Ointments for sprained ligaments

The human musculoskeletal system performs the following main functions:

• motor (allows a person to move in space);
• protective (prevents injury to internal organs);
• supporting (helps to support organs, systems and tissues in a certain position).

The musculoskeletal system is divided into two main parts: active and passive.

The active components include:

• skeletal muscles, motor neurons (large nerve cells located in the anterior horns of the spinal cord that transmit movement impulses from the central nervous system to the muscles);
• receptors (permeate muscles, joints, tendons, transmit "information" to the central nervous system about the state of all components of the musculoskeletal system);
• afferent neurons (cells of the nervous system that transmit information to the central nervous system from receptors);

The passive component of the musculoskeletal system includes: bone tissue, joints, ligaments and tendons.

Tendons are muscle elements that provide their articulation with bones. Tendons are thread-like protein structures (fibrils) containing a large amount of collagen. Fibrils are very strong, practically non-tearing and non-deforming structures. The main functional task of tendons is to transmit muscle force to bones.

Ligaments are the part of the joint that ensures its stability by holding bone fragments close to each other. The basis of the ligamentous apparatus, like tendons, is collagen, but it contains more elastin, which has the ability to stretch, which ensures joint mobility without displacement of bone components.

The mechanical characteristics of tendons and ligaments are affected by their size, thickness and composition. The peculiarity of tendons is that they are not subject to ruptures under forced physical load, but immediately break away from the attachment point. Ligaments under excessive load can stretch greatly, tear or rupture completely. Sprains and ruptures of ligaments are treated conservatively, and ruptures are treated surgically.

The strength and elasticity of ligaments and tendons are directly dependent on hormonal levels. The amount of hormones affects the amount and quality of collagen, and accordingly, the ability of ligaments to stretch. This quality can also be affected by prolonged immobilization of the limb and excessive physical strength loads. The likelihood of ligament and tendon injuries increases.

When ligaments are sprained, it takes a long time to restore their full functionality. For this purpose, ointments are widely used, which are applied externally to the damaged areas.

An ointment is a form of medicine that necessarily includes a natural or artificial fat component. When using an ointment, the active substance penetrates the layers of the skin and is transported through the capillaries to the affected area. Ointments are applied locally, at the site of injury, and have a therapeutic effect. Active substances do not accumulate in individual organs and tissues of the body. Minor penetration of the active component into the systemic bloodstream is possible, but its metabolites are quickly excreted from the body.

The main tasks of medicinal ointments used for sprained ligaments are to relieve pain, reduce swelling, eliminate inflammation and restore mobility.

[ 1 ], [ 2 ]

Release form

Medicinal ointments are divided into several categories:

• anti-inflammatory,
• analgesics,
• warming,
• cooling.

One of the ointments that has an anti-inflammatory and analgesic effect is heparin ointment.

Heparin ointment

A product for external use. According to the pharmacological classification, it belongs to drugs that affect metabolic processes in tissues. It has an analgesic effect, accelerates the resorption of hematomas, promotes the lysis of formed blood clots and prevents the formation of new ones. Release form - aluminum tubes with a volume of 10, 25 g with a plastic, tightly screwed cap.

Composition: heparin, benzocaine, nicotinic acid ester, ointment base.

Heparin ointment is recommended for use in cases of superficial thrombophlebitis, subcutaneous and intradermal hematomas, injuries with ligament damage, and to relieve swelling that occurs with soft tissue bruises.

Method of application of the ointment. The product is applied with gentle massaging movements 2-3 times a day (0.5-1 g per affected area of the skin). The course of therapy is carried out for 3-7 days until the symptoms disappear completely.

Side effects of heparin ointment include local allergic reactions on the skin (itching, burning, hyperemia, rashes).

There are contraindications for the use of heparin-containing agents:

• Do not use in case of hypersensitivity to the ingredients of the drug,
• do not apply to open wound surfaces,
• do not use the ointment if the integrity of the skin at the site of the injury is compromised,
• Do not use if you have a tendency to bleeding (hemophilia, Werlhof's disease) or have thrombocytopenic conditions with impaired platelet aggregation.
• the drug is not prescribed to children under 10 years of age, pregnant women, and nursing mothers;
• It is prohibited to use the drug simultaneously with NSAIDs, tetracycline antibiotics, and antihistamines.

The expiration date of the drug is indicated on the factory cardboard packaging, on the seam of the tube with ointment and is 3 years.

Storage conditions: keep in a dry and cool place, out of reach of children.

Diclofenac ointment can be used as an analgesic and anti-inflammatory drug.

[ 3 ]

Diclofenac ointment

The preparation is applied to the skin at the site of projection of the lesion of the bone-ligament-muscle tissue. It is effective for relieving pain at the site of inflammation.

Pharmacological classification: NSAID.

The active ingredient is sodium diclofenac.

Excipients: propylene glycol, crabmer, lavender oil, ethanol, purified water.

Pharmacodynamics of the active ingredient of the ointment.

The drug is a derivative of alpha-toluic acid. It has antiphlogistic, analgesic and antipyretic effects.

The mechanism of action is the suppression of COX activity (an enzyme of omega-6 unsaturated fatty acid metabolism), which is one of the causes of inflammation, pain and fever. The analgesic effect is achieved due to diclofenac blocking various levels and links in the pathogenesis of pain syndrome in the central and peripheral nervous systems. The drug suppresses proteoglycan synthesis in cartilage tissue. Inhibits platelet aggregation.

Pharmacokinetics of diclofenac sodium. When taken orally, it is quickly and easily absorbed by the gastrointestinal tract. Food consumed immediately after taking the drug significantly reduces the rate of diclofenac entering the systemic bloodstream. During the use of the prolonged-release drug, absorption and excretion are slow, but the effectiveness of Diclofenac does not decrease. The absorption rate depends on the form of release of the drug. If the ointment is applied externally, then the penetration of the active ingredient into the bloodstream is minimal. The highest concentrations of the active component are observed in the blood plasma with an injection method after 1/3 of an hour, after using suppositories ½ an hour, after oral administration after 1-2 hours. High binding of the drug to plasma proteins is noted (99.7%). Metabolic transformations of the substance are carried out by the liver. It does not have the property of accumulation and addiction. It is excreted by the kidneys with urine (70%), the remaining inactive metabolites are eliminated by the intestine.

Diclofenac ointment is prescribed for: relief of symptoms of inflamed muscles and joints resulting from trauma (sprains, bruises, hematomas); diseases of joint tissues of rheumatic origin (bursitis, tendovaginitis); pain syndrome and swelling associated with destructive changes in joint tissue (osteoarthrosis, radiculitis, arthritis associated with rheumatism, etc.); myalgia; neuralgia; pain syndrome in the postoperative period.

Contraindications are: hypersensitivity to the ingredients of the ointment, pregnancy, lactation, children under 6 years of age, “aspirin” asthma, erosive and ulcerative pathologies of the gastrointestinal tract.

Use during pregnancy. The use of the drug is excluded in the third trimester of pregnancy. Use in the first and second trimesters of the gestation period and during breastfeeding is possible, but after the doctor's recommendations received during the consultation, because there is no clinical data on the use of the ointment in these situations.

Method of administration and dosage. The drug is used exclusively externally. Adults and children over 12 years old - 2-3 times a day. Diclofenac ointment is applied with light massage movements to the affected area. The dosage required for therapy depends on the extent of the skin surface being treated. A single use of 2 g is allowed (about 4 cm of the drug strip with the tube opening fully open). Children 6-12 years old - 1-2 times a day. (up to 1 g). After the procedure, hands must be thoroughly washed with soap. The duration of therapy depends on the individual dynamics of the disease, but not more than 14 days. The interaction of Diclofenac ointment with other drugs is minimal. Sometimes the ointment form of diclofenac is prescribed in combination with injections or tablet forms of the same drug.

When used simultaneously with non-ointment forms of Diclofenac and potassium-sparing diuretics, it can lead to accumulation of potassium in the bloodstream, a decrease in the effect of loop diuretics, and an increased risk of side effects when used together with other NSAIDs.

Side effects: local allergic reactions such as itching, burning, redness, peeling;

Systemic – urticaria, bronchospasm, angioedema.

Overdose of the ointment when used externally is impossible.

Storage conditions for the medicine - a dark, cool place, inaccessible to children. Do not freeze the ointment. The shelf life with proper storage is up to 3 years.

Ointments for sprained ligaments on the leg

When a sprain occurs on the leg, most often used are ointments, gels, creams that relieve pain, inflammation, activate blood flow and reduce swelling in the area of injury. In the acute period with severe pain syndrome, in the first day after injury, do not use warming and irritating ointments that help increase the intensity of blood circulation. You will need analgesic, cooling, herbal extract-containing preparations:

• Golden Star balm is a natural product containing clove, mint and eucalyptus oil.
• Lidocaine ointment has anesthetic and analgesic effects. It should be applied several times a day.

Gels can be used for sprained leg ligaments. Gels are absorbed by the skin faster than ointments. Gel preparations have a better cooling effect (Geparil-gel, Venoruton - analogues of Rutoside, Troxevasin; Indovazin, Essaven-gel). After 1-2 days, you can move on to using warming ointments on the affected area and thermal procedures. In this case, the following preparations will help:

• Espole is a drug with capsicum extract (distracting and analgesic effects);
• Naphthalgin - active ingredients - sodium metamizole, monohydric alcohols, sperm whale fat;
• Finalgon - dilates blood vessels, improves blood supply to the injured area;
• Nikoflex - a cream containing lavender oil that helps reduce swelling and has a distracting effect. When used, the drug causes a rush of blood to the injured area and warms the affected area.

Ointments for ankle sprains

Ankle injuries are common among athletes, especially basketball players, football players, tennis players, etc. During competitions and training, athletes have to jump, run quickly and stop abruptly. This puts a huge strain on the ligaments of the ankle joint. The sharper and faster the movements, the greater the strain on the ankle.

The risk group includes hyperactive children who do not sit still, but are almost constantly on the move, jumping, running intensively and stopping abruptly.

In everyday life, anyone can get a sprained ankle. The risk of potential injury increases when you have to catch up with public transport, when you fall, when you dislocate, when you slip on ice in winter. High heels in women can also cause a sprained ankle. If an ankle injury occurs, you need to determine the severity of the injury.

When the ligament apparatus is damaged, sharp pain appears, then swelling and hematoma. Increasing pain that does not go away for a long time, significant swelling of the injured joint is a reason to contact the trauma department to exclude fractures and cracks in the ankle bones. In case of ligament damage, a tight bandage or tape on the leg is recommended. Ice should be applied on the first day after the injury. Starting from the second day, you can begin physiotherapy, ankle massage, antiphlogistic drugs. For sprained ligaments, use:

• Indovazin;
• Lyoton;
• Troxevasin;
• Dolobene.

They are applied to the affected area with light massaging movements twice a day. Over time, the swelling decreases, the hematoma disappears. The ointment in each specific case is selected by the doctor, taking into account the characteristics of the injury and the patient's tendency to allergic reactions.

Ointments for stretching of knee ligaments

The ligamentous apparatus of the knee is injured in the case of excessive forced loads on the knee, as a result of which the ligaments stretch and can rupture.

Situations that may result in a sprain of the ligamentous apparatus of the knee joint:

• sports that require quick bending and unbending of the leg at the knee (long and high jumps, running, weightlifting, hockey, football, etc.);
• lifting heavy objects (loading and unloading operations, carrying heavy bags, suitcases);
• a sudden start of movement or a sharp stop (walking with a small child, walking a dog);
• falls on the kneecap or blows to the knee area.

Symptom complex that occurs when the knee ligaments are stretched:

• the appearance of bruising and hyperemia at the site of injury;
• limited joint mobility;
• crunching sensation when moving;
• severe pain when palpating the joint.

Pain-relieving ointments can be used immediately after an accurate diagnosis has been made (sprained knee ligaments), warming ointments can be used 2-3 days after the injury. To prevent the occurrence of persistent limitation of the joint's motor ability, the use of ointments must be combined with therapeutic exercises. The time when you can start doing rehabilitation exercises will be determined by a traumatologist. A set of exercises will be developed by a doctor in the physiotherapy department, taking into account individual characteristics and the nature of the injury.

The most commonly used treatments for knee sprains are:

• NPS (Indomethacin, Voltaren, Diclofenac);
• drugs containing steroid hormonal components (ointment with prednisolone, hydrocortisone);
• medicines containing terpene ketone, camphor, nicotinic acid and essential oils that have a warming and local irritating effect;
• products with a cooling effect (contain menthol and ethyl chloride);
• ointments with anesthetic effect (Ultrafastin);
• absorbent agents (containing heparin);
• ointment forms of drugs that strengthen blood vessels (Venoruton, Aescin, Troxevasin);
• combination drugs are some of the most effective (Diclobene, Nikoflex, Apizartron, Finalgon).

Ointments for shoulder sprains

The ligamentous apparatus of the shoulder is injured during intense sports activities, falls and heavy physical strain on the upper limbs.

Shoulder ligament sprains can occur with circular rotations, sharp and energetic arm swings, a strong blow to the shoulder area, or an unsuccessful fall on the arms or shoulder.

Symptoms accompanying a sprain of the ligamentous apparatus of the shoulder girdle are manifested by swelling and hyperemia of the shoulder area, the occurrence of severe pain during passive movements of the injured upper limb and during palpation of the joint, limited movement or pathological mobility of the shoulder joint, and the possible occurrence of hyperthermia of the patient's body.

Therapy carried out in case of a sprain begins with immobilization of the injured limb. An immobilization bandage (support) is applied for several days. The duration of wearing the bandage directly depends on the degree of injury. In case of loss of integrity of the ligaments or their minimal stretching, the traumatologist recommends a state of rest, cooling compresses, applying ice to the affected area for 20 minutes three to four times a day for the first two days. Of the modern drugs, the doctor can prescribe an ointment that relieves pain and swelling in the acute period, and then warming or combination drugs. Self-prescribing ointment drugs can lead to a deterioration in the patient's condition, therefore, before using the ointment, a doctor's consultation is necessary, since many of the drugs offered by the pharmaceutical industry, in addition to side effects, also have contraindications. After the acute period, they begin to restore the functionality of the damaged joint. Drugs that promote rapid restoration of the functionality of the shoulder ligaments are:

• Dolobene gel;
• Apizartron;
• Nikoflex
• Finalgon;
• Menovazin;
• Capsoderm;
• Viprosal;
• Alflutop gel.

Anti-inflammatory ointments for sprains

In case of injury, inflammation is caused by microcirculatory disorder in the trophic zone of ligament fibers. Regeneration of the ligament apparatus slows down. The process of restoration of joint functionality is extended. Inflammatory manifestations can be minimized by using various preparations in the form of ointment, gel, foam, aerosol. These preparations help to eliminate the negative consequences of ligament sprains (pain, swelling, inflammation), improve nutrition in the affected area and accelerate the process of restoration of the damaged ligament apparatus. The use of therapeutic anti-inflammatory ointments for injuries is recommended in order to exclude complications in the form of limited joint mobility.

Most often, ointment forms containing nonsteroidal anti-inflammatory drugs (NSAIDs) are used. Antiphlogistic ingredients of ointments block the synthesis of neural mediators, which are a response to damage due to trauma and cause pain irritation and swelling of various tissues. Active compounds contained in ointment preparations help reduce swelling and relieve pain at the site of injury. Anti-inflammatory ointments most often contain: ibuprofen (propionic acid derivative), aspirin (salicylic ester of acetic acid), indomethacin (indoleacetic acid derivative), ketoprofen (propionic acid derivative), voltaren (phenylacetic acid derivative).

[ 4 ]

Sports ointments for sprains

People who are professional athletes have a high risk of tendon and ligament injuries. Due to constant forced physical activity, the ligamentous apparatus of athletes is subject to chronic microdamage. In the center of microtrauma, the ligament fibers are replaced by connective tissue, which leads to a partial loss of elasticity by the ligamentous apparatus. Ligaments, compared to muscle tissue, are very poorly amenable to strengthening during numerous workouts. An imbalance occurs between the increased muscle strength and the strength of the ligaments and tendons. Significantly increased muscle potential begins to exceed the ability of the ligamentous apparatus to withstand stress. As a result, a potential danger of tendon or ligament injury develops. For complex closed tissue injuries, ligament sprains, bruises, etc.; diseases of the musculoskeletal system, as well as for preventive purposes, various ointments, creams, gels are used, the action of which is aimed at relieving pain, swelling, improving regeneration, tissue trophism. Such ointments may have a warming or cooling effect, an analgesic and anti-inflammatory effect. For sprains in athletes, the following ointments may be used:

An alcohol-based anesthetic liquid containing menthol, novocaine, and anesthesin compounds. It is used for local anesthesia for bruises, hematomas, and sprains. A small amount of liquid is applied to the damaged areas. Rub into the skin over the affected area with light massaging movements.

Apizartron ointment. The main active ingredient is bee venom. Additionally, the product contains mustard oil and methyl salicylate. The ointment has a warming effect. Due to this, metabolism and blood flow improve, and pain symptoms are reduced.

Butadion. It has an anti-inflammatory effect and is used to treat inflammation of soft tissues, ligaments, joints of traumatic origin, arthritis of rheumatic genesis, radiculitis, sciatica and lumbago.

Diclofenac. It is used for tendon and synovial membrane injuries, damage to the capsular-ligamentous apparatus, joint inflammation; it has a local analgesic effect (analogues - voltaren, orthofen).

Deep Relief. Contains the active ingredient ibuprofen. Used to reduce pain that occurs during rheumatoid arthritis, myalgia, and musculoskeletal injuries.

These ointments are intended to relieve pain symptoms, as well as to reduce swelling and hyperemia of soft tissues that occur with injuries associated with sports and forced physical exertion.

Ointments for children with sprains

A characteristic feature of childhood is activity, restlessness, emotionality. Children enjoy participating in active games. The result of such dynamic activity are injuries sustained during falls. Most often, in childhood, the ligamentous-muscular apparatus of the lower and upper extremities is damaged. Large joints (knee, ankle, elbow, shoulder) and small joints of the hands are subject to injury.

When ligaments are stretched or torn, severe and sharp pain occurs. The child begins to cry, scream and panic. Soft tissue swelling gradually increases. Redness and hematoma are observed at the site of injury. When ligaments of a large joint (ankle or knee) are stretched or torn, difficulties with movement arise. The child tries to spare his injured joint as much as possible. In situations where a fall has occurred, it is advisable for the child to be examined by a traumatologist or surgeon to rule out a bone fracture and prescribe further treatment tactics.

First aid if you suspect a sprain or ligament rupture.

It is necessary to calm the injured child and ensure maximum immobilization of the injured limb. Ice is applied to the resulting hematoma and the site of injury. At home, you can take any frozen product in a bag from the freezer and apply it to the affected area. To avoid frostbite, the ice is first wrapped in a cloth or towel. To reduce pain, the child can be given painkillers (paracetamol, ibuprofen). The joint is loosely fixed with an elastic bandage. A specialist consultation is required to exclude more serious diagnoses.

The treatment tactics are determined by the doctor depending on the results of the diagnostics. Treatment of ligament sprains is carried out for a week. In the acute stage, antiphlogistic drugs, tight bandages on the affected joint and ointments with an analgesic effect are prescribed. Dolobene (active ingredients - dexpanthenol, heparin), Traumeel gel (consists of plant components), Kapilar (based on resin) are used. For therapy of the acute period, the ointment is applied 4-5 times a day. In case of severe injury to the ligamentous apparatus, the child may need hospitalization. After the disappearance of severe pain symptoms and swelling, exercises are recommended that restore the functionality of the affected joint. Gymnastics must be performed in the exercise therapy room.

It is almost impossible to eliminate traumatic factors in childhood. It is necessary to constantly inform children about the rules of safe behavior, and also to control that physical activity is moderate.

Effective ointments for sprains

The most common type of injury is a sprain or rupture of the ligament apparatus during active sports, in transport, at work or at home. Sprains occur with traumatic loads on the shoulder, elbow, hip, knee and other large joints.

In case of ligament sprains, therapeutic treatment is carried out in the area of injury using ointment forms of medicines. Doctors recommend using ointments and gels sold in pharmacies. Ointment forms of drugs contain active compounds that have a therapeutic effect on the injured ligament apparatus. Ointments have the property of easily penetrating the skin and acting directly at the site of injury. The basis of ointments are fats of vegetable or animal origin.

The therapeutic effect of ointments is due to the presence of active medicinal ingredients in them. The most effective ointments for ligament damage are those that use non-steroidal antiphlogistic substances.

The effectiveness of using such ointments is due to the fact that active ingredients penetrate the skin and help reduce inflammation, swelling and pain. Ketoprofen, Diclofenac, Voltaren and other ointments prevent the aggravation of the above processes and stimulate faster healing of the ligamentous apparatus.

An ointment containing hormones used for ligament damage is considered quite effective. Its effectiveness is due to the presence of hormonal ingredients that relieve inflammation, reduce the permeability of vascular walls and prevent the formation of edema.

Ointments with a complex content of several drugs are produced, for example, non-steroidal antiphlogistic compounds are combined with an anesthetic or analgesic. Such ointments increase the effectiveness of complex therapy. There is no need to buy drugs of different pharmacological series. Most often, doctors recommend the use of effective ointments with a complex effect:

• Dolobene gel;
• Nikoflex;
• Finalgon;
• Capsoderm, etc.

In most cases, the use of ointment forms of drugs is convenient. Ointments are applied to the damaged joint carefully, without causing additional painful sensations. Creams, gels, ointments do not have significant contraindications, dangerous side effects and specific storage conditions. Ointments are intended for external use only. Despite the simplicity and ease of use, it is necessary to pay attention to the individual hypersensitivity of the patient to certain active components of the ointment drug. Before starting to use ointments for sprains, a doctor's advice and a thorough study of the instructions for use are required.

[ 5 ]