSAIDs can be purchased without a prescription.

Unlike glucocorticoids, non-steroidal anti-inflammatory drugs have fewer side effects. Compared with chondroprotectors, NSAIDs have a faster clinical effect.

What are NSAIDs?

Nonsteroidal anti-inflammatory drugs are medications that relieve pain, normalize body temperature, and suppress inflammation in the joints. The word “non-steroidal” emphasizes their origin and chemical structure. These are non-hormonal drugs. This differs from steroidal anti-inflammatory drugs (glucocorticoids), which provoke many side effects, but have greater anti-inflammatory activity.

Pharmaceutical effectiveness

Inflammation is a universal protective process. The task of inflammation is to neutralize the harmful agent. But this process is followed by “side” effects: pain, limitation of movements in the joint, stiffness, swelling, decreased standard of living.

Regardless of the location of the damage, inflammation always occurs through the same mechanisms. The task of non-steroidal anti-inflammatory drugs is to neutralize the biochemical chain of inflammation, after which pain will decrease, swelling and stiffness will eliminate.

Inflammation in the joints develops due to the production of prostaglandins– protein substances that affect pain receptors, increase vascular permeability, create swelling, and increase local and general body temperature. The soft tissues of the joint become inflamed, the joint increases in volume, hurts and is limited in movement.

Non-steroidal anti-inflammatory drugs block the biochemical chain of conversion of arachidonic acid into prostaglandins in the joints by inhibiting cyclooxygenase (COX) of the first and second types. This is how NSAIDs relieve joint pain, reduce swelling and block the entire inflammation process.

What groups of drugs help with pain?

Nonsteroidal anti-inflammatory drugs are divided into groups depending on the method of synthesis and chemical structure.

Group	Active substance
salicylates	aspirin, diflunisal
pyrazolidines	phenylbutazone
indoleacetic acid derivatives	indomethacin, sulindac, etodolac
phenylacetic acid derivatives	diclofenac, aceclofenac, ketorolac
oxicams	piroxicam, tenoxicam, lornoxicam, meloxicam
propionic acid derivatives	ibuprofen, ketoprofen, naproxen, flurbiprofen
alkanones	nabumethon
sulfonamide derivatives	celecoxib, nimesulide, rofecoxib

Not all of the active ingredients presented are used to treat joint inflammation. Some of them (paracetamol) have weak anti-inflammatory activity and are used primarily to relieve pain and eliminate fever. This does not cancel their anti-inflammatory effect, they are just weaker.

Non-steroidal active ingredients with the greatest anti-inflammatory activity for joints:

Release forms: injections, tablets, suppositories, ointments

Anti-inflammatory non-steroidal drugs for the treatment of joints are available in gels and creams, ointments, tablets, capsules, rectal suppositories and solutions for injections.

1. Diclofenac:
2. Ketorolac:
3. :
   • pills: Brufen SR, Deblock, Ibuprofen Welfarm, Nurofast, Nurofen, Solpaflex, Brustan;
   • ointments and gels: Dolgit, Nurofen Express, Deep Relief, Next Activegel;
   • rectal suppositories: Brudol for children, Nurofen for children.
4. Ketoprofen:
5. Indomethacin:
6. Piroxicam:
   • pills: Vero-Piroxicam;
   • gels: Piroxicam, Finalgel.
7. Flurbiprofen:
   • pills: Rakstan-Sanovel;
   • topical spray: Strepsils Intensive.

The best painkillers of the new generation

New generation non-steroidal anti-inflammatory drugs for joints cause fewer side effects, but in terms of anti-inflammatory power they are the same as representatives of the previous generation.

Their relative safety is due to the fact that these drugs selectively, that is, selectively inhibit type 2 cyclooxygenase. This distinguishes them from first-generation drugs, which equally block COX-1 and COX-2 and cause side effects from the gastrointestinal tract.

Another advantage of new generation non-steroidal anti-inflammatory drugs for joints is that they do not have an antithrombotic effect and do not affect the composition of the blood.

New generation non-steroidal drugs have a disadvantage - they increase the likelihood of myocardial infarction, heart failure and hemorrhagic stroke.

When assessing the benefit-risk ratio, selective COX-2 inhibitors for target patients (without a predisposition to cardiovascular diseases) have more benefits than risks.

The new generation includes drugs for the treatment of knees, hip, elbow and other joints with such active ingredients:

Scientists have improved first-generation non-steroidal anti-inflammatory drugs - they came up with retard tablets(from the English slowdown, delay), which reduce the likelihood of side effects. The essence of retard tablets is that the active substance is released more slowly and undergoes processing. It is enough to take one tablet per day to stably maintain the amount of active substance in the blood.

Representatives of innovative anti-inflammatory drugs “retard”:

1. Diclofenac Retard Obolenskoe, Dikloberl Retard;
2. Methindol Retard, Indomethacin Retard.

What NSAIDs are prescribed for ankylosing spondylitis, arthrosis and other pathologies?

Anti-inflammatory non-steroidal drugs for joint diseases are prescribed depending on the individual characteristics of the patient: rhythm of pain, degree of stiffness, presence of stiffness in the morning, secondary diseases and tolerability of a particular drug. The duration of use of non-steroidal anti-inflammatory drugs for joints depends on these same properties.

IMPORTANT! Doses, release forms, duration of treatment and rules of administration are determined by the attending physician. The following information is for informational purposes only.

The disease is treated according to clinical protocols developed by experts from the Ministry of Health:

1. ankylosing spondylitis(2013 protocol): celecoxib, meloxicam;
2. arthrosis(2016 protocol): paracetamol, diclofenac, aceclofenac, etoricoxib, lornoxicam, meloxicam, nimesulide;
3. reactive arthritis(2016 protocol): diclofenac, aceclofenac, nimesulide, meloxicam, etoricoxib;
4. rheumatoid arthritis(2014 protocol): ibuprofen, diclofenac, naproxen, celecoxib, etoricoxib;
5. pseudarthrosis(2014 protocol): ketoprofen, ketorolac, paracetamol;
6. psoriatic arthritis(2016 protocol): diclofenac, aceclofenac, etoricoxib, meloxicam;
7. deforming osteoarthritis(2016 protocol): diclofenac, aceclofenac, etoricoxib, lornoxicam, meloxicam.

General contraindications

Anti-inflammatory non-steroidal drugs for joints should not be taken if the patient has:

Take only under medical supervision for the following conditions::

• arterial hypertension;
• diabetes;
• mental disorders;
• age over 60 years.

How long can I use the medicines?

To make your appointment as safe as possible, please adhere to the following information::

1. injections – no longer than 3 days;
2. rectal suppositories – no longer than 2 days;
3. tablets and capsules – 10–14 days;
4. ointment, gel and cream – no longer than 14 days;
5. spray for external use – no longer than 3 days.

Useful video

The “Live Healthy” program talks about the rules for taking non-steroidal anti-inflammatory drugs.

Results:

1. Nonsteroidal anti-inflammatory drugs are included in international clinical guidelines for the treatment of joint diseases.
2. NSAIDs relieve pain, suppress inflammation and increase joint mobility.
3. Substances with the greatest anti-inflammatory activity: diclofenac, ketorolac, ketoprofen, ibuprofen, indomethacin, piroxicam, meloxicam, nimesulide, flurbiprofen.
4. For the treatment of joints, non-steroidal anti-inflammatory drugs are available in the form of tablets and capsules, injection solutions, rectal suppositories, ointments, gels and sprays for external use.
5. New generation NSAIDs are safer, but are not recommended for patients with cardiovascular diseases. New generation non-steroidal anti-inflammatory drugs include the following substances: meloxicam, celecoxib, nimesulide and etoricoxib.
6. NSAIDs should not be taken by patients with acute diseases of the gastrointestinal tract, hemophilia and severe conditions.
7. The maximum period for administering injections is 3 days, rectal suppositories – 2 days, tablets and capsules – 10–14 days, ointments, gels and creams – 14 days, sprays – 3 days.

Every third person over the age of 35 experiences joint pain. They can be aching and sharp, pinpoint and widespread, short-term and long-lasting. Whatever the pain, it affects the quality of life, often leading to disability. The reasons for their occurrence are different. Painful sensations appear in endocrine, infectious, rheumatic, tumor and other diseases. For their diagnosis and further treatment, it is necessary to undergo a full medical examination. Special means will help reduce pain, and sometimes get rid of it completely: ointments, creams, gels and various oral medications. They are aimed not only at relieving the syndrome, but also perform an anti-inflammatory function.

By choosing the right product for joints, you can significantly reduce pain and quickly relieve inflammation and swelling. We have compiled a rating of the best drugs for joints, taking into account the following factors:

• patient reviews;
• doctors' opinion;
• effectiveness after use.

There are contraindications. Consult your doctor.

The best ointments, creams and gels for joints

The pain may come unexpectedly. Special ointments, creams and gels that will reduce discomfort will help you quickly get rid of it. Many of them not only relieve pain, but also have an anti-inflammatory effect. The use of the drug increases blood flow and restores joint mobility. Ointments are made based on natural ingredients: bee or snake venom, hot pepper, eucalyptus or clove oil.

5 FASTUM GEL

Gentle impact
Country: Germany
Average price: FASTUM GEL
Rating (2019): 4.7

The active ingredient in Fastum Gel is ketoprofen, which is a non-steroidal anti-inflammatory drug. The drug not only relieves pain and swelling, but also affects the cause of their occurrence. It is used to treat joints, muscles, tendons and ligaments for rheumatism, arthritis, gout, osteochondrosis, and sports injuries. After using the medicine, blood supply increases, as a result, mobility returns, pain, inflammation and fever disappear.

The gel with a pleasant smell and delicate consistency is instantly absorbed into the skin and begins to act within a few minutes. The pain soon disappears completely. The effect lasts from 2 to 4 hours. The advantages include a quick and gentle effect, the drug is not addictive, neutral aroma, economical consumption. No cons found.

4 VOLTAREN EMULGEL

The most popular remedy
Country: Switzerland
Average price: 280 rub.
Rating (2019): 4.7

Swiss complex action drug "Voltaren Emulgel" quickly eliminates pain in muscles, ligaments and joints. Thanks to the diclofenac included in the composition, it has a pronounced anti-inflammatory, analgesic and antipyretic effect. It relieves swelling and restores mobility, improves metabolic processes. Diclofenac is recognized as the most effective non-steroidal drug. According to reviews, gels based on it are the best medications for reducing pain and relieving tension in muscles and joints.

The product has a pleasant texture and is quickly absorbed, leaves no residue on the skin, and smells pleasant. The effect occurs within a few minutes, and soon the discomfort and swelling subside. Benefits: powerful analgesic effect. Disadvantages: Side effects may occur.

3 LONG

The best combination of price and quality
Country: Germany
Average price: 130 rub.
Rating (2019): 4.8

A powerful anti-inflammatory agent that quickly and effectively relieves pain and swelling and restores muscle mobility. It is indicated for arthritis, rheumatism, gout, osteochondrosis, and radiculitis. The cream is suitable for dislocations, sprains, bruises and other injuries, and also has a warming effect before training. The active component ibuprofen, a non-steroidal anti-inflammatory drug, has a strong analgesic effect. The cream relieves heat, redness, and promotes the resorption of bruises.

After application, a warming effect is felt within a few minutes, and the pain gradually disappears. Lasting results appear in 15 minutes and last up to 6 hours. Advantages: wide spectrum of action, effectively relieves pain and swelling, optimal cost. Disadvantages: if you are hypersensitive to the medicine, allergic reactions are possible.

2 Capsicam

Natural remedy
A country:
Average price: 260 rub.
Rating (2019): 4.9

"Capsicam" is a combined action ointment. It has an irritating, vasodilating and analgesic effect. The drug is made on the basis of hot pepper extract. It is excellent for joint pain and is often used by athletes to warm up muscles before training. The ointment is quickly absorbed and after a few minutes causes a feeling of warmth. The skin temperature rises, thereby increasing blood flow to the treated area. Muscle spasms stop.

The positive effect occurs after 30 minutes, which lasts up to 6 hours. Advantages: fast-acting pain reliever, natural ingredients, few contraindications, optimal price. Disadvantages: Sensitive skin may experience a strong burning sensation.

1 Viprosal

Better efficiency
A country: Latvia (produced in Estonia)
Average price: 230 rub.
Rating (2019): 5.0

The ointment is based on viper venom, which has an irritating effect and promotes vasodilation and blood flow. The composition also includes salicylic acid, turpentine and camphor, which are excellent antiseptics. The drug is recognized as the best fast-acting pain reliever. It is used for sprains and bruises, and is indicated for athletes during heavy physical activity.

The drug is quickly absorbed, so relief occurs within a few minutes, and the pain syndrome completely disappears after 30. The effect lasts for 2-3 hours. The product is available in tubes, is economically used, one package is enough for a long period of use. Advantages: ointment based on natural ingredients, instant action, few side effects, optimal cost. No cons found.

The best pills for joints

Joint pain is the cause of various diseases. These are arthritis, arthrosis, gout and others. It can appear as a result of injuries in athletes or after intense physical exertion. To eliminate unpleasant symptoms, it is necessary to identify their cause. Tablets and vitamins for joints have preventive, anti-inflammatory, antipyretic, analgesic and decongestant effects. These are the most common types of remedies recommended by doctors and used by patients.

5 Texamen

Long-term use allowed
Country: Türkiye
Average price: 174 rub.
Rating (2019): 4.6

Taking the drug relieves pain, relieves inflammation, reduces fever, eliminates joint swelling and prevents the formation of blood clots. Refers to oxicam derivatives. Recommended for the treatment of bursitis, gout, various types of neuralgia, osteoarthritis, rheumatism, myalgia. Eliminates pain of a traumatic nature when there is no result from ointments, creams or gel. Quickly brings the joint into working condition. Long-term use of the drug is safe for the body. Patients with progressive diseases of the urinary system are treated with caution and under the supervision of a physician.

Texamen quickly and deeply enters the joint 2 hours after its use. Absorption takes place in the digestive tract. A single dose per day is sufficient. It is recommended to take painkillers at the same time to achieve maximum results. The dose for a single dose is no more than 20 mg. If the drug is used for more than 5 days, the volume of one dose is halved. To effectively influence the patient, doctors advise taking the smallest dose in a short course. The upcoming operation serves as a reason to discontinue the drug. An attack of gout can be relieved with an increased dosage of 40 mg. After the acute syndrome is relieved, they switch to a five-day course.

4 Ketorolac

Best price. Effective for intense pain
Country Russia
Average price: 35 rub.
Rating (2019): 4.7

Used to treat patients with severe pain. It is considered one of the fastest-acting remedies. The main component of the drug is trometamol. It reduces the activity of lipid compounds, relieving the patient of pain of varying intensity. The drug is available in several forms: tablets, gel, drops, liquid. It has antipyretic and anti-inflammatory properties. It is not addictive and does not have a narcotic or sedative effect. Ketorolac is not recommended for chronic pain syndrome.

The effect of the drug begins 40-60 minutes after administration. The highest concentration is observed after 3 hours. The tablets are completely absorbed in the intestines. Eating fatty foods can increase the duration of action of the drug. The product is recommended for single or double use. The first dose is 10 mg, the second is up to 4 times a day, 10 mg. The maximum period of admission is 5 days.

3 LORNOXICS

Quick pain relief
Country: Austria
Average price: 150 rub.
Rating (2019): 4.8

Lornoxicam is one of the most powerful painkillers in its group. It relieves unpleasant symptoms of arthritis (rheumatoid and infectious), gout, and arthrosis. Reduces stiffness and swelling of joints. Instantly relieves pain, slows down the inflammatory process, and relieves fever. The effect lasts up to 8 hours. The drug is quickly and completely absorbed.

Lornoxicam is included in the list of vital and essential medicines. It is available in the form of tablets in a hard film shell. Reviews from patients indicate the effectiveness of the drug for severe and moderate pain. Before use, you should consult your doctor. Benefits: quick pain relief, reduced inflammation. Disadvantages: there are contraindications.

2 MOVALIS

Effective anti-inflammatory effect
Country: Austria
Average price: 520 rub.
Rating (2019): 4.9

The drug is intended for the treatment of arthrosis, arthritis and other diseases of the musculoskeletal system. It belongs to non-steroidal anti-inflammatory drugs. Has an analgesic and antipyretic effect. After using the tablets, swelling decreases and stiffness in movements is eliminated. As a result of laboratory studies, it was proven that movalis affects inflammation of various etiologies.

A high therapeutic effect is achieved with complex treatment. The drug is well absorbed from the gastrointestinal tract. Advantages: rapid reduction of inflammation, prevention of musculoskeletal diseases, combined with other drugs, few side effects. No cons found.

1 TERAFLEX

Better restoration of cartilage tissue
Country: Germany
Average price: 1,300 rub.
Rating (2019): 5.0

The drug contains natural components glucosamine and chondroitin. They restore cartilage tissue, increase collagen synthesis, relieve inflammation and pain, and improve mobility. It is indicated for use in osteochondrosis, osteoarthrosis, osteoporosis, pathology of the spine and joints. The tablets stimulate tissue regeneration and prevent cartilage destruction.

The therapeutic effect is achieved with long-term and regular treatment. It is recommended to take the product 2 times a year in spring and autumn for 3 months. Advantages: effective stimulator of cartilage tissue regeneration, relieves inflammation and pain, well tolerated by patients. The downside is the length of time it takes to take the drug and the high price.

The best vitamins for joints

For help with sore joints, people often turn to vitamin and mineral complexes. They play an important role in the complex therapy of the patient. The most effective of them are presented below.

5 ARTRIVIT

Based on herbal ingredients
Country: Canada
Average price: 330 rub.
Rating (2019): 4.6

The vitamin and mineral preparation "ArtriVit" is intended for complex treatment of the musculoskeletal system and joints. It is recommended for use by athletes during increased physical activity, as well as during the recovery period after injuries. The product has a preventive effect against osteoporosis. It provides joints with essential nutrients and stimulates tissue metabolism.

After use, pain and swelling decrease, flexibility improves, and crunching disappears. In addition to vitamins and minerals, the composition includes plant extracts: skullcap roots, licorice and black cohosh, alfalfa. Natural components have antirheumatic, anti-inflammatory and antibacterial effects, normalize temperature. Advantages: effective remedy, no contraindications (except for individual intolerance). No cons were found.

4 CALCEMINE

A quality preventative
Country Russia
Average price: 370 rub.
Rating (2019): 4.7

The strength of bone tissue directly depends on the amount of calcium in the body. The natural mineral complex “Kalcemin” compensates for its deficiency. The composition contains zinc, manganese, copper, boron, vitamin E3, which help restore cartilage, reduce inflammation, and increase the absorption of microelements. The drug is recommended for complex treatment and prevention of osteoporosis.

According to reviews, this is an excellent remedy for strengthening bones and joints. Suitable for children over 5 years old, as well as pregnant and lactating women. The average duration of a preventive course is 30 days, for the treatment of osteoporosis - 3 months. Advantages: natural composition, easy to digest, few side effects, optimal price. No deficiencies found.

3 Artron Complex

Helps normalize the formation of joint fluid
Country: USA
Average price: 550 rub.
Rating (2019): 4.7

The best modern drug from the group of chondroprotectors. Contains chondroitin and glucosamine. Additionally included are magnesium stearate, MCC, and calcium phosphate. Glucosamine produces collagen, which takes an active part in the formation of joint structure. It has an anti-inflammatory effect and acts as an antioxidant. The patient regains lost physical activity. Chondroitin is considered to lubricate the joint, providing it with youth and mobility. The drug stimulates regeneration, normalizes blood circulation, and provides nutrition to bone tissue. Thanks to this, pain disappears, saturation with minerals occurs, and injured areas are restored.

Artron Complex is indicated for use by athletes, heavy physical labor workers, and elderly people during the recovery period after fractures. Starting from 15 years of age, it is recommended to take the medicine 1-3 times a day, 1 tablet. Improvement in the patient's condition serves as a reason to reduce the dosage to one tablet per day. The effective course of therapy reaches 3 months. It is enough to carry out treatment 2 times a year.

2 Doppelhertz-active

Serves as a building material for cartilage tissue
Country: Germany
Average price: 528 rub.
Rating (2019): 4.8

The drug is considered the best biologically active food supplement. Prescribed for prophylactic purposes against degenerative processes in the joints and spine. The active components are glucosamine and chondroitin. They are involved in the construction of connective and cartilaginous tissue. Helps restore bone tissue after injury. The product contains Ca, which ensures better strength of joints and bones, and also improves the functioning of all systems and organs, and increases the amount of hemoglobin in the blood.

Doctors recommend taking the drug from adolescence, when the musculoskeletal system is actively growing. Vitamins are prescribed to people who experience heavy mechanical stress on their joints during work. The tablets are taken day and evening, thoroughly washed down with water. The effective time of administration is after eating. The duration of treatment is discussed with the doctor. Usually the drug is taken for up to three months. Then they take a break, and the course can be repeated.

1 Calciferol

The best remedy for preventing and treating osteoporosis
Country: USA
Average price: 1,160 rub.
Rating (2019): 5.0

The basis of the drug is vitamin D, the main function of which is considered to normalize the absorption of Ca in the body. Thanks to this, it inhibits osteoporosis and serves as a prevention of osteomalacia in people of different ages. Doctors prescribe the vitamin to children from the first days of life, as it is the safest in the fight against rickets. To prevent fractures, the medicine is prescribed to elderly patients whose bone tissue becomes sparse with age. It should be taken by pregnant women. This will help to properly form the child’s skeleton and preserve the mother’s bone structure.

The drug is taken orally. The best dosage is selected individually by the doctor, taking into account age, physical activity, and the starting content of the vitamin in the patient’s body. 400-600 IU are prescribed per day. For effective prevention, it is permissible to consume 200 IU per day. Adolescents from 8 to 12 years old are prescribed 1 tablet per day, adults - 2 times a day, without chewing. Regular intake of the vitamin improves the functioning of the nervous system and normalizes sleep.

The best drugs for intra-articular administration

At the beginning of the onset of pain, patients begin to actively use external agents for treatment in the form of ointment, cream or gel. When the unpleasant symptoms disappear, treatment is stopped, but inflammatory processes sometimes proceed deeper than these drugs penetrate. Then injections into the joint are required. The method is considered innovative and the most effective in the fight against arthritis and arthrosis. It is carried out only in a hospital by a specially trained medical professional. As a result of intra-articular infusion, pain is relieved, swelling is reduced and inflammation is eliminated.

5 Kenalog

Limits the movement of leukocytes to the area of ​​inflammation
Country: Slovenia
Average price: 570 rub.
Rating (2019): 4.6

The action of the drug is based on the inhibition of neurotransmitters by eosinophils, which suppresses the development of inflammation. Administration into the joint is recommended for bursitis, arthritis of traumatic etiology, tendinitis and synovitis. With deep penetration of the product, the movement of leukocytes to the lesion is inhibited. It is recommended to use the product for the treatment of minor residual foci of inflammation, gout, and dropsy. It successfully treats wrinkling of the shoulder joint bursa.

The standard dosage for people over 12 years of age depends on the parameters of the joint and the nature of the disease. For injection into small joints, 10 mg is enough, medium – 20 mg, large – up to 40 mg. If a large area of ​​inflammation or a large number of joints is detected, the dose per day is increased to 80 mg. Preparation of the injection site is similar to preoperative. The break between injections is at least 2 weeks. The duration of therapy depends entirely on the body's response to treatment, which is assessed by the doctor.

4 Hydrocortisone

Has an anti-shock effect
Country Ukraine
Average price: 214 rub.
Rating (2019): 4.7

A hormonal drug classified as a potent drug. Actively used for severe inflammation, autoimmune diseases, shock conditions. It is administered inside the joint in a medical facility, under the strict supervision of a doctor. The procedure is equivalent to a surgical intervention and requires careful preparatory measures and complete disinfection. They try to use the drug in the most difficult cases, when there is a high risk of threat to the patient’s life or in the absence of the desired result of preliminary treatment. The action is based on a process that suppresses the patient’s immunity. The body accelerates the breakdown of proteins in muscles.

As a result of exposure, swelling is relieved, the total volume of blood in the body increases, and blood pressure rises. When administered into a joint, a slow disintegration of the drug components is observed, which prolongs the period of its action. A single dose of the drug depends on the size of the joint and its damage and varies from 0.1 to 1.0 ml. Injections are given once every 7 days. The full course consists of 3-5 procedures. The analgesic effect begins 6-24 hours after administration. The effect of the medicine is observed for up to several weeks. Additionally, it is available in the form of ointment, gel and cream based on it.

3 Diprospan

Strong anti-inflammatory agent
Country: USA
Average price: 383 rub.
Rating (2019): 4.8

The drug has glucocorticosteroid activity. Prescribed as a strong anti-inflammatory agent when ointments and creams have not previously helped. Has antihistamine and immunosuppressive effects. Concentrated in the liver and excreted by the body through the urinary system. Available in the form of a suspension intended for intramuscular, intraarticular, intradermal injections. Used for skin diseases, musculoskeletal disorders, nephrotic syndrome, allergies. The drug can play the role of auxiliary therapy against the background of the main treatment. The medicine crystals are small in size, which allows you to use the smallest needles for injections. The process of injection into the site of inflammation becomes less painful. Such procedures should be carried out under conditions of increased disinfection.

The dosage is selected only by the doctor depending on the patient’s age, the severity of symptoms and his general condition. The single volume is 1-2 ml, the frequency of administration is individual. For effective effects, the use of the minimum permissible doses for a short period of time is indicated. The drug is discontinued according to the regimen prescribed by the doctor.

2 Flosteron

Has an antitoxic effect
Country: Slovenia
Average price: RUB 1,107.
Rating (2019): 4.9

Available in the form of a suspension. It is used in anti-shock measures, reduces the toxic effect and permeability of blood vessels in the circulatory system. Due to this, after administration it quickly penetrates to the site of inflammation, easily overcoming even the placental barrier. Breaks down in the liver into inactive metabolites. Excretion routes: kidneys, bile and breast milk.

The dosage of the drug depends on the size of the joint and the degree of its damage. When developing a treatment regimen, the doctor focuses on the patient’s age, severity of the disease and individual characteristics. For large joints this figure is 1-2 ml, for medium ones - 0.5-1 ml, and for small joints - from 0.25 to 0.5 ml. Exceeding the dose is possible with confirmed symptoms of gout. The frequency of administration of the drug for large joints is 3-4 times a year. Single doses should not be exceeded. Repeated administration of the drug is allowed after 7-14 days. It is permissible to mix the drug with a local anesthetic.

1 Don

Better regeneration of cartilage tissue
Country: Italy
Average price: 1,330 rub.
Rating (2019): 5.0

The drug behaves as an active chondroprotector, a strong analgesic and anabolic agent. It has a pronounced anti-inflammatory effect, starts the process of regeneration of injured tissues and affects the absorption of nutrients. The pain goes away, the inflammation is eliminated, and the patient’s physical activity is restored. The basis of the drug is glucosamine, which activates the regenerative process in cartilage tissue. The permeability of the articular membrane increases, which leads to the normalization of all processes.

The dose of administration and treatment regimen are developed by the doctor individually for each patient. A solvent is used to dilute the suspension. It is mixed with the main drug and administered simultaneously. It is tolerated without complications, but patients with diabetes need to monitor glucose levels in the body during treatment.

The inflammatory process in almost all cases accompanies rheumatic pathology, significantly reducing the patient’s quality of life. That is why one of the leading areas of treatment for joint diseases is anti-inflammatory treatment. Several groups of drugs have this effect: nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids for systemic and local use, and partly, only as part of complex treatment, chondroprotectors.

In this article we will look at the group of drugs listed first - NSAIDs.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

This is a group of drugs whose effects are anti-inflammatory, antipyretic and analgesic. The severity of each of them varies from drug to drug. These drugs are called non-steroidal because they differ in structure from hormonal drugs, glucocorticoids. The latter also have a powerful anti-inflammatory effect, but at the same time they have the negative properties of steroid hormones.

Mechanism of action of NSAIDs

The mechanism of action of NSAIDs is their non-selective or selective inhibition (inhibition) of varieties of the COX enzyme - cyclooxygenase. COX is found in many tissues of our body and is responsible for the production of various biologically active substances: prostaglandins, prostacyclins, thromboxane and others. Prostaglandins, in turn, are mediators of inflammation, and the more of them, the more pronounced the inflammatory process. NSAIDs, by inhibiting COX, reduce the level of prostaglandins in tissues, and the inflammatory process regresses.

NSAID prescription regimen

Some NSAIDs have a number of quite serious side effects, while other drugs in this group are not characterized as such. This is due to the peculiarities of the mechanism of action: the influence of drugs on various types of cyclooxygenase - COX-1, COX-2 and COX-3.

In a healthy person, COX-1 is found in almost all organs and tissues, in particular in the digestive tract and kidneys, where it performs its most important functions. For example, prostaglandins synthesized by COX are actively involved in maintaining the integrity of the gastric and intestinal mucosa, maintaining adequate blood flow in it, reducing the secretion of hydrochloric acid, increasing pH, secretion of phospholipids and mucus, stimulating cell proliferation (reproduction). Drugs that inhibit COX-1 cause a decrease in the level of prostaglandins not only in the site of inflammation, but throughout the body, which can lead to negative consequences, which will be discussed below.

COX-2, as a rule, is absent in healthy tissues or is found, but in insignificant quantities. Its level increases directly during inflammation and at its very source. Drugs that selectively inhibit COX-2, although often taken systemically, act specifically on the lesion, reducing the inflammatory process in it.

COX-3 is also involved in the development of pain and fever, but it has nothing to do with inflammation. Some NSAIDs act specifically on this type of enzyme and have little effect on COX-1 and 2. Some authors, however, believe that COX-3, as an independent isoform of the enzyme, does not exist, and is a variant of COX-1: these questions require conducting additional research.

Classification of NSAIDs

There is a chemical classification of nonsteroidal anti-inflammatory drugs based on the structural features of the active substance molecule. However, biochemical and pharmacological terms are probably of little interest to a wide range of readers, so we offer you another classification, which is based on the selectivity of COX inhibition. According to it, all NSAIDs are divided into:
1. Non-selective (affect all types of COX, but mainly COX-1):

• Indomethacin;
• Ketoprofen;
• Piroxicam;
• Aspirin;
• Diclofenac;
• Acyclofenac;
• Naproxen;
• Ibuprofen.

2. Non-selective, affecting equally COX-1 and COX-2:

• Lornoxicam.

3. Selective (inhibit COX-2):

• Meloxicam;
• Nimesulide;
• Etodolac;
• Rofecoxib;
• Celecoxib.

Some of the drugs listed above have virtually no anti-inflammatory effect, but rather have an analgesic (Ketorolac) or antipyretic effect (Aspirin, Ibuprofen), so we will not talk about these drugs in this article. Let's talk about those NSAIDs whose anti-inflammatory effect is most pronounced.

Briefly about pharmacokinetics

Nonsteroidal anti-inflammatory drugs are used orally or intramuscularly.
When taken orally, they are well absorbed in the digestive tract, their bioavailability is about 70-100%. They are better absorbed in an acidic environment, and a shift in gastric pH to the alkaline side slows down absorption. The maximum concentration of the active substance in the blood is determined 1-2 hours after taking the drug.

When administered intramuscularly, the drug binds to blood proteins by 90-99%, forming functionally active complexes.

They penetrate well into organs and tissues, especially into the source of inflammation and synovial fluid (located in the joint cavity). NSAIDs are excreted from the body in the urine. The half-life varies widely depending on the drug.

Contraindications to the use of NSAIDs

It is undesirable to use drugs in this group in the following conditions:

• individual hypersensitivity to components;
• , as well as other ulcerative lesions of the digestive tract;
• leuko- and thrombopenia;
• heavy and;
• pregnancy.

Main side effects of NSAIDs

These are:

• ulcerogenic effect (the ability of drugs in this group to provoke the development of the gastrointestinal tract);
• dyspeptic disorders (stomach discomfort, etc.);
• bronchospasm;
• toxic effects on the kidneys (impaired kidney function, increased blood pressure, nephropathy);
• toxic effects on the liver (increased activity of liver transaminases in the blood);
• toxic effects on the blood (reduction in the number of formed elements up to aplastic anemia, manifested);
• prolongation of pregnancy;
• (skin rashes, anaphylaxis).

Number of reports of adverse reactions of NSAID drugs received in 2011-2013

Features of NSAID therapy

Since drugs in this group, to a greater or lesser extent, have a damaging effect on the gastric mucosa, most of them must be taken after meals, with a sufficient amount of water, and, preferably, with the parallel use of drugs to maintain the gastrointestinal tract. As a rule, proton pump inhibitors play this role: Omeprazole, Rabeprazole and others.

Treatment with NSAIDs should be carried out for the minimum permissible time and in the minimum effective doses.

Persons with impaired renal function, as well as elderly patients, are usually prescribed a dose lower than the average therapeutic dose, since the processes in these categories of patients are slowed down: the active substance both has an effect and is eliminated over a longer period.
Let us consider individual drugs of the NSAID group in more detail.

Indomethacin (Indomethacin, Methindol)

Release form: tablets, capsules.

It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Inhibits the aggregation (sticking together) of platelets. The maximum concentration in the blood is determined 2 hours after administration, the half-life is 4-11 hours.

Prescribed, as a rule, 25-50 mg orally 2-3 times a day.

The side effects listed above are quite pronounced for this drug, so at present it is used relatively rarely, giving way to other drugs that are safer in this regard.

Diclofenac (Almiral, Voltaren, Diklak, Dikloberl, Naklofen, Olfen and others)

Release form: tablets, capsules, injection solution, suppositories, gel.

It has a pronounced anti-inflammatory, analgesic and antipyretic effect. Quickly and completely absorbed from the gastrointestinal tract. The maximum concentration of the active substance in the blood is achieved after 20-60 minutes. Almost 100% absorbed from blood proteins and transported throughout the body. The maximum concentration of the drug in synovial fluid is determined after 3-4 hours, its half-life from it is 3-6 hours, from blood plasma - 1-2 hours. Excreted in urine, bile and feces.

As a rule, the recommended dose of diclofenac for adults is 50-75 mg 2-3 times a day orally. The maximum daily dose is 300 mg. The retard form, equal to 100 g of the drug in one tablet (capsule), is taken once a day. When administered intramuscularly, the single dose is 75 mg, the frequency of administration is 1-2 times a day. The drug in the form of a gel is applied in a thin layer to the skin in the area of ​​inflammation, the frequency of application is 2-3 times a day.

Etodolac (Etol Fort)

Release form: 400 mg capsules.

The anti-inflammatory, antipyretic and analgesic properties of this drug are also quite pronounced. It has moderate selectivity - it acts predominantly on COX-2 at the site of inflammation.

Rapidly absorbed from the gastrointestinal tract when taken orally. Bioavailability is independent of food intake and antacid medications. The maximum concentration of the active substance in the blood is determined after 60 minutes. 95% binds to blood proteins. The half-life from blood plasma is 7 hours. It is excreted from the body mainly in urine.

It is used for emergency or long-term treatment of rheumatological pathology: as well as in the case of pain syndrome of any etiology.
It is recommended to take the drug 400 mg 1-3 times a day after meals. If long-term therapy is necessary, the dose of the drug should be adjusted once every 2-3 weeks.

Contraindications are standard. Side effects are similar to those of other NSAIDs, however, due to the relative selectivity of the drug, they appear less frequently and are less pronounced.
Reduces the effect of some antihypertensive drugs, in particular ACE inhibitors.

Aceclofenac (Aertal, Diclotol, Zerodol)

Available in the form of 100 mg tablets.

A worthy analogue of diclofenac with a similar anti-inflammatory and analgesic effect.
After oral administration, it is quickly and almost 100% absorbed by the gastric mucosa. When eating at the same time, the rate of absorption slows down, but its degree remains the same. It binds to plasma proteins almost completely, spreading throughout the body in this form. The concentration of the drug in the synovial fluid is quite high: it reaches 60% of its concentration in the blood. The average half-life is 4-4.5 hours. It is excreted primarily by the kidneys.

Among the side effects, dyspepsia, increased activity of liver transaminases, dizziness should be noted: these symptoms occur quite often, in 1-10 cases out of 100. Other adverse reactions are observed much less frequently, in particular, in less than one patient per 10,000.

The likelihood of side effects can be reduced by prescribing the patient the minimum effective dose in the shortest possible time.

It is not recommended to take aceclofenac during pregnancy and breastfeeding.
Reduces the antihypertensive effect of antihypertensive drugs.

Piroxicam (Piroxicam, Fedin-20)

Release form: 10 mg tablets.

In addition to anti-inflammatory, analgesic and antipyretic effects, it also has an antiplatelet effect.

Well absorbed from the gastrointestinal tract. Simultaneous food intake slows down the rate of absorption, but does not affect the degree of its effect. The maximum concentration in the blood is observed after 3-5 hours. The concentration in the blood is much higher when the drug is administered intramuscularly than after taking it orally. Penetrates 40-50% into synovial fluid and is found in breast milk. Undergoes a number of changes in the liver. Excreted in urine and feces. The half-life is 24-50 hours.

The analgesic effect appears within half an hour after taking the tablet and persists throughout the day.

Dosages of the drug vary depending on the disease and range from 10 to 40 mg per day in one or more doses.

Contraindications and side effects are standard.

Tenoxicam (Texamen-L)

Release form: powder for the preparation of solution for injection.

Apply intramuscularly at 2 ml (20 mg of the drug) per day. In acute cases - 40 mg 1 time per day for 5 days in a row at the same time.

Enhances the effects of indirect anticoagulants.

Lornoxicam (Xefocam, Larfix, Lorakam)

Release form: tablets of 4 and 8 mg, powder for the preparation of solution for injection containing 8 mg of the drug.

The recommended dose for oral administration is 8-16 mg per day 2-3 times. The tablet should be taken before meals with plenty of water.

8 mg is administered intramuscularly or intravenously at a time. Frequency of administrations per day: 1-2 times. The injection solution must be prepared immediately before use. The maximum daily dose is 16 mg.
Elderly patients do not need to reduce the dosage of lornoxicam; however, due to the likelihood of adverse reactions from the gastrointestinal tract, persons with any gastroenterological pathology should take it with caution.

Meloxicam (Movalis, Melbek, Revmoxicam, Recoxa, Melox and others)

Release form: tablets of 7.5 and 15 mg, injection solution of 2 ml in an ampoule containing 15 mg of active substance, rectal suppositories also containing 7.5 and 15 mg of Meloxicam.

Selective COX-2 inhibitor. Less common than other drugs in the NSAID group, it causes side effects such as kidney damage and gastropathy.

As a rule, the drug is administered parenterally in the first few days of treatment. 1-2 ml of solution is injected deep into the muscle. When the acute inflammatory process subsides a little, the patient is transferred to the tablet form of meloxicam. It is taken orally, regardless of food intake, 7.5 mg 1-2 times a day.

Celecoxib (Celebrex, Revmoxib, Zycel, Flogoxib)

Release form: capsules of 100 and 200 mg of the drug.

A specific inhibitor of COX-2, which has a pronounced anti-inflammatory and analgesic effect. When used in therapeutic doses, it has virtually no negative effect on the mucous membrane of the gastrointestinal tract, since it has a very low degree of affinity for COX-1, therefore, it does not cause disruption in the synthesis of constitutional prostaglandins.

As a rule, celecoxib is taken at a dosage of 100-200 mg per day in 1-2 doses. The maximum daily dose is 400 mg.

Side effects are rare. In case of long-term use of the drug in high dosage, ulceration of the mucous membrane of the digestive tract, gastrointestinal bleeding, agranulocytosis, etc. is possible.

Rofecoxib (Denebol)

Release form: solution for injection in 1 ml ampoules containing 25 mg of active substance, tablets.

A highly selective COX-2 inhibitor with pronounced anti-inflammatory, analgesic and antipyretic properties. It has virtually no effect on the mucous membrane of the gastrointestinal tract and kidney tissue.

Prescribed with caution to women in the 1st and 2nd trimesters of pregnancy, during breastfeeding, to persons suffering or severe.

The risk of developing side effects from the gastrointestinal tract increases when taking high dosages of the drug for a long time, as well as in elderly patients.

Etoricoxib (Arcoxia, Exinef)

Release form: tablets of 60 mg, 90 mg and 120 mg.

Selective COX-2 inhibitor. It does not affect the synthesis of gastric prostaglandins and has no effect on platelet function.

The drug is taken orally regardless of food intake. The recommended dose directly depends on the severity of the disease and varies between 30-120 mg per day in 1 dose. Elderly patients do not need to adjust the dosage.

Side effects are extremely rare. As a rule, they are noted by patients taking etoricoxib for 1 year or more (for serious rheumatic diseases). The range of undesirable reactions that arise in this case is extremely wide.

Nimesulide (Nimegesic, Nimesil, Nimid, Aponil, Nimesin, Remesulide and others)

Release form – tablets of 100 mg, granules for the preparation of a suspension for oral administration in sachets containing 1 dose of the drug – 100 mg each, gel in a tube.

A highly selective COX-2 inhibitor with pronounced anti-inflammatory, analgesic and antipyretic effects.

Take the drug orally, 100 mg twice a day, after meals. The duration of treatment is determined individually. The gel is applied to the affected area, lightly rubbing into the skin. Frequency of application – 3-4 times a day.

When prescribing Nimesulide to elderly patients, no dose adjustment is required. The dose should be reduced in case of severe impairment of the patient's liver and kidney function. May have a hepatotoxic effect, inhibiting liver function.

During pregnancy, especially in the 3rd trimester, taking nimesulide is strictly not recommended. The drug is also contraindicated during breastfeeding.

Nabumethon (Sinmeton)

Release form: tablets of 500 and 750 mg.

Non-selective COX inhibitor.

A single dose for an adult patient is 500-750-1000 mg during or after meals. In especially severe cases, the dose can be increased to 2 grams per day.

Side effects and contraindications are similar to those of other non-selective NSAIDs.
It is not recommended to take during pregnancy and breastfeeding.

Combined non-steroidal anti-inflammatory drugs

There are drugs that contain two or more active substances from the NSAID group, or NSAIDs in combination with vitamins or other drugs. The main ones are listed below.

• Dolaren. Contains 50 mg diclofenac sodium and 500 mg paracetamol. In this drug, the pronounced anti-inflammatory effect of diclofenac is combined with the strong analgesic effect of paracetamol. Take the drug orally, 1 tablet 2-3 times a day after meals. The maximum daily dose is 3 tablets.
• Neurodiclovit. Capsules containing 50 mg of diclofenac, vitamin B1 and B6, as well as 0.25 mg of vitamin B12. Here, the analgesic and anti-inflammatory effect of diclofenac is enhanced by B vitamins, which improve metabolism in nervous tissue. The recommended dose of the drug is 1-3 capsules per day in 1-3 doses. Take the drug after meals with a sufficient amount of liquid.
• Olfen-75, produced in the form of an injection solution, in addition to diclofenac in an amount of 75 mg, also contains 20 mg of lidocaine: due to the presence of the latter in the solution, injections of the drug become less painful for the patient.
• Fanigan. Its composition is similar to that of Dolaren: 50 mg of diclofenac sodium and 500 mg of paracetamol. It is recommended to take 1 tablet 2-3 times a day.
• Flamidez. A very interesting drug, different from others. In addition to 50 mg of diclofenac and 500 mg of paracetamol, it also contains 15 mg of serratiopeptidase, which is a proteolytic enzyme and has fibrinolytic, anti-inflammatory and decongestant effects. Available in the form of tablets and gel for topical use. The tablet is taken orally, after meals, with a glass of water. As a rule, 1 tablet is prescribed 1-2 times a day. The maximum daily dose is 3 tablets. The gel is used externally, applying it to the affected area of ​​the skin 3-4 times a day.
• Maxigesik. A drug similar in composition and action to Flamidez, described above. The difference lies in the manufacturing company.
• Diplo-P-Pharmex. The composition of these tablets is similar to that of Dolaren. The dosages are the same.
• Dollar The same.
• Dolex. The same.
• Oksalgin-DP. The same.
• Cynepar. The same.
• Dilocaine. Like Olfen-75, it contains diclofenac sodium and lidocaine, but both active ingredients are in half the dosage. Accordingly, it is weaker in action.
• Dolaren gel. Contains sodium diclofenac, menthol, linseed oil and methyl salicylate. All these components, to one degree or another, have an anti-inflammatory effect and potentiate each other’s effects. The gel is applied to the affected areas of the skin 3-4 times during the day.
• Nimid forte. Tablets containing 100 mg nimesulide and 2 mg tizanidine. This drug successfully combines the anti-inflammatory and analgesic effects of nimesulide with the muscle relaxant (muscle relaxing) effect of tizanidine. It is used for acute pain caused by spasm of skeletal muscles (popularly - when the roots are pinched). Take the drug orally after meals with plenty of liquid. The recommended dose is 2 tablets per day in 2 divided doses. The maximum duration of treatment is 2 weeks.
• Nizalid. Like nimide forte, it contains nimesulide and tizanidine in similar dosages. The recommended doses are the same.
• Alit. Soluble tablets containing 100 mg of nimesulide and 20 mg of dicycloverine, which is a muscle relaxant. Take orally after meals with a glass of liquid. It is recommended to take 1 tablet 2 times a day for no longer than 5 days.
• Nanogan. The composition of this drug and recommended dosages are similar to those of the drug Alit described above.
• Oxygen. The same.