Best Ointments for Knee Pain (What to Discern)

There are dozens of medications for knee pain. If the pain is mild, topical pain relievers such as ointments are worth a try. Ointments contain a higher concentration of oil so they are stickier and greasier than creams. They are likely to remain on the skin longer. Do they work? The efficacy is dependent on the specific ingredients they have. To help you find the best ointments for pain relief, here are pieces of information to discern.

Benefits of topical treatment with ointments

Why topical pain relievers? When it comes to treating knee pain, most of us will look for a pain-relieving pill, especially if your knee huts a lot — many times Tylenol (acetaminophen) for starters, or probably one of NSAIDs (e.g. ibuprofen, aspirin, or naproxen).

But popping this pill doesn’t work for everyone. For people with poor gastrointestinal tract in which the digestive system doesn’t respond well to NSAIDs, they need alternative options. Some people are also reluctant to go with pills due to certain reason.

Here topical pain relievers may help. Applying pain-relieving medication right on the painful area has many intuitive appeals, though there are also some drawbacks.

Unlike a pill that involves gastrointestinal tract function (to absorb the medication) and circulation of the medication in the blood — topical approach allows you to treat the problem locally, reducing counterproductive effects to other areas. This may also help reduce side effects of the medication. Plus, there is no question that the medications can penetrate the skin.

Are ointments better than creams? This depends on several factors.

Since ointments are higher in oil than creams and stay on the skin longer, they are more recommended if the medication is intended to be absorbed slowly. This doesn’t soothe the pain as quick as creams, but they’re likely to keep the pain off longer.

But in cases when medications are intended to be absorbed quickly, creams are your best bet. Creams are likely to provide pain relief more quickly than ointments, because they are lower in oil and allow the skin absorb the medicine quickly.

Ointments containing counterirritants

It’s common to find counterirritants in topical pain relievers, including ointments. Counterirritants are ingredients thatcreate sensation (cooling or burning) to distract the mind from the pain. These include camphor, menthol, and methyl salicylate [1].

It used to be produced from the camphor trees that natively grow in East Asian countries. But today, it can also be chemically produced from turpentine oil.

It has a counter irritant effect. It stimulates a cool sensation when topically applied on the skin. Also, it numbs the nerve endings so the transmission of pain is eliminated.

But don’t take it by mouth. When ingested, it can cause serious side effects. People with seizure disorder should use it extra carefully, because camphor fumes make their seizure more likely to flare up.

To reduce the counterproductive effects of camphor, a few additional substances are usually mixed with camphor. Avoid using pure camphor oil – or only use it with extra caution!

It soothes knee pain by releasing cooling sensation. It drives the skin to feel cool, the flip side of burning sensation. This feeling may be effective to distract you from feeling pain deeper in your knee joint, muscles, and tendons.

Menthol may not have to do with the real temperature of your skin since it doesn’t change your overall skin temperature. It causes cooling sensation because it attaches to a certain neuronal receptor.

In general, menthol is harmless substance and safe for most people. But although it works for pain relief, it doesn’t target the underlying cause of the problem (e.g. inflammation).

Methyl salicylate belongs to a group of chemicals called salicylates due to its salicylic acid content. It is one of common ingredients in many OTC pain relief ointments. In the plants that produce this wintergreen-scented active compound, scientists have found that it has a role to help the plant stave off disease.

Does it work for pain relief? This is probably not fully known. There is little reliable evidence to confirm its effectiveness as a pain reliever. But once a salicylate compound is absorbed and turned into salicylic acid, this can help ease inflammation and pain -- there’s not much question for this one!

Precaution: use any topical ointments containing salicylate with prescription if you’re taking blood thinners for heart problems or if you have an aspirin allergy!

Capsaicin ointments

The word ‘capsaicin’ might not be familiar for most people, but we all do know the taste especially for those who love spicy foods. This substance is responsible for the hot taste of chili peppers. And did you know that it also has a medical purpose, including for pain relief!

Capsaicin is a counter irritant. When you apply it on the skin, it causes a burning sensation so the pain massages to the nerves are blocked. When first applied, you may find it’s quite bothersome — but you will get used to it over time. For pain relief, you may need to put capsaicin ointments on your knee joint for a few days up to a couple of weeks.

Depending on what causes the pain, capsaicin may help provide benefits more than just drive your mind off the pain. For instance, it may help improve inflammation, redness, scaling, and pain from psoriasis. It may also work effectively to help relieve nerve damage pain caused by peripheral diabetic neuropathy and singles [2].

You usually don’t need prescription to get capsaicin ointments since most of them contain low concentrations of capsaicin. However, stop right away if you experience any unusual symptoms (e.g. chest tightness, itching, trouble breathing, and hives). Capsaicin, even though in low concentration, might cause a counterproductive, allergic reaction in some people.

Ointments containing NSAIDs

NSAIDs in topical form such as ointments and gels are getting a closer look nowadays. As well we know that NSAIDs are powerful to soothe pain, but they also carry a number of side effects. Here topical versions may help deal with. A number of topical pain relief products containing NSAIDs have been approved by the FDA.

In oral form, NSAIDs are quite commonly associated with gastrointestinal problems such as increased risk of ulcers, stomach upset, and bleeding. This occurs because NSAIDs can irritate the gut’s mucosal lining and decrease the amount of prostaglandin in the blood.

NSAIDs topically applied on the skin may also go to the bloodstream and affect prostaglandin levels. Even though there is no direct contact with the gastrointestinal mucosal lining, a decrease in prostaglandin is still possible to cause a similar counterproductive effect profile as one taken orally. But topical applications are likely to result in lower amounts of NSAIDs in blood than the pill forms.

The next question, is this effective enough to relieve pain? The data from various clinical trials on this is mixed [1].

The bottom line: when topically applied on the skin, NSAIDs probably are less likely to cause negative effects (though there are doubts on the effectiveness of topical application with NSAIDs for pain relief).

How to use your ointments properly?

Whatever the kind of ointment you choose for your knee pain relief, it’s important to use it properly. Here are a few things to remember.

  1. First off, make sure the package of your ointment is in a good condition.
  2. Read the package insert (a document /guideline included in the package of your ointment) so you can completely understand how to use the product properly.
  3. Make sure the area where you want to apply the ointment is clean and dry enough. Wash your knee, and pat the skin afterwards.
  4. Apply the ointment evenly to the painful area, gently massage it.
  5. Don’t put it to damaged skin /wounds! Never use it under a tight bandage or along with a heating pad.

Also, don’t touch your eyes, genitals, or other sensitive areas with the ointment on your hands. Always wash your hands cleanly every time after using the ointment or wear gloves if necessary!

All medications are potential to cause side effects. It’s difficult to predict who might get a negative reaction. But in general, there is a standard caution. Topical pain relief application (including ointments) should not be used by infants, children, pregnant women, if you’re taking a medication (blood thinners, for example), or people with certain condition (e.g. sensitive skin and a personal history of gastrointestinal bleeding) – in such cases, check with a doctor first to keep safe!

RICE formula can help, too

While topical pain relievers may help relieve your knee pain, do also the RICE formula. RICE stands for Rest, Ice, Compression, and Elevation.

Rest

Take a break (if possible) from your daily activities and take a rest. This can help a lot to reduce unnecessary repetitive strain on the knees, allowing the injured part of the knee to heal more quickly and preventing the risk of further damage.

How long does it take is dependent on the severity of your knee pain. If it is mild, 1-2 days of rest is probably enough. But if it is severe damage, this may require a longer recovery time.

Ice

Ice therapy is a good way to help ease pain and inflammation. An ice pack (wrapped in a towel), for example, can be applied on the skin to ease swelling. Another idea, use a bag of frozen peas!

But don’t do this ice therapy when your knee is already stiff. See also how to use ice and heat therapy safely!

Compression

When your knee gets hurt, fluid buildup may occur in damaged tissues. Here compression helps prevent this problem. It can also help maintain the alignment and stability of your knees.

There are many products of knee compression to choose from. Look for one that fits comfortably in your knees. It should be breathable, lightweight, self-adhesive, and tough enough to give support without affecting the blood circulation.

Elevation

Elevation is a simply idea to reduce knee swelling. Use a pillow or something else to prop your knee so it is above your heart. Do this a few hours a day!

If your knee pain is caused by arthritis, you might also like to read effective home remedies for arthritis knee pain!

Resources:

  1. https://www.health.harvard.edu/newsletter_article/Rubbing_it_in
  2. https://www.webmd.com/pain-management/what-is-capsaicin