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Ointment for joint pain: choosing the right one
Last reviewed: 03.07.2025
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Ointment for joint pain is rightfully considered the most popular and very effective means of local, that is, external action on pain syndrome.
Today, the range of such drugs is extremely wide, so their choice must be approached with an understanding of the causes of the existing pathologies: what ointment for pain in the knee joint to use when it is injured, and what ointment for pain in the shoulder joint to use, say, with inflammatory changes in its synovial membranes (chronic osteoarthritis), bursitis or traumatic arthritis.
It is quite difficult to evaluate the merits of all the drugs of this pharmacological group within the framework of one review, so we will focus on what names of ointments for joint pain are most often voiced by doctors who recommend these drugs to their patients, and why.
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Indications for the use of ointments for joint pain
The main indications for the use of ointments for joint pain include a wide range of diseases of the musculoskeletal system and the musculoskeletal system of various etiologies: traumatic, inflammatory or associated with metabolic disorders affecting the joints.
Depending on the principle of therapeutic action, anti-inflammatory ointments and local irritants are distinguished. Anti-inflammatory ointment for joint pain is used for diseases such as rheumatoid arthritis, deforming arthrosis, spondylitis, osteochondrosis, osteoarthrosis and osteoarthritis; for radiculitis and inflammation of the soft tissues surrounding the joints (bursitis, tendovaginitis). Local painkillers are also recommended for use in joint and muscle injuries, in lesions of the peripheral nerves (neuralgia) and myalgia (muscle pain).
Ointments for joint pain are included in the complex systemic therapy of arthralgic syndrome, which accompanies some infectious, endocrine, neurological and autoimmune diseases.
In many cases, it is most appropriate to use nonsteroidal anti-inflammatory drugs (NSAIDs), which not only relieve joint pain, but also affect the inflammatory process that causes it. The form of these drugs is ointments, gels or creams in tubes. These include Diclofenac (Diklak-gel, Voltaren, etc.), Ibuprofen (Deep Relief, etc.), Ketonal (Fastum gel, etc.), Piroxicam (Finalgel), etc.
To get rid of pain caused by a bruise, dislocation or strain, ointments with local irritant action can be used: Bengin (Bom-Benge), Vipralgone (Viprosal, Alvipsal, etc.), Gevkamen (Efkamon), Kapsikam (Espole, Finalgon).
Pharmacodynamics of ointments for joint pain
The main mechanism of anti-inflammatory and analgesic action of Diclofenac (other trade names - Diclac-gel, Diclofenacol, Dicloran, Voltaren emulgel, Ortofen, Ortoflex) is triggered by the active substance diclofenac (sodium salt of phenylacetic acid). It slows down the process of biosynthesis of local mediators of prostaglandins, which at the site of damage to cell membranes during inflammation provide a response of the body - somatic pain.
The active ingredient of the joint pain ointment Ibuprofen (other trade names - Deep Relief, Dolgit, Ibalgin, Ibutop) is a non-steroidal anti-inflammatory drug ibuprofen. In the ointment Piroxicam (synonyms Piroxicam-Verte, Finalgel) the main component is piroxicam. And in the drug Ketonal (synonyms: Valusal, Fastum gel, Ketonal Forte, Bystrumgel, Ultrafastin) the active ingredient is a derivative of propionic acid ketoprofen, also belonging to the group of non-steroidal anti-inflammatory drugs. The pharmacodynamics of all these ointments is similar to Diclofenac: they are prostaglandin inhibitors.
In ointments for joint pain, which are classified as local irritants, the pharmacological action is provided by:
- Bengin (Bom-Benge) - menthol and methyl salicylate;
- Vipralgone (generics: Viprosal, Viprapin, Viprobel, Nizhvisal, Alvipsal, etc.) - gyurza venom, camphor, salicylic acid and turpentine;
- Gevkamen (Flucoldex, Efkamon) - clove flower oil, camphor, menthol, eucalyptus oil;
- Apizartron (analogues - Apifor, Ungapiven, Forapin) - bee venom, methyl salicylate;
- Kapsikam (analogues - Finalgon, Betalgon, Espol) - an extract of hot pepper capsaicin.
The active substances of these drugs act reflexively, stimulating the nerve endings of skin receptors. As a result, the vessels expand, blood circulation at the site of inflammation or injury increases (as evidenced by reddening of the skin), and oxygen supply to the tissues increases. Due to this, the production of biogenic amines, which reduce pain sensitivity, increases many times over. And the analgesic effect of capsaicin is explained by its powerful suppressive effect on the neuropeptide that transmits signals from peripheral nerve endings to the brain.
Pharmacokinetics of ointments for joint pain
Considering the external method of application of all gels, creams and ointments for joint pain, the level of absorption of their active ingredients is insignificant. Thus, for ointments based on NSAIDs (diclofenac, ibuprofen, ketoprofen, etc.) it does not exceed 6%, and the connection with proteins is almost 100%. When these drugs are applied to the area of the affected joint, the main amount of active substances is concentrated in the synovial fluid filling the cavities of the joints. And what gets into the plasma is excreted through the kidneys. Information on the metabolism of most irritating ointments, according to their official instructions, is missing. At best, it can be indicated that the drug does not have a systemic effect.
Method of administration and dosage
All ointments for joint pain have one method of application - topical. Ointments and gels based on diclofenac are rubbed into the skin above the painful area three times a day - 2-4 g of the drug at a time. A single dose prescribed for children aged 6-12 is 1.5-2 g (applied twice a day).
Piroxicam gel (Finalgel) should be applied to the affected area by squeezing out a column of the preparation no longer than 1 cm and rubbing it into a thin layer - three times a day. Finalgon ointment should be applied to the skin by rubbing the ointment with the attached applicator, 5 mm at a time - no more than three times a day. To enhance the therapeutic effect, it is recommended to wrap the place of application of the preparation.
Ointments with camphor and turpentine are rubbed in 5-10 g once every 24 hours (twice a day for intense pain). Duration of therapy is no more than 10 days. The same method of application and doses are used for ointments based on poisons.
Since the systemic absorption of active components of ointments, creams and gels is minimal when applied externally, an overdose of these drugs is considered impossible. Although the manufacturers of Finalgel warn: with a significant excess of the drug dosage, in rare cases, headaches, nausea, gastrointestinal disorders, and in isolated cases, functional renal failure have been recorded.
Contraindications to the use of ointments for joint pain
Among the contraindications to the use of Diclofenac and its analogues is the presence in the anamnesis of patients of bronchospasms, allergic rhinitis or skin reactions after using any non-steroidal anti-inflammatory drug or aspirin. In case of gastric ulcers, liver and kidney dysfunction, chronic heart failure and bronchial asthma, Diclofenac and all other ointments with NSAIDs are prescribed with caution. Children under 6 years of age (and Finalgel - children under 14 years of age) do not use these ointments.
Absolute contraindications to the use of irritating ointments are hypersensitivity to their components and the presence of open wounds, dermatoses or even minor damage to the skin at the site of application of the drug.
The use of ointments for joint pain during pregnancy is not recommended in most cases, since there is no sufficiently convincing clinical experience of their use in this situation. Diclofenac ointment and its analogues are not used during the third trimester of pregnancy and during lactation, and should be used with caution in the first two trimesters. Fastum gel can be used during pregnancy only as prescribed by the attending physician. And ointments that contain ketoprofen, as well as bee or snake venom, are prohibited for pregnant and lactating women.
Side effects of ointments for joint pain
The use of ointments for joint pain based on all of the above non-steroidal anti-inflammatory drugs may be accompanied by undesirable side effects in the form of skin itching or burning, redness or rashes. The possibility of systemic side effects is not excluded: nausea, vomiting, headache, dizziness, swelling, increased blood pressure and gastrointestinal disorders.
The use of Efkamon, Gevkamen or Flucoldex ointments, as well as ointments based on snake or bee venom, quite often causes allergic skin reactions at the site of their application.
Interactions of joint pain ointments with other drugs
Diclofenac and other NSAIDs can enhance the effect of drugs that cause increased sensitivity to ultraviolet radiation (sulfonamides, antibiotics, antifungal agents). Interaction with other drugs has not been observed in clinical practice.
Ibuprofen ointment (and its generics) reduces the effectiveness of diuretics (furosemide and hypothiazide) and some drugs to lower blood pressure. And when taken simultaneously with oral glucocorticoids, there is a risk of gastrointestinal bleeding.
Storage conditions for ointments for joint pain
The optimal storage conditions for almost all ointments for joint pain presented in this review are temperatures no higher than +25°C. Diclofenac-based drugs should be stored at temperatures no higher than +15°C. The expiration date of drugs is indicated on their packaging.
Attention!
To simplify the perception of information, this instruction for use of the drug "Ointment for joint pain: choosing the right one" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.