home→Stomach→ Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of joints. Anti-inflammatory drugs for the joints (NSAIDs): an overview of the means Video

Non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of joints. Anti-inflammatory drugs for the joints (NSAIDs): an overview of the means Video

From this article you will learn: which non-steroidal anti-inflammatory drugs are prescribed for the treatment of joints, what other anti-inflammatory drugs are used. List of pills, classification and review of popular and effective drugs.

Article publication date: 06/22/2019

Article last updated: 11/29/2019

Anti-inflammatory drugs for joint diseases help reduce or stop the inflammatory process, as well as eliminate the symptoms that accompany it (pain, swelling, fever, and others).

The most common and widely used are non-steroidal anti-inflammatory drugs (NSAIDs or NSAIDs). This group includes a large number of medicines with different active substances and mechanism of action. They are united by one thing - there are no hormones (steroids) in the composition of NSAIDs.

NSAIDs - drugs that are prescribed for the treatment of any articular pathologies:

effectively and quickly relieve the pronounced symptoms of certain diseases of the joints (reactive arthritis, exacerbation of arthrosis);
long-term use helps to postpone the next exacerbation (with rheumatoid, psoriatic arthritis).

In addition to NSAIDs, corticosteroids with hormones in the composition are used for articular pathologies. They are prescribed in combination with NSAIDs or after a course of NSAID treatment if:

inflammation and symptoms of the disease are very strong (for example, with rheumatoid arthritis, articular rheumatism);
manifestations cannot be removed by other drugs.

1 - non-steroidal anti-inflammatory drug Ibuprofen; 2 - glucocorticosteroid Medrol

Anti-inflammatory drugs for the joints are selected and prescribed by the attending physician - a rheumatologist, orthopedist, traumatologist.

Classification of anti-inflammatory drugs for the treatment of joints

NSAIDs

The vast group of drugs under the general name "NSAIDs" includes a large number of drugs that differ from each other in the mechanism of action and active substances.

Classification of non-steroidal anti-inflammatory drugs (NSAIDs):

Drug group	Examples of drugs
Non-selective inhibitors of COX-1 and COX-2 (explanations about COX - at the bottom of the table)	Acetylsalicylic acid
	Butadion
	diclofenac
	Indomethacin
	Ibuprofen, Ketoprofen
Selective COX-2 inhibitors
Selective COX-2 inhibitors	Nimesulide
	Celebrex

COX-1 is a cyclooxygenase enzyme (abbreviated as COX-1), which protects the cells of the gastric and intestinal mucosa, COX-2 is a cyclooxygenase enzyme, which is synthesized directly in the foci of inflammation and is responsible for the development of an inflammatory reaction.

Non-selective inhibitors have the same effect on all types of cyclooxygenase, affecting the activity of COX-1 and COX-2. Therefore, against the background of taking non-selective NSAIDs, side effects appear in the form of inflammatory and erosive diseases of the stomach and intestines (gastritis, ulcers).

Corticosteroids

Corticosteroids for the treatment of joints are usually divided into groups according to the duration of the action of the drugs and the effectiveness:

Tool group description	Examples of drugs
Drugs with a short duration of action (duration therapeutic effect lasts 1–1.5 weeks), with a weak therapeutic effect	Hydrocortisone
Means of medium duration of action with a moderately pronounced therapeutic effect (up to 2 weeks)	prednisolone, methylprednisolone
Medicines with a pronounced therapeutic effect and a long duration of action (up to 4 weeks)	Triamcinolone
Fast-acting drugs (pain relief within 1 hour) with a long duration of action (up to 6 weeks) and a pronounced therapeutic effect	Betamethasone

NSAIDs: advantages and disadvantages, prices

General properties of these drugs

Non-steroidal anti-inflammatory drugs have a number of common qualities:

Restrain the development of inflammation, affecting the process at the stage of its occurrence (regardless of the causes of origin).
In addition to anti-inflammatory, they have antipyretic and analgesic effects.
Reduce swelling, aggregation (clumping) of platelets, prevent the formation of blood clots.
They inhibit the production of ATP (participates in the processes of energy metabolism), which is necessary for the development of a violent inflammatory reaction.
Bioavailable (quickly absorbed, binding to plasma proteins, excreted before 6 or after 6 hours of "work", stay longer in the synovial fluid).

The mechanism of action of NSAIDs is based on the ability of active active substances to suppress the activity of the cyclooxygenase enzyme, which is involved in the synthesis of inflammatory mediators (prostaglandins).

Mechanism of action of NSAIDs. Click on photo to enlarge

Influencing the amount of COX:

non-steroidal anti-inflammatory drugs interrupt the chain of chemical transformations;
reduce the amount of substances responsible for the development of local inflammation, irritation of nerve endings, the appearance of pain, swelling, and an increase in local and general temperature.

These drugs are highly effective drugs:

analgesic effect occurs within a few hours after ingestion;
anti-inflammatory - after 1-4 weeks from the start of therapy.

Indications

Indications for the appointment of NSAIDs are:

Joint diseases (arthritis, Bechterew's disease, osteoarthritis, osteochondrosis).
Injuries and post-traumatic diseases of the joints (traumatic arthritis, arthrosis).
Neurological complications of articular pathologies (sciatica, sciatica, lumbago).

NSAIDs are used for pain of any origin (headache, postoperative, dental, post-traumatic) and with an increase in body temperature.

Side effects

From side effects When taking NSAIDs, you should keep in mind:

possible deterioration of the functions of the liver, kidneys, gastrointestinal tract;
development allergic reactions(from skin to Quincke's edema);
coagulation disorder, decrease in the number of blood cells (leukocytes, erythrocytes);
asthma attacks in patients with chronic bronchitis, asthma.

NSAIDs should not be taken by patients with acute illnesses stomach and intestines (with ulcers, gastritis, colitis), as the likelihood of bleeding is too high.

Gastric toxicity NSAIDs. The figure shows that the higher the selectivity, the less the negative effect on the gastrointestinal tract.

Contraindications

Non-steroidal anti-inflammatory drugs for joints are not prescribed for:

intolerance of components;
pregnancy;
severe violations of the function of the kidneys, liver;
leukocytopenia and thrombocytopenia (lack of blood cells).

Choice of drug

Pick up the most effective medicine only the attending physician can. Despite the apparent monotony of NSAIDs, one drug from one group may be the best, while another will be completely ineffective. In this case, the selection is made:

Prescribing new and canceling non-working medicines.
Determining the maximum and maintenance dosage.
Evaluating the results of treatment after some time.

When prescribing a drug, the doctor repels general information about the patient and his disease (diagnosis, presence of concomitant diseases, age, etc.)

General rules for taking NSAIDs

Anti-inflammatory drugs for articular pathologies are prescribed:

from 1 to 3 times a day (in tablets, in injections);
2 to 4 times a day (in the form of ointments);
ointments, gels and creams are rubbed into the joint (gel and cream - lightly, ointment - until completely absorbed);
tablet preparations are washed down with water (after meals);
the general course of treatment for NSAIDs does not exceed 14 days, sometimes the doctor can extend the time to a month or more (with rheumatoid arthritis, maintenance doses are taken for years).

Combining (taking at the same time) several different NSAIDs is not recommended. This combination can cause side effects.

Below in the article is an overview of some popular NSAIDs.

Review of drugs, COX-1 inhibitors

diclofenac

Different forms of release of the drug Diclofenac

One of the oldest drugs of the group (developed in the 60s of the last century). Since then, it has been successfully used for the treatment of articular pathologies, for pain in the joints.

The active substance is diclofenac. The tool is available in different forms - in the form of a gel, ointment, solution for injection, rectal suppositories(candles) and tablets.

It has a pronounced anti-inflammatory, antipyretic effect, is an analgesic - an effective pain reliever. Diclofenac is a reliable, working and inexpensive drug that does not need to be looked for (it is available in all pharmacies).

Drug price:

for 1% gel (40 g) - from 135 rubles;
for 2% ointment (30 g) - from 23 rubles;
for 20 tablets (50 mg each) - from 39 rubles;
for 10 ampoules (3 ml each) - from 42 rubles.

Indomethacin

The active ingredient in the composition is indomethacin. The drug is produced in the form of rectal suppositories (candles), ointments and tablets. Indomethacin effectively and quickly relieves joint pain, quickly relieves inflammation. A noticeable anti-inflammatory effect occurs on the 5-7th day of continuous use.

It is a good local anesthetic (acts as an anesthetic). In the form of an ointment and gel, it has a pronounced anti-inflammatory, anti-edematous effect, reduces morning stiffness, stiffness of any joints (for example, the knee).

for 10% ointment (40 g) - from 58 rubles;
for 30 tablets (25 mg each) - from 12 rubles.

Ibuprofen

The active ingredient in the composition is ibuprofen. The drug is produced in the form of an ointment and gel, in the form of tablets and suppositories. Ibuprofen quickly relieves fever, local temperature (an hour after ingestion), anesthetizes (within a few hours), relieves inflammation a little more slowly (you can count on a pronounced anti-inflammatory effect by the end of 2 weeks of taking the tablets).

for 5% ointment (25 g) - from 34 rubles;
for a 5% gel (50 g) - from 92 rubles;
for a pack of tablets (20 pieces of 200 mg each) - from 16.50 rubles.

Review of drugs, COX-2 inhibitors

Selective inhibitors - this is with a selective action (inhibition of the activity of COX-2, which is responsible for pain, inflammation, fever). As a result, selective anti-inflammatory drugs for joints have far fewer side effects. They do not provoke inflammation, ulceration of the mucous membrane of the stomach and intestines.

Movalis

The active ingredient of the drug is meloxicam, it can be purchased in injections, tablets, in suspension (taken instead of tablets) or in rectal suppositories.

Movalis effectively relieves pain (within a few hours after ingestion), as well as inflammation, swelling, fever (pronounced effect occurs on 3-5 days).

Unlike Diclofenac, Ibuprofen, Indomethacin, does not prolong bleeding time.

for 3 ampoules (1.5 ml each) - from 591 rubles;
for 10 tablets (15 mg each) - from 469 rubles.

Highly selective COX-2 inhibitors

The latest drugs that selectively act on COX-2, without affecting COX-1 and all processes associated with this enzyme. Due to this, highly selective NSAIDs are much safer than other drugs in the group - they are not able to provoke the appearance of side effects from the digestive tract.

Celebrex

The active ingredient in Celebrex is celecoxib. In pharmacies, the drug is sold in capsules in a gelatin shell.

Safe for people with chronic diseases gastrointestinal tract (in remission), has a strong analgesic, antipyretic and anti-inflammatory effect (usually a course of treatment of 5-7 days is enough).

In people with cardiovascular pathologies, it can cause edema, while taking it with anticoagulants significantly increases the time of blood clotting.

Price for 10 capsules (200 mg each) - from 350 rubles.

Corticosteroids: indications, effectiveness, features

Corticosteroids are a group of medicines that, among other things, are used to treat joints. The active components in the composition of corticosteroids are hormonal substances (hormones of the adrenal cortex). Thanks to them, drugs have a number of common properties:

They quickly relieve severe inflammation, swelling, irritation of nerve endings, pain, and allergic reactions.
Stimulate the rapid healing of damaged tissues.
Affect metabolism.

The mechanism of action of corticosteroids is based on their participation in numerous chemical reactions and inhibition of the synthesis of prostaglandins (inflammatory mediators responsible for the development of the pathological process).

Mechanism of action of glucocorticosteroids. Click on photo to enlarge

Indications

Corticosteroids are helpful for:

acute diseases of the joints (spondyloarthritis, rheumatoid arthritis);
diseases of the joints that are accompanied by synovitis (trauma, osteoarthritis, gouty arthritis);
inflammation of the periarticular tissues (periarthritis).

Corticosteroids are not intended for long-term use - they are used to treat joints if other drugs (NSAIDs) are ineffective.

Contraindications

Do not prescribe hormones for:

arthritis of infectious origin;
lack of inflammation (arthrosis without synovitis);
obvious deformation and destruction of the joint;
aseptic (non-infectious) necrosis of bone tissue;
drug allergies.

Further treatment with corticosteroid injections does not make sense (ineffective) if 2 previous injections did not give the expected result.

Side effects

Hormones have a whole list of side effects:

Change, thinning of tissues (up to rupture).
When injected into the joint cavity, a short microcrystalline inflammation occurs (the drug crystallizes and settles on the joint tissue, but dissolves after 6-12 hours).
Aseptic necrosis of the bones of the joint.
Jumps in blood pressure.
Violation of the menstrual cycle.
Removal of calcium from the body, osteoporosis, muscle weakness.
growth retardation.
Depression, nervousness.
Slow tissue healing.

Performance and Features

Corticosteroids are incredibly effective for treating joints:

provide a quick result (anti-inflammatory and analgesic), for example, 1-2 hours after the injection of Hydrocortisone;
"work" for a long time (1 injection is valid from 1 to 6 weeks);
effective in 90% of cases (although the effect may be temporary until the effect of the drug wears off).

Features of the use of corticosteroids:

injections into the capsule are not prescribed in a course (in a row), they are repeated after the expiration of the drug (for example, 8 days after the first injection of Hydrocortisone);
tablets are taken in courses (starting with the maximum and ending with the maintenance dose);
hormonal ointments are ineffective and are not used for diseases of the joints.

Corticosteroids are prescribed by the attending physician.

Overview of popular drugs in this group

Metipred

The drug with methylprednisolone in the composition is produced in injections and tablets.

The duration of action is up to 2 weeks, the therapeutic effect is moderate (relieves pain and inflammation of moderate severity).

When injected into the joint capsule, it may precipitate as microcrystals and cause short-term inflammation. Metipred does not affect the structure of tissues, so it is often injected into periarticular tissues.

Price for tablets (4 mg), 30 pcs. - from 170 rubles.

Primary sources of information, scientific materials on the topic

Joint diseases in the practice of a family doctor, a practical guide. Dzyak GV Sections "Rheumatoid arthritis", "Osteoarthritis".
Rheumatology. Clinical guidelines. Nasonov L. E. Sections "Rheumatoid arthritis", "Osteoarthritis".
Internal diseases, Makolkin V.I., Ovcharenko S.I. Sections "Diseases of the joints".
Non-steroidal anti-inflammatory drugs, prospects for use in medicine. Nasonov L. E. M., Anko, 2000.
Pharmacotherapy of pain: a rheumatologist's view. Nasonov E. L. Council, 2000, No. 1.
Local therapy with glucocorticoids. Nasonov E. L., Chichasova N. V., Kovalev V. Yu. Russian Medical Journal, 1999, No. 8.

Joint pain significantly complicates life and interferes with a full life. Pain does not go away on its own. Therefore, treatment is accompanied, first of all, by anti-inflammatory drugs. Their list is quite wide. In structure, they differ from others in the absence of steroid hormones, which allows a large group of patients to take the medicine.

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 influence on the vessels, the 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, the temperature returns to normal, inflammation subsides.

NSAIDs have a positive effect on diseases:

relieve inflammation;
have analgesic properties;
effectively lower the temperature;
have an antiaggregatory effect - eliminate the adhesion of platelets.

Do not forget that drugs - immunosuppressants, help in the treatment of rheumatism, but have a depressing effect on immune system generally.

Classification of drugs

It is worth noting that COX is divided into two types. The first produces prostaglandin, which protects the lining of the stomach and intestines from damage. And the second connects prostaglandins that 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 act equally on both COX, others on COX1.

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

Indications for the use of NSAIDs for the treatment of joints

Anti-inflammatory drugs are safe for short-term use and in the absence of contraindications.

Medicines are used in chronic and acute inflammatory processes:

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

List of non-steroidal anti-inflammatory drugs

Acetylsalicylic acid (aspirin).

In practice for over a hundred years. Assign to fight SARS, relieve headaches. Together with other substances, they are used for the treatment of osteoarthritis. But at acute inflammation aspirin is replaced by more powerful medicines.

Diclofenac.

Available in tablets, suppositories, gel and injection. The popular pain reliever is absorbed within twenty minutes and understands the fever.

Ibuprofen.

Release form - candles, tablets. It is easy to carry, has a low price tag. It is prescribed for neuralgia, bursitis, hematomas, sprains, influenza, SARS, rheumatoid arthritis, gout, Bechterew's disease, osteoarthritis, feverish conditions. Ibuprofen has many analogues in different price categories.

Nimesulide.

When using it, the temperature normalizes, the body becomes mobile as a result of anesthesia. The ointment is applied to the arthritic area. There is a slight redness, so the effect of the drug is manifested.

Indometacin is one of the strongest drugs with analgesic effect.

Produced 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 arthrotic joints. Before use, a doctor's consultation is required due to the impressive list of side effects.

Meloxicam belongs to the group of NSAIDs.

Available in tablets and in solution for intramuscular injection. Pharmacological action - anti-inflammatory analgesic with antipyretic effect. Indicated for symptomatic therapy, reducing 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. It is possible to purchase a substance under various names - Movalis, Melbek, Melox, Artrozan, Mesipol, Mataren, etc.

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

The doctor may prescribe:

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

It is forbidden to drink medicines on your own.

NSAIDs of a new generation for the treatment of joints

Medical technology does not stand still. Every day, hundreds of scientists are trying to develop the latest pills and modernize the time-tested. 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 "drugs", Movalis with the active ingredient in the form of meloxicams became the most effective. With arthrosis, a real lifesaver. Long-term use has practically no effect on the work of the stomach and intestines. Analogues work in the same area - Melbek, Mesipol, Mirloks.

The drug Ksefokam has the ability to stretch the effect of the panacea, so that patients do not feel pain for about twelve hours. Most importantly, Ksefokam is not addictive, and the ability to relieve pain is comparable to morphine. However, the high cost does not allow everyone to purchase the drug in the first-aid kit. Produced by prescription.

The antioxidant Nimesulide blocks the action of substances that break down collagens and cartilage. Arthrosis of the joints is treatable, the pain becomes dull, the inflammation disappears. Sold in granules for solution, tablets, in the form of a gel.

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

Etoricoxib is sold under the brand name Arcoxia. Reception 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 medicines varies. On the advice of a doctor, the patient can buy a more expensive drug or its analogue, in accordance with contraindications and side effects. Means stop unbearable pain and eliminate inflammation. After taking them, another treatment should be prescribed.

General application rules

Take on an independent guide to medicines is not worth it. 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 chooses the right treatment.

Tablets are taken immediately after meals with half a glass of water or low-fat milk to assimilate and protect the gastrointestinal tract from harmful effects. In parallel, 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

Allergy.
Bronchospasms.
Dyspeptic disorders.
Violation of renal functions (nephropathy, vessels narrow).
Ulcerogenic action (development of erosion or stomach ulcers).
Increased blood activity in the liver.
miscarriages.
In rare cases, bleeding disorders.

Contraindications to the use of NSAIDs

Any, even the most harmless drug, has contraindications. NSAIDs have several of them:

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

Non-steroidal anti-inflammatory drugs for the treatment of joints are part of complex therapy. They do not completely relieve the patient of arthrosis and other pathologies, but they do a good job of eliminating painful symptoms.

With exacerbation of joint diseases, most of the physiotherapy procedures are contraindicated. Methods traditional medicine also do not have the desired effectiveness, and sometimes can cause significant harm. NSAIDs can significantly reduce or stop the pathological process.

Non-steroidal anti-inflammatory drugs for joint pain are effective in the presence of diseases such as:

Syndromes of Reiter and Bekhterev;
Rheumatic diseases;
arthrosis;
Autoimmune, rheumatoid, psoriatic, infectious and other arthritis;
Osteochondrosis;
Primary neoplasia and metastases;
Rheumatic arthropathy.

In these cases, the use of non-steroidal anti-inflammatory drugs only eliminates the symptoms of articular pathologies, but does not affect the pathogenesis.

Taking NSAIDs will not be able to stop the degradation of the joints. Also ointments and injections based on nonsteroidal drugs are used for diseases of the musculoskeletal system of non-rheumatoid etiology (sprains, bruises, tendovaginitis, myositis).

Types of NSAIDs for joint pain

All NSAIDs are divided into 3 groups, which are based on the selectivity of exposure:

Non-selective inhibitors of COX and COX1;
Non-selective drugs that inhibit COX1, COX2;
New generation selective drugs that affect COX2.

The first cluster includes:

Ketaprofen ( active substance Ketoprofen, a propionic acid derivative);
Diclofenac (active ingredient Diclophenacum, a synthetic derivative of phenylacetic acid);
Naproxen (active ingredient Naproxen, a propionic acid derivative);
Indomethacin (active substance Indomethacin, a derivative of indoleacetic acid);
Piroxicam (active ingredient Piroxicamum of the oxicam group);
Aspirin (active ingredient Acetylsalicylic acid).

The second group includes Lornoxicam.

The third group includes:

Etodolac ( active ingredient Etodolac, an indoleacetic acid derivative);
Celecoxib (Celecoxibum group of coxides);
Meloxicam (Meloxicam, a class of oxicam);
Rofecoxib (Rofecoxib);
Nimesulide (Nimesulide).

Along with Ibuprofen, Acetylsalicylic acid is mainly used to reduce high fever, and Ketorol is used to reduce the intensity of pain. In the treatment of inflammation, they are ineffective and are prescribed only as symptomatic relief therapy (for pain relief and fever reduction).

Nonsteroidal drugs perform the following functions:

Anti-inflammatory. Suppress inflammation in the exudative and partially proliferative phases. In this case, Indomethacin and Diclofenac are most effective. Following are acetylsalicylic acid, Piroxicam and Ibuprofen. Ketorolac and Metamizole differ in the least anti-inflammatory activity.
Painkiller. Effectively relieve pain Ketaprofen, Metamizole, Ketorolac, Diclofenac. They are used not only for muscle pathologies, but also for toothache, headache, renal colic (due to the absence of a spasmodic effect). Compared to morphine, which belongs to the group of narcotic analgesics, the above drugs do not depress the function of the respiratory center and are not addictive.
Antipyretic. All NSAIDs effectively relieve fever.
Antiaggregatory. The function that prevents thrombus formation is most pronounced in Aspirin (due to inhibition of thromboxane synthesis).
Immunosuppressive. Non-steroidal anti-inflammatory drugs worsen the permeability of capillary walls, thereby providing artificial suppression of immunity. The effect is secondary and rarely used in therapeutic regimens due to the availability of drugs with a more advanced immunosuppression mechanism.

Mechanism of action of NSAIDs

The effectiveness of NSAIDs, ointments and gels for the joints is determined by the development of inflammation. Progressive disease is accompanied by severe pain, fever, swelling and general deterioration of the patient's condition. The synthesis of prostaglandins (direct participants in the inflammatory process) is directly dependent on the isoforms of the COX enzyme (cyclooxygenase). It is on them that the pharmacological inhibition of NSAIDs is directed.

Non-steroidal anti-inflammatory drugs for the treatment of joints differ both in effectiveness and in the number of side effects.

This is due to the mechanism of their influence on different kinds prostaglandin synthase (COX). Non-selective drugs inhibit both types of COX. But the COX-1 enzyme protects and stabilizes the pH of the gastric mucosa, and improves platelet viability, preventing bleeding. Long-term use of non-selective agents adversely affects the state of the gastrointestinal tract.

New generation non-steroidal anti-inflammatory drugs for joints inhibit only COX-2, which is produced only in the presence of deviations from normal values against the background of other neurotransmitters. In the absence of inflammation, this type of enzyme is not detected or is present in the tissues in a minimal amount. The ability of selective NSAIDs to selectively inhibit the activity of COX-2 and gives them the opportunity to act on the immediate focus of the pathology. Due to the selective properties, new drugs are distinguished by the necessary effectiveness with a lower risk of side effects.

Often, patients have a question, which is more effective and safer: NSAIDs or therapy using hormonal drugs. Both types of medicines have many similar properties and potent formulations. But NSAIDs, due to the presence of their anti-inflammatory system, are perceived by the body as a foreign component. Glucocorticosteroids are artificially synthesized analogs of hormones produced by the adrenal glands. Due to the non-hormonal nature of NSAIDs, they have milder side effects compared to hormonal medications.

All NSAIDs for joint pain should be prescribed only by a qualified specialist and used under the mandatory control of the dynamics of the disease. All negative changes in well-being should be immediately reported to the attending physician. An important condition is the selection of the minimum effective dose and duration of therapy. To reduce the negative impact on the digestive tract, oral medications are taken after a meal and washed down with a large volume of clean water. It should be borne in mind that the use of gels and ointments, due to the lack of absorption into the bloodstream, reduces the likelihood of side effects to almost zero.

Forms of release of NSAIDs

Non-steroidal drugs for the treatment of joints have various forms, so for most patients with different diagnoses and degrees of their intensity, it will not be difficult to choose the optimal treatment regimen:

Tablet form;
suppositories;
plasters;
Creams, gels, ointments;
Ampoules for injections.

Each form has its own advantages, disadvantages and indications for use. Sometimes several forms are involved in therapy at once (for example, tablets, injections and ointments).

Injections are prescribed when diagnosing the acute stages of the disease in order to eliminate pain and inflammation as quickly as possible and prevent the appearance of new foci. The course can be from 3 to 10 days, 2 intravenous or intramuscular injections per day. Some of the benefits of injections include:

Efficiency;
Impact speed;
Small risk of damage to the gastrointestinal mucosa.

Tablets are prescribed after the injection course to consolidate the positive results of therapy. They can be taken for a longer period. Of the shortcomings, it is important to note:

High risk of ulcers, erosions, gastritis and other injured gastrointestinal tract;
The effect does not occur immediately, since the active substance needs time to be absorbed and enter the circulatory system.

Creams and ointments are usually prescribed in addition to the main therapy. Their advantages include:

Direct impact on the lesion;
Strengthening the impact of other forms;
Ease of use;
Safety for the gastrointestinal tract;
Pronounced analgesic effect;
Fewer side effects and contraindications.

At the same time, ointments require time to be absorbed, act for a short period and cannot be used as the main type of therapy. The patches have a longer shelf life. Otherwise, their mechanism of their work is similar to soft forms.

Suppositories are an alternative to pills and injections and can be prescribed in older childhood. The method of administration is rectal. They, like injections, are instantly absorbed into the bloodstream, do not injure the stomach, kidneys and liver. The main disadvantage is strict storage rules and a short shelf life.

Contraindications and side effects

An important rule is to choose yourself non-steroidal anti-inflammatory drug for joint pain is strictly prohibited!

Means can have an additional adverse effect: contribute to the suppression of the immune system, thin the blood. In the presence of certain pathologies, an incorrectly selected composition can provoke the appearance of gastric perforations, renal failure.

Contraindications for the use of non-steroidal anti-inflammatory drugs for the treatment of joints include:

Negative sensitivity to the active substance and other components;
The period of pregnancy and breastfeeding;
erosion of the stomach;
Complications in the work of the kidneys and liver;
High blood pressure;
cytopenia;
Childhood;
Anemia.

Side effects appear as:

edema;
jumps in blood pressure;
Violations of the functioning of the digestive system;
Allergic manifestations;
Kidney disorders;
Nosebleeds

Despite the extensive list of side effects, NSAIDs are often indispensable for joint pain. To minimize the risk of negative phenomena, the following recommendations must be strictly observed:

Do not exceed the recommended dosage;
If there is a history of gastrointestinal surgery, use the rectal form;
To avoid allergic reactions, rub the ointment only into the affected areas;
Exclude the use of alcohol, strong tea and coffee, pickled foods, pickles, drinks with gases;
Do not smoke;
Additionally, take funds with an enveloping effect (Almagel);
Do not combine different types of NSAIDs.

It is also necessary to control some indicators - once every 3 weeks, take an analysis for creatinine, blood and feces tests (for occult blood)

At least once a quarter, undergo an examination for the level of liver enzymes.

List of drugs and popular analogues

The list of modern NSAIDs is quite extensive, so the patient is often faced with the question of whether to buy a drug or an analogue (for example, Diclofenac or Voltaren, Metindol or Indomethacin). Pharmacists in most cases recommend expensive drugs. In reality, the composition of the originals and generics is almost identical. Different names are due to different manufacturing companies.

In tablets

"Indomethacin" ("Indobene", "Indocollir", "Elmetacin", "Metindol");
"Etodolak" ("Nobedolak", "Etodin", "Etol forte");
"Diclofenac" ("Zerodol", "Diclotol", "Aertal", "Aceclofenac");
"Piroxicam" ("Piroxifer", "Khotenim", "Fedin-20");
"Meloxicam" ("Amelotex", "Artrozan", "Movasin", "Mirloks", "Movalis")
"Aproxen" ("Aprol", "Apronax", "Naprobene").

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

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

NSAIDs have a positive effect on diseases:

relieve inflammation;
have analgesic properties;
effectively lower the temperature;
have an antiaggregatory effect - eliminate the adhesion of platelets.

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

Classification of drugs

Therefore, drugs are usually differentiated into two parts:

selective (they inhibit COX2);
non-selective.

The latter, in turn, are also grouped. Some act equally on both COX, others on COX1.

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

Indications for the use of NSAIDs for the treatment of joints

Anti-inflammatory drugs are safe for short-term use and in the absence of contraindications.

Medicines are used in chronic and acute inflammatory processes:

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

List of non-steroidal anti-inflammatory drugs

Acetylsalicylic acid (aspirin).

In practice for over a hundred years. Assign to fight SARS, relieve headaches. Together with other substances, they are used for the treatment of osteoarthritis. But in acute inflammation, aspirin is replaced by more powerful medicines.

Diclofenac.

Available in tablets, suppositories, gel and injection. The popular pain reliever is absorbed within twenty minutes and understands the fever.

Ibuprofen.

Nimesulide.

Indometacin is one of the strongest drugs with analgesic effect.

Meloxicam belongs to the group of NSAIDs.

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

The doctor may prescribe:

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

It is forbidden to drink medicines on your own.

NSAIDs of a new generation for the treatment of joints

List of new generation non-steroidal anti-inflammatory drugs

General application rules

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

Side effects of non-steroidal anti-inflammatory drugs

Allergy.
Bronchospasms.
Dyspeptic disorders.
Violation of renal functions (nephropathy, vessels narrow).
Ulcerogenic action (development of erosion or stomach ulcers).
Increased blood activity in the liver.
miscarriages.
In rare cases, bleeding disorders.

Contraindications to the use of NSAIDs

Any, even the most harmless drug, has contraindications. NSAIDs have several of them:

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

General classification of drugs for joints
Non-steroidal 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 are recommended by specialists in the pathology of the articular apparatus. The second part describes the treatment regimens for the most common joint diseases - arthrosis and arthritis.

The appointment of any means, control over the dosage and duration of treatment is carried out by the therapist, orthopedist-traumatologist, 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 in the treatment of:

reduce inflammation in the tissues of the joint;
anesthetize;
contribute to the 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 administration is often combined with other drugs for the treatment of articular pathology (for example, with glucocorticoids, chondroprotectors). According to existing international treatment protocols, NSAIDs are included in the 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 the foci of inflammation. Non-selective NSAIDs block both types of the 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 (+) marks existing forms release of drugs.

(if the table is not fully 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 action of these funds is long - within a day after the administration of the drug.

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

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

Selective NSAIDs

NSAIDs with 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 manifestations of inflammation.

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

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

NSAIDs with analgesic effect

Chondroprotectors

Means that restore the affected hyaline cartilage of the joints are called chondroprotectors. When applied:

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

The composition of chondroprotectors includes substances that form hyaline cartilage of the joint: chondroitin and glucosamine. The first is the main building substance 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) and combined (contain both substances). The effectiveness of combined forms is higher than single-component ones.

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

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

Chondroprotectors

Systemic glucocorticoid hormones

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

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

Glucocorticoid drugs

Drugs for intra-articular administration

If one joint hurts (for example, knee or shoulder), it is advisable to administer drugs directly to 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 reduces the risk of side effects. Such injections are performed only by an experienced orthopedic traumatologist or surgeon.

Substitutes for intra-articular fluid

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. Action hyaluronic acid on the joint complex: cartilage is restored; reduction of inflammation; creation of a liquid environment in the articular cavity, which softens the movement of rubbing surfaces.

The most commonly used products based on hyaluronic acid:

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 cartilage nutrition;

restoration of the properties of the 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 the articular cartilage.

The most effective drugs:

hydrocortisone,
betaspan,
Diprospan,
Kenalog,
Flosteron.

Drugs for intra-articular administration

How to use drugs for the most common joint diseases?

The two most common joint diseases are osteoarthritis 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 fully visible, scroll to the right)

Medical treatment for arthritis

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

Reactive (joint response to any changes in the body: trauma, infections, allergies).
Rheumatoid (the disease is appropriately called rheumatoid arthritis).
Psoriatic (with psoriasis).
Gouty (for gout).

Non-steroidal anti-inflammatory (Naklofen, Movalis, Nimesil). In the acute stage of the disease is more appropriate intramuscular injection, and with a decrease in inflammation, you can switch to a tablet intake. Preparations of this group are indicated for all arthritis, regardless of type and origin.

Systemic glucocorticoids (Methylprednisolone, Dexamethasone, Triamcinolone) have a positive result in 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 pills (Metipred) may be indicated to prevent recurrences 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). Assign after the elimination of inflammation in order to restore the cartilaginous tissue of the cartilaginous tissue, more often with rheumatoid arthritis.

Basic preparations for treatment rheumatoid arthritis. They directly treat the disease, as they block the triggers of inflammation, but do not reduce the symptoms of the disease. This group includes gold derivatives (Aurotimarat, Auranofin), cytostatics (Methotrexate, Cyclophosphamide), Sulfasalazine, special immune preparations (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 may 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 designed to stop inflammation, get rid of pain, which is strongly manifested at the 2-3 stage of the development of pathology.

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

eliminate joint pain;
reduce inflammation, prevent it from developing.

Currently, such drugs are widely used, show high efficiency compared to other drugs. They are able to 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 great with her. These medicines bring relief from the disease, which other remedies cannot achieve.

When arthrosis worsens, you can not do physical therapy, do some physiotherapy. Some patients lean towards traditional medicine, but its methods are very slow. In this situation, non-steroidal anti-inflammatory drugs for the treatment of joints can help.

Popular remedies

There is a diverse range of non-steroidal anti-inflammatory drugs (NSAIDs) that are formulated to treat conditions such as osteoarthritis and arthritis. When using them, the disease ceases to develop, 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 designed to treat a disease in acute form. You should not independently decide on the choice of the drug, it must be prescribed by a doctor.

Application methods

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

tablets;
intra-articular injections;
candles;
joint cream;
ointments.

When the disease of the joints is in severe form, the condition worsens, then strong drugs are used that have a wide range side effects. The doctor uses injections for the joints so as not to apply great harm body. Often such procedures are done with gonarthrosis, 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, useful 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 the form of tablets.

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, then there will be problems, complications that can even lead to the death of a person.

People who have problems with the gastrointestinal tract, kidneys, who have allergies, cirrhosis of the liver, diseases of the heart and blood vessels 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, it is required to combine drugs carefully, it is best to consult a specialist.

The 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 the result obtained, feels relief, no pain, quits the treatment. But arthrosis or arthritis has not yet been defeated. When the symptoms are gone, the person needs to diligently deal with the treatment of the underlying disease. For this, there are such ways:

proper nutrition;
taking chondroprotectors;
massage;
swimming;
gymnastics;
folk methods;

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

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

impair 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 for up to 20 weeks.

People who are observed bronchial asthma, these funds are contraindicated.

It's important to know

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

When a patient has a stomach ulcer, asthma, hypertension, serious diseases of the kidneys, liver, heart, then these drugs cannot be used.
Taking these drugs can cause bleeding in the gastrointestinal tract. Because of this, tests are constantly being taken to control the situation.
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.
A person who has had coronary bypass surgery should stop taking these drugs.

Doctor prescribing various nonsteroidal drugs

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

"Ibuprofen" (tablets). Instructions for use indicate the almost complete absence of side effects. This drug is very effective. It is also available in the form of a solution for injection. Included in ointments.
"Ketoprofen". It is released in different form, namely: ointment, gel, tablets, injections, joint cream. Either form reduces inflammation. Most often, the drug is prescribed for arthritis of the hip joint and rheumatoid arthritis.
Meloxicam. Like the previous tool, the release occurs in a variety of variations. A long course of treatment is required.
"Celecoxib". The drug is potent, available in the form of capsules. It does not adversely affect the gastrointestinal tract. This can be considered a big advantage.
"Indomethacin". Fast acting and quite effective. Available in the form of suppositories, tablets, gels.
"Nimesulide". It is a unique tool. With its help, pain is eliminated, inflammation disappears, while the cartilage tissue is not destroyed in the future. Especially often it is used for pathologies of the hip joints.
"Sulfasalazine". It has a lasting result, but it takes about 6 weeks for it to be noticeable.
"Diclofenac" (ointment). The price of the drug is low, while it differs in its power. It is produced in the form of a solution for injection, tablet preparations (Diclofenac, Voltaren Akti, Ortofen, etc.).

Rules of use

When used nonsteroidal drugs certain rules must be followed:

Follow the instructions strictly.
When taking a capsule or tablet, take it with a full glass of water. This will create a certain protection for the stomach, it will not be so much irritated.
You can not combine drugs with alcohol. This increases the risk of developing stomach pathologies.
It is better for pregnant women to refrain from nonsteroidal drugs.
After taking the capsule or tablet, half an hour should pass, after which it is allowed to go to bed. The vertical position of the body contributes to the rapid passage of the drug through the esophagus, this is affected by gravity.
If, for example, anti-inflammatory ointments for joints were taken, then other non-steroidal drugs should not be used on the same day. From this, the effect does not become greater, and the side effects are superimposed on each other.
If there is no effect from any drug, you need to pay attention to the dosage. You should not increase the dose on your own, this must be agreed with the doctor. You may need to change your medication to something else. This may result in the desired result.

"Ibuprofen"

Reduces fever, relieves headache remedy "Ibuprofen" (tablets). Instructions for use include various nuances of using the drug. In large doses, it is used for diseases of the joints, spine.

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

disorders of the gastrointestinal tract;
dizziness;
headache;
increased blood pressure;
insomnia.

There are other side effects as well as contraindications. You need to carefully read them so as not to get complications. It is best to consult a doctor and then follow his instructions.

"Diclofenac"

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

The downside of the drug is the presence of side effects, so it can not be used for a long time. Diclofenac can cause dizziness, headache, tinnitus. This disrupts the activity of the liver. It should not be used if you have asthma, pregnancy or breastfeeding.

diclofenac with paracetamol

"Panoxen" is an effective tool that contains two powerful components. The drug reduces pain in:

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

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

renal, hepatic and heart failure;
bowel disease;
recent coronary artery bypass grafting;
active, progressive diseases of the kidneys and liver;
pregnancy, childhood.

"Indomethacin"

As well as diclofenac, indomethacin relieves inflammation, anesthetizes. That's just this drug is considered obsolete, as it has a number of side effects, contraindications. Do not use this remedy for children under 14 years of age.

There are various anti-inflammatory ointments for joints, creams, tablets, injections, suppositories, which 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 only suppress the symptoms. Non-steroidal anti-inflammatory drugs are relatively harmless when compared with hormonal ones. They perfectly relieve the signs of the disease, remove the pain, after which the patient will be able to begin complex treatment.

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

The 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 abnormalities. In addition, the age threshold of patients has also decreased, an increasing number of people under the age of forty turn to orthopedists with complaints of pain in the joints and ligaments.

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

General information

Non-steroidal anti-inflammatory drugs - such a pharmaceutical group of drugs that is used in the treatment and prevention of inflammation in the area:

Large and small joints.
Ligaments.

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 the bark of the willow in 1829. Since then, nonsteroidal drugs have been one of the most indispensable groups of drugs in pharmacology, and their list is updated every year with newer and newer types of nonsteroidal drugs.

The meaning of the treatment of joints and ligaments with non-steroidal anti-inflammatory drugs is based on the suppression of the production of prostaglandins due to cyclooxygenase.

The chemical structure of nonsteroidal drugs divides them into 2 large groups:

Acidic - the most common group containing at its core acid (salicylic acid), the directed action of which effectively relieves fever and anesthetizes. These drugs include Ibuprofen, Indomethacin, Meloxicam.
Non-acid - anti-inflammatory drugs that direct their action to suppress inflammation and pain. These 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, except for the appointment of non-steroidal anti-inflammatory drugs. However, despite their powerful effect in relieving inflammation, these remedies have a long list of side effects on many systems in the human body. The most common are:

stomach disorders;
Nausea and vomiting;
Loss of vision and hearing;
dry mouth;
Cardiopalmus;
Violation of hematopoiesis;
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 with:

Ulcerative colitis.
Gastritis, erosion, stomach ulcers.
Children's age up to 12 years.
Pregnancy, lactation period.
Hypersensitivity to the components of the drug.
Liver and kidney failure.

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

Injections (shots).
Ointments for the treatment of joints (gels, creams).
Tablets.
Plasters.
Suppositories.
Suspensions.
Capsules.

Advantages and disadvantages

Each release form has its own advantages and disadvantages. Depending on the type of disease, its severity, time of course and form, one or another type of drug and its specific form are prescribed. Sometimes several forms can 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 course of the disease is in an acute stage, and inflammation and pain must be removed as soon as possible in order to alleviate the patient's suffering and prevent the disease from hitting new foci. Injections can be administered intravenously or intramuscularly, more often intramuscularly for a course of 7 to 10 days twice a day. Injections are the first in the list in terms of the frequency of prescription for patients with pain in the joints and ligaments.

Advantages of injections:

Speed of action;
Minimal risk of damage to the gastric mucosa;
No additional time is required for the absorption of the drug into the walls of the stomach.

Disadvantages of injections:

Painful insertion.
Inconvenience (you need a second person in order to administer the drug).

Tablets, as well as injections, are popular in the treatment of joints and ligaments. Very often prescribed after injections to continue treatment and consolidate the result.

Benefits of tablets:

Can be taken for a long time (much longer than injections);
Painless introduction;
The help of other people is not required;

Disadvantages of the tablet form:

Additional time is needed for the absorption of the drug into the walls of the stomach and its entry into the blood.
Tablets, getting into the stomach, can injure it, cause erosion, ulcers and gastritis.

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

Advantages of gels and ointments, creams:

Action on the lesion (joint or ligaments);
Ease of use;
Strengthening the action of other non-steroidal anti-inflammatory drugs;
Does not injure the walls of the stomach, liver;
It has a pronounced analgesic (and sometimes cooling) effect;
It has much fewer contraindications and side effects than the first two forms of release.

Disadvantages of ointments, gels, creams:

It takes time to absorb the product.
Valid for a short period.
Can leave stains that are difficult to wash on clothes.
Leaves a sticky feeling on the skin.

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

Advantages of patches:

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

Disadvantages of patches:

Visible under clothing.
May come off when sweating or moving fast.
Leave traces of glue.

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

Advantages:

Rapid absorption into the blood (in terms of speed it is equivalent to injections);
Do not injure the liver, kidneys and stomach;
Ease of use.

Disadvantages of suppositories:

Short shelf life.
Strict rules for wounding (in the refrigerator), which makes it difficult to take the drug with you on the road.

Treatment with non-steroidal anti-inflammatory drugs

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

Anti-inflammatory non-steroidal drugs are the main drugs used for the treatment of joints and ligaments. The form of the drug, the period of use and dosage is determined only by the doctor in accordance with the age of the patient, the diagnosis and the degree of neglect of the disease. Painkillers anti-inflammatory drugs quickly relieve pain, swelling, redness of the joint.

After examining a patient complaining of pain in the joints and ligaments, the doctor comes to a decision 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, it is strictly prohibited:

Pregnant and lactating women;
Children under 12;
Patients with problems with the cardiovascular, excretory systems, 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 allowed:

Children over 3 months old.
Pregnant women.
Nursing mothers.

It has several release forms:

Suspension;
Tablets;
Ointments;
suppositories;
Gels.

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

Tablets.
Ointment.
Candles.
Gel.
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 the joints and tissues. The advantages of nimesulide are in a small list of contraindications and side effects. This drug is available in the form:

Tablets;
injections;
Ointments;
Candlelight.

Ketoprofen is one of the most powerful anti-inflammatory non-steroidal drugs with a powerful analgesic effect. Widely applicable by orthopedists for the treatment of diseases:

Joint treatment More >>

joints.
Backs.
Ligaments.

Ketoprofen and its analogues have the following release forms:

Tablets;
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 to get 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 age characteristics of the patient, the type of disease and general condition health.

Painkillers direct their action to suppress the production of prostaglandins that affect the occurrence of inflammation.

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

Anti-inflammatory and analgesic injections: what means to inject

When severe pains appear 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 knee joint), coxarthrosis (arthrosis of the hip joint), tendinitis, dislocation or sprain of the ankle, trauma or bursitis of the elbow.

Whatever caused pain in the limbs, the patient must be examined by a neurologist, osteopath, traumatologist, orthopedist, perhaps even a gynecologist, urologist and gastroenterologist. After all, often diseases of the joints are 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 survey should be comprehensive. After diagnosing and determining the cause of joint pain, the doctor may prescribe anti-inflammatory, non-steroidal painkillers - NSAIDs and B vitamins to the patient.

How to treat the musculoskeletal system

Modern medicine has a huge arsenal of drugs that are effective in various articular pathologies.

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

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

massage;
physiotherapy 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 medicines, it should be noted that the treatment of diseases of the joints (elbow, knee, shoulder, ankle) requires the appointment of combined vitamin complexes, which also provide moderate pain relief and, most importantly, supply cartilage and bone tissue with essential trace elements.

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

normalizes muscle innervation;
participates in the transmission of excitatory impulses;
stimulates metabolic processes;
normalizes the functioning of the nervous system;
restores damaged nerve tissue.

Numerous clinical researches proved 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 tissues, the patient may be offered injections for inflammation in combination with the stretching method. The essence of this technique is as follows:

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

Immediately after the procedure, it is necessary to passively stretch the muscle. Next, a hot compress is applied to the sore spot. After removing the compress, the patient should maximize the use of the sore muscle with active movements.

The main goal of novocaine blockade is to "turn off" the nerve. Therefore, injections for inflammation should be as close as possible to the exit points of nerve endings.

Preparations for the treatment of joint diseases

B vitamins are also available in the form of tablets that are intended for oral use. However, intramuscular injections for pain in the joints and muscles are most effective.

It is on them that it is worth dwelling in more detail: to find out their composition, pharmachologic effect, 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 r.
10 ampoules - 400 r.
25 ampoules - 900 rubles.

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

paresis facial nerve, neuritis, trigeminal neuralgia;
if joints and muscles hurt, there are pains in the spine caused by neurological manifestations and degenerative-dystrophic changes in tissues;
alcoholic, diabetic polyneuropathy;
nocturnal muscle cramps;
shingles.

Kombilipen

5 ampoules - 120 r.
10 ampoules - 200 rub.

The drug has the following contraindications:

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

Neurobion

Price: 3 ampoules - 220 rubles. Distinctive feature Neurobion is that it does not contain Lidocaine.

Negative manifestations during treatment:

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

Overdose:

symptoms of intoxication - nausea, vomiting;
tachycardia;
dizziness.

Trigamma

Price: 5 ampoules - 100 rubles.

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

Anti-inflammatory, non-steroidal painkillers

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

Unfortunately, half of the patients treated with NSAIDs experience side effects, sometimes severe. With this development of events, the medication should be stopped and a doctor should be consulted, who will prescribe another treatment.

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

When choosing an analgesic, doctors advise their patients to pay attention to the fact that some analogues are significantly inferior in their 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 of all NSAIDs is the least toxic and has minimal side effects.

Manufacturers of the new COX-2 inhibitor, Celebrex, claimed that the drug had practically no negative manifestations, but an 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, have side effects, but different frequency, severity and intensity of negative manifestations. The price range between one and the other NSAIDs 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.

In some advanced joint pathologies, anti-inflammatory painkillers are of low efficiency, and increasing the dose does not lead to the elimination of 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 an anesthetic drug

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

In acute pain, the risk of side effects of prescribed drugs on the gastrointestinal tract should be determined. If such a risk is small and there is no dyspepsia, any non-steroidal anti-inflammatory drugs can be prescribed to the patient.

In the presence of dyspepsia, one of these drugs should be prescribed:

Ibuprofen.
Naproxen.
Diclofenac.
Miloxicam.
Nimesulide.

With a high probability of developing cardiovascular complications, the appointment of NSAIDs should be avoided, and Paracetamol should be content. With 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 in this group (regardless of the likelihood of gastroduodenal bleeding) implies the appointment of proton pump blockers.

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

Local injections of corticosteroids are possible in the absence of tuberculosis of the spine or joints. With intense incessant pain, you need to make sure that the nature of the disease is non-infectious. The patient should be examined in the TB and venereal dispensary.

Non-steroidal anti-inflammatory drugs for the treatment of joints

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

Targets for non-steroidal anti-inflammatory drugs
Popular remedies
Application methods
Precautionary measures
Some Important Facts
Side effects, contraindications
It's important to know
Rules of use
- Ibuprofen
- diclofenac
Conclusion

Targets for non-steroidal anti-inflammatory drugs

Having given the idea to create non-steroidal anti-inflammatory drugs for the treatment of joints, pharmacists hoped to solve a number of problems with their help:

Remove pain in the joint;
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. They can be used to significantly reduce pain symptoms at various diseases joints.

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

During periods of exacerbation of arthrosis, physiotherapy exercises, as well as certain physiotherapy procedures, are contraindicated for patients. Often, patients have a desire to use traditional medicine, but it takes a long time to wait for the effect. The solution in such a situation can be just non-steroidal anti-inflammatory drugs for the treatment of joints.

Popular remedies

Pharmacy chains offer a wide variety of non-steroidal anti-inflammatory drugs, which were originally intended for the treatment of such common joint diseases as arthritis and arthrosis. Regular use of these drugs allows you to completely stop the disease, as well as weaken 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 do not have such a bright effect, others show themselves well 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 precious time, but also face the side effects of an improperly selected nonsteroidal drug.

Application methods

Non-steroidal anti-inflammatory drugs available today in pharmacies are presented in several forms:

tablets;
intramuscular injections for joints;
intra-articular injections;
candles;
joint cream;
ointments.

With an exacerbation of the disease of the joints, which is accompanied by a deterioration in the patient's condition, it is necessary to use potent drugs, which, unfortunately, have many adverse reactions. To minimize harm to the body, doctors prescribe injections for the joints. In most cases, such a measure is resorted to in the treatment of gonarthrosis and coxarthrosis. Compared with tablets, entering the body after injection active substances do not penetrate the gastrointestinal tract, thereby eliminating the negative impact on the gastric mucosa. Injections allow you 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 oral non-hormonal anti-inflammatory drugs. They are available in the form of tablets.

Precautionary measures

In order for the non-steroidal anti-inflammatory drugs used to bring relief to the patient and at the same time harm from them was minimized, they must be used strictly in accordance with the doctor's recommendations. When visiting a specialist, the patient must receive a prescription that he must follow. The desire to overdose the drug to hasten recovery will not be beneficial. On the contrary, it can cause a number of complications that can be very severe, sometimes even fatal.

It is extremely careful to use the means of the category of patients who suffer from diseases of the gastrointestinal tract, kidneys, have pronounced allergies, cirrhosis of the liver, heart and vascular diseases. It should also be noted 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 drugs. 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 desired therapeutic effect can be achieved after the entire course has been completed, which includes 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 when 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 throw all his strength into the treatment of the underlying disease. You can solve this problem using the following methods:

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

With a long course of treatment with NSAIDs, cartilage tissue is no longer able to synthesize new cells, this function stops. One of the main signs of arthrosis is the destruction of cartilage. Therefore, when taking these drugs, you can accelerate the process of deformation. As a result of their intake, the production of proteoglycans worsens, and this leads to water loss. Thus, with prolonged use of NSAIDs, it is necessary to constantly be observed by a specialist. The patient should have an idea of which ointments he is allowed to use in his case in order to minimize possible harm.

Side effects, contraindications

Few cases are known when non-steroidal anti-inflammatory drugs were harmful, worsening the patient's condition. But at the same time, one must not forget that these drugs have a number of side effects:

Negatively affect the functioning of the kidneys;
Have a negative impact on the activity of the gastrointestinal tract;
At long-term use conditions may arise for the development of diseases of the heart or blood vessels;
May cause symptoms such as rash, nausea, and diarrhea;
When taken by women during pregnancy up to 20 weeks, there is a chance of miscarriage.

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

It's important to know

Statistics show that, unlike steroid drugs, non-steroidal anti-inflammatory drugs can quickly achieve a stable remission. However, there are important points to keep in mind:

It is forbidden to take drugs for patients diagnosed with stomach ulcers, asthma, hypertension, as well as severe forms of kidney, liver and heart diseases.
In the case of taking these drugs, there is a possibility of bleeding in the gastrointestinal tract. To avoid this, the patient should be regularly tested to avoid such complications.
Regardless of the form in which nonsteroidal drugs are taken, there is a risk of blood clots, stroke or heart attack. With these drugs, you need to be careful for people with diseases of the cardiovascular system.
Patients who have recently undergone coronary bypass surgery should not take non-steroidal anti-inflammatory drugs.

Rules of use

While taking non-steroidal anti-inflammatory drugs, as in the treatment of steroid drugs, the patient must follow certain rules exactly.

Medicines can only be used as directed in the instructions.
When taking the drug in the form of a capsule or tablet, it is washed down with a full glass of water. This can help the stomach avoid significant irritation.
During the course of treatment with nonsteroidal drugs, it is unacceptable to take alcohol. In this case, there is a possibility of developing pathology of the stomach.
It is strongly recommended that women stop taking non-steroidal drugs during pregnancy.
After drinking the drug in the form of a capsule or tablet, you must wait 30 minutes, and then you can lie down. When a person is in vertical position, this accelerates the passage of the drug through the esophagus due to the effect of gravity.
Patients who are being treated with anti-inflammatory ointments for the joints need to choose separate days for the use of non-steroidal drugs. The combination of drugs will lead to the fact that the side effects will increase, and this will not bring much benefit.
Sometimes when taking certain drugs difficult to achieve the desired effect. In this case, it is necessary to reconsider the dosage. It is not worth making changes to the treatment regimen on your own. Be sure to get permission from your doctor. It is possible that you may need to change your medication.

Ibuprofen

This anti-inflammatory non-steroidal drug is offered in the form of tablets and can reduce fever, as well as relieve headaches. It must be taken, like all steroid drugs, 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 of the instructions, since non-compliance with them will lead to the manifestation of side effects:

Problems with the gastrointestinal tract;
Dizziness;
Headaches;
Increased arterial pressure;
Sleep disturbance.

This drug also has other side effects. Therefore, before you start taking the medicine, you must carefully study them in order 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 relieve 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 prolonged use. Failure to follow this recommendation can lead to unpleasant symptoms such as dizziness, headaches, and tinnitus. At the same time, there are problems with the functioning of the liver. It should also be avoided in people with asthma, during pregnancy and breastfeeding.

Osteoarthritis is a disease of the joints caused by internal malfunctions in the body or external factors. Treatment of arthrosis with drugs is necessary especially at the first stage, when it is still possible to stop the process of destruction. Doctors prescribe nonsteroidal drugs, antibiotics, anti-inflammatory drugs. Self-medication is absolutely unacceptable!

Nonsteroidal drugs

NSAIDs are non-steroidal anti-inflammatory drugs. Unlike corticosteroids, it does not contain hormonal supplements, which reduces possible side effects. Modern drugs are relatively safe, but despite this, they have a number of contraindications.

Contraindications for non-steroidal drugs for the treatment of arthrosis:

With existing diseases of the liver and kidneys. If the disease is treated with drugs of this group, then they affect the process of blood circulation in the organs, delaying the excretion of sodium, potassium, and water salts. As a result, blood pressure rises, the function of the liver and kidneys is impaired, which can lead to their temporary failure.
Diseases of the stomach and digestive tract, colitis, ulcers and others. Drinking tablets for arthrosis is recommended with a large amount of water 1-2 glasses to increase their absorption and dissolution in the stomach cavity. Other liquids are not allowed - they can affect the absorption process, slowing it down, which can lead to ulcers and gastritis.
Complete abstinence from alcohol. Alcohol is absolutely unacceptable during the period of treatment with nonsteroidal drugs for arthrosis of the joints. Ethanol comes into conflict with chemical compounds, causing unpredictable reactions and consequences.
If the doctor has prescribed several types of new generation NSAIDs for arthrosis, then they should be used at different times of the day. This will not affect the quality of treatment and will help to avoid both side effects and overdose.

Against arthrosis, both modern, young medicines are used, as well as long-known ones, such as acetylsalicylic acid. The initial task is to eliminate severe pain.

Non-steroidal anti-inflammatory drugs for arthrosis
Name	Analogues	healing effect
Aspirin or acetylsalicylic acid	Has no analogues. Known drug for the treatment of various inflammatory processes for more than 100 years.	Among the advantages note the absence of side effects. It has good dynamics during the treatment period, although it is considered a rather weak remedy. Aspirin slows down blood clotting by thinning it out.
diclofenac	Naklofen, Ortofen, Voltaren, Diklak, Clodifen, Dicloberl, Dolex, Olfen, Diklonak P, Wurdon.	It successfully combines anti-inflammatory properties and analgesic effect. In one capsule of the active substance is enough to relieve moderate pain. It is also available in the form of tablets, ointments and creams.
Ibuprofen	Dolgit, Bolinet, Solpaflex, Burana, Brufen, Ibalgin, MIG-400, Bonifen, Nurofen, Faspin, Ibuprom, Advil, Reumafeni.	A long-known remedy for arthrosis and other inflammatory processes. Well tolerated by humans, has a small list of side effects and contraindications. Relieves pain and increases joint activity.
Indomethacin	Indovis EU, Indocollier, Metindol, Indovazin, Indotard.	Doctors are considered as the most effective remedy from arthrosis of the joints. Reduces puffiness and inflammation. Available in the form of capsules and tablets, gels and ointments, and even rectal suppositories.
Ketoprofen	Flexen, Flamax, Bystrum, Fastum, Artrozilen, Ketonal, Artrum, Febrofid.	The effectiveness is comparable to Ibuprofen. Available in the form of: tablets, capsules, there are ampoules for injection, gels, ointments, creams.

Despite a long list of contraindications and side effects, Indomethacin is the most effective medicine for arthrosis. A nice bonus when choosing this drug from the list of medicines is its affordable price of 20–50 rubles. Affects directly on the area of destruction. It has high analgesic properties. NSAIDs can create a masking effect.

The patient, taking the pills, eventually notices a decrease in pain, which at times does not bother the person at all. It seems that the crisis has passed, but in fact the situation may worsen even more. The less pain in the collapsing joint, the more movement and load on it. The patient may overdo it physical activity and not even feel the warning pain symptoms.

The medicine is selected individually

After 3-6 months, a person feels stiffness in the joint. The crunch characteristic of arthrosis intensifies. If you make repeated X-rays, you will find even more destruction of the cartilage. There are COX-1 and COX-2 inhibitors. The second group is a new generation of drugs that have fewer side effects on the gastrointestinal tract. COX-2 has a selective effect on the area of inflammation, so it is easier to tolerate.

In the medical community, there is a growing belief that drug treatment arthrosis with drugs of the COX-1 group leads to an even more dynamic destruction of cartilage tissue. Therefore, doctors prefer the second group. But nonsteroidal agents of the COX-2 group have an unpleasant side effect: they affect the functioning of the cardiovascular system and the heart.

Recent studies confirm physicians' fears that long-term non-steroid therapy in the case of arthrosis only exacerbates the destruction of cartilage plates. The components of NSAIDs affect the synthesis of proteoglycans, which is inhibited. Proteoglycans are responsible for the entry of water into the cartilage tissue and nutrients. The less they become during treatment with nonsteroidal therapy, the less cartilage receives nutrition and moisture. Therefore, they begin to break down even faster: they crack, dry out, and become thinner.

Medicines for arthrosis of the COX-2 group:

Celecoxib. A good cure for osteoarthritis. It has a high anti-inflammatory property and analgesic effect. It has a minimum of contraindications and side effects.
Meloxicam. This is the name of the active ingredient, which is part of the medicine for arthrosis. For example, it is contained in the drug for osteoarthritis Movalis. The advantage of the drug is that it can be used for a long time, unlike most other drugs that are prescribed exclusively in courses. If you drink the drug in the morning, the effect will last until the evening.
Nimesulide. In addition to its main action, it has antioxidant properties. Protects cartilage and collagen fibers inside the joint from further destruction. Prevents the situation from getting worse. Known under the following names: Nise, Mesulid, Aulin, Rimesid, Aktasulide, Nimegesik, Kokstral, Nimid, Prolid, Nimika, Flolid, Aponin.

Every third inhabitant of Russia suffers from joint disease. Most are self-medicating, which is completely unacceptable. With arthritis and arthrosis, pain occurs in the knee, iliac joint, hands and elbows. This leads to a decrease in physical activity of a person.

As consequences, curvature of the spine, weight gain and obesity are observed, this leads to problems with the heart and blood vessels, causes pressure surges. If the disease is not treated, then mobility can stop completely. The joint will stiffen and stop working. And the worst thing is that in the last stages, growths can appear that turn into malignant tumors.

Chondoprotectors

Chondoprotectors do not stop the symptoms, but they treat. The result can be noticeable only after a few months, but it will also last much longer. Drugs for the treatment of osteoarthritis should be used in the overall treatment regimen under the supervision of a physician.

When using drugs of this group, it is necessary to increase blood flow in the joints, as well as accelerate the production of synovial fluid, with which the active components will get inside the synovial bag and begin their work. To do this, you need to regularly do massages and perform physical therapy exercises. You can simply warm up the joint by actively rubbing it. Chondoprotectors contain glucosamine, which restores cartilage tissue.

Treatment of osteoarthritis with chondoprotectors:

Artra. Glucosamine and chondroitin sulfate in equal proportions are part of the drug. USA manufacturer.
Teraflex. Combined drug manufactured in the UK.
Don. Manufacturer Italy. The composition of the drug includes only glucosamine.
Structum. France. Contains only chondroitin sulfate.
Chondrolon. Russia. Chondroitin sulfate. Available in the form of injections. Well suited for intra-articular blockades.
Elbon. Also made in Russia. And it is also a monopreparation, which includes glucosamine.
For intra-articular administration: Alflutop, Adgelon, Noltrex, Chondrolon, Elbona. Intra-articular blockades are performed exclusively by trained medical personnel. Such actions allow medicines immediately directly enter the synovial region, providing fluid replacement. So, 20-30 sessions are enough for emergency treatment, after which they switch to pill therapy.

Chondroprotectors are taken in courses of 3-5 months, which are repeated every six months for 3-5 years. Arthrosis cannot be completely cured. You can stop the course of the disease, stop the symptoms and pain symptoms. If you treat the disease with medication, use massages, physiotherapy exercises, diet and lead a proper lifestyle, then the disease will not cause great inconvenience.

Chondoprotectors and NSAIDs - the main drugs for the treatment of arthrosis

A group of preparations based on hyaluronic acid. They are injected into large joints. Ostenil, Sinvisk, Sinokrom, Fermatron. On the initial stages arthrosis, 1-3 injections are enough to alleviate the condition. The course is repeated in a year. Chondoprotectors of this group completely replace the synovial fluid, which allows the joint to rejuvenate and start active work again. The destructive action slows down.

Cartilage tissue is restored. In the future, the synovial fluid in composition and its qualities is normalized for the period of action of the drugs. When the effect weakens, the course is repeated. Glucosamine and chondroitin sulfate are key ingredients for joint health. Glucosamine stimulates the work of chondrocyte cells and increases the production of proteoglycans. Together, this effect creates the conditions for healthy cartilage activity.

Proteoglycans are produced in greater quantities and are able to hold and carry more water molecules, which makes the cartilage plate more elastic and stronger. Glucosamine creates the conditions for a natural natural restoration of cartilage tissue. Glucosamine and chondroitin sulfate are not a panacea in the treatment of arthrosis of the second and third stages. The components stimulate the synthesis of proteoglycans.

In existing cartilage, they are able to improve its performance, increase elasticity, improve the production of synovial fluid, as well as significantly improve its quality and ability to lubricate the space between individual cartilage tissues. But glucosamine is unable to re-grow cartilage. Each course of chondoprotectors lasts 2-3 months, depending on the severity of the course of the disease. To get a positive effect, you need to take 3-4 courses. This means that the actual treatment lasts from 6 months to 1.5-2 years.

Glucosamine manufacturers promise a faster effect, but this is nothing more than a marketing ploy.

Vasodilator drugs in the treatment of arthrosis

Trental, Agapurin, Theonicol affect blood circulation in the articular bag. Vasodilator drugs increase blood flow in the diseased joint. If you take them together with chondoprotectors, then the effect of the latter will be increased. Glucosamine and chondroitin sulfate will be easier to penetrate into the diseased area. Medicines eliminate the stagnation of blood flow, which is almost always observed in arthrosis.

If a patient complains of poor sleep due to pain in a joint affected by arthrosis, then vasodilator drugs will help eliminate such discomfort. Drugs are contraindicated in diseases of the heart and blood vessels. If they are prescribed, then only under the supervision of the attending physician. After a heart attack or stroke, they are prescribed with caution.

Drug therapy with muscle relaxants for arthrosis is carried out to relieve muscle tone, which causes persistent pain. With the destruction of large joints of the shoulder or hip part, the muscular frame gradually begins to tighten. Increased tone becomes the norm. The most common are Mydocalm and Sirdalud. They are introduced gradually so that the body gets used to the action of the drug.

If you immediately prescribe large doses, then the body will react with instant relaxation, which is not very good. The gait will become shaky, the coordination of the limbs will decrease, the ability to hold objects will weaken

Muscle relaxants are not prescribed by themselves, only in combination with general treatment using chondoprotectors to restore cartilage tissue. Muscle tone is a protective reaction of the body. When destructive processes in the joints pass, the muscles around them tense up to reduce the load on the thinned cartilage plates.

The drugs affect nervous system. The reaction to what is happening around is reduced, the sleep pattern is disturbed, a headache may appear. Therefore, when treating with muscle relaxants, work related to driving should be avoided. Any employment requiring increased attention should be excluded for the duration of the course of treatment. NSAIDs against arthrosis relieve symptoms: pain, swelling and redness. Chondoprotectors treat the joint, restoring cartilage tissue, because they contain glucosamine. Intra-articular blockades act quickly. The course is not more than 30 injections.