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2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14
Joint injuries, the introduction of an infectious agent - these reasons can cause an inflammatory process in the musculoskeletal system in general and specifically in the joints. Inflammation can affect bone tissue, cartilage, ligaments.
The complex treatment includes not only medications that are taken orally or injected directly into the affected joint, but also local drugs - ointments and gels.
Of course, it is impossible to stop the inflammatory process and bring arthritis to remission only with an anti-inflammatory ointment or gel, as well as stimulate the regeneration of the ligaments, but these funds help to eliminate pain and enhance the effectiveness of drugs of other forms.
NSAIDs in the treatment of joint pathology
When it comes to topical drugs, which simultaneously relieve pain and eliminate inflammation, then first of all we remember NSAIDs - non-steroidal drugs.
On the shelves of pharmacies, they are represented by a wide assortment, but they need to be selected, focusing not on advertising appeals, but on specific problems, taking into account the degree and severity of the inflammatory process, concomitant history, selectivity of this drug, etc.
Each non-steroidal drug has its own characteristics in use and contraindications, but there is also something that unites them - an irritating effect on the mucous membrane of the digestive organs. With external agents, it is less pronounced than with oral administration, but it can also cause erosive lesions or internal bleeding with prolonged use.
The drugs of the new - the latest generation - cause fewer side effects, but their use should also be limited.
Contraindications for oral and external dosage forms are similar.
The means of the previous generation - COX-1 - act on all cyclooxygenase produced in the body. COX-2 is a new generation of drugs, only for the one that is produced directly in the foci.
Cyclooxygenase is an enzyme that is actively involved in the synthesis of prostanoids. Their inhibition reduces the symptoms of the inflammatory process and pain. Cyclooxygenase catalyzes the conversion of arachidonic acid to prostaglandin H2, which stimulates regeneration processes in the body.
COX-2 drugs are gentle on the gastric mucosa, however, with prolonged use, they also destroy it.
Preparations of the COX-1 group quickly eliminate inflammation in the joints and periarticular ligaments, have a medicinal effect, but treatment often causes side effects regarding the state of the gastrointestinal tract. The active ingredients of these drugs are diclofenac, ibuprofen and indomethacin, as well as ketorolac, piroxicam and ketoprofen.
COX-2 medicines are most often made on the basis of meloxicam. Their action is longer, and the effect of the application is more pronounced.
Anti-inflammatory joint ointments - an overview
COG-1.
- The main active ingredient is diclofenac. The names of the drugs are: "Diclofenac", "Diclac" and "Voltaren" in the form of gels, ointments "Funigan" and "Olfen".
- Ointments with indomethacin - "Indovazin" and "Indomethacin".
- The active substance is ibuprofen - preparations "Dip-Rilif", "Nortafen", "Ibuprofen".
- The most pronounced analgesic effect in ointments with ketoprofen is Fastum-gel and Ketonal.
- As part of "Finalgel" piroxicam, due to which the anti-inflammatory effect is most pronounced
COG-2. Drugs with nimesulide are considered safer, they can be used longer than drugs of the first group. They are not so destructive to the intestinal mucosa, getting into the bloodstream: "Nimid", "Nise", "Remisid".
All of these medicines are used to relieve pain in inflammatory and degenerative processes in the joints, as well as in tears and ruptures of the ligaments.
Contraindications to NSAIDs
Contraindications and side effects to ointments and gels of a number of NSAIDs are approximately the same.
They cannot be used for the following organic pathologies:
- aspirin triad - an allergic reaction to acetylsalicylic acid;
- erosive and ulcerative lesions of the stomach and duodenum, intestines;
- dysfunction of hematopoiesis;
- dermatological diseases in the acute stage;
- renal or hepatic impairment.
You should also be aware that there are individual contraindications to each drug composition, such as childhood, violation of the integrity of the skin, heart or vascular problems.
You should also pay attention to the possible course of treatment - it can be limited to 1 week or 21 days. Longer use is usually not recommended, even for the healthiest patients.
Possible side effects are also represented by a similar "set" of ailments.
Systemic reactions, hyperemia of the skin in the area of the affected joint, itching, burning, urticaria. In case of an overdose of the drug, purulent vesicles or pustules may appear on the skin.
If a side effect - redness, burning, fever - appears immediately after applying the ointment or gel, the substance must be removed from the skin immediately - first with a fat cream or vegetable oil, and only then rinse thoroughly. If the composition gets into your eyes, you must rinse them with running water.
Cooling or warming ointments - anti-inflammatory effect
The anti-inflammatory effect of ointments, in which the ingredients that cool the affected joint, are practically not expressed, but they eliminate pain.
When the ligaments are stretched or after direct injuries, the joint needs rest - immobilization. During injury, small vessels are damaged, and in order to reduce capillary permeability and prevent further inflammation, ointments with menthol, camphor, essential oils or alcohol compounds are used. If coolants are used early, inflammation can be prevented.
The funds of this group include: "Troxevasin", "Gevkamen", "Reparil gel", "Bengin" and the like.
On the second or third day after the injury, to restore blood supply and prevent a possible inflammatory process, warming ointments are applied - they perfectly help with stretching the muscles and ligaments, relieve pain in the affected joints.
These remedies are used not only to relieve pain in post-traumatic treatment, but they can also prevent possible muscle sprains or ligament tears. If they are applied with massage movements before training or work, the joint will be ready for the load and the heated ligaments will fully function, preventing excessive displacement of the articular surfaces.
Examples of such external remedies:
- ointment "Apizartron", the main active ingredient is bee venom;
- "Bystrum-gel" - active substances essential oils of neroli and lavender;
- "Finalgon" - in the composition of hot pepper.
When choosing funds in this group, you should carefully read the instructions in order to avoid allergic reactions to the components.
Features of the use of ointments for joints
Does it make a difference which product to use for the hands and which for the legs?
There is not much difference in the treatment of the joints of the upper or lower extremities, but the skin on the hands is more delicate, so you should choose products with a less pronounced effect and it is desirable that the composition contains protective emollient ingredients.
The choice of ointments and gels for the treatment of arthritis, arthrosis and sprains must be entrusted to the doctor. Only in this case can you be sure that the product was used for its intended purpose.