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Ointments for muscle strains
Last reviewed: 03.07.2025
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In order to choose an effective ointment for muscle strain, it is necessary to take into account that the external agent should relieve pain, remove swelling of soft tissues above the site of strain, prevent or stop the inflammatory process. As a result, a truly effective ointment will help injured muscle fibers return to normal.
Release form
The names of ointments for muscle strains included in the review (names of different manufacturers are given in brackets) are grouped both by their mechanism of action (warming) and by the main therapeutic effect (painkillers and anti-inflammatory). However, it should be borne in mind that the components of drugs with different pharmacodynamics can provide a combined effect: warming ointments and anti-inflammatory ointments based on NSAIDs are simultaneously painkillers.
Warming ointments for muscle strains: Efkamon, Kapsikam, Espole, Nikoflex, Finalgon.
Pain-relieving ointments for muscle strains: Bom-Bengue (Bengay), Ketoprofen (Ketonal, Fastum-gel, Febrofid, Flexen, etc.), Heparin ointment. Also included here are the above-listed warming (locally irritating) agents with analgesic properties.
Anti-inflammatory ointments for stretching: Ibuprofen (Dolgit, Deep Relief, Brufen), Diclofenac (Diclak-gel, Diclovit, Dicloran, Voltaren emulgel, etc.), Nimesulide (Nimulide, Remisid).
For those who prefer Chinese ointments for stretch marks, it is worth noting such products as Tiger Balm and Zheng Gu Shui.
As for such a concept as sports ointment for sprains, among the pharmacological agents of this group there is no “special” ointment intended exclusively for athletes.
Vishnevsky ointment (Vishnevsky liniment) is not used for muscle strains, since this ointment is antiseptic and is used for purulent wounds, abscesses and ulcers of the skin and superficial soft tissues.
Pharmacodynamics
The pharmacodynamics of warming and pain-relieving ointments depend on the ingredients they contain. Efkamon ointment contains clove and mustard oils, camphor, bitter pepper extract (containing the alkaloid capsaicin), menthol, and methyl salicylate. The active ingredients of Bom-Benge ointment are methyl salicylate and menthol.
The ointment for muscle strain Kapsikam contains camphor, benzyl nicotinate, vanillyl nonamide (a synthetic analogue of capsaicin) and turpentine oil (turpentine). The main ingredient of the ointment Espol is capsaicin, which is also contained in the ointment Nikoflex (enhanced by the derivative of nicotinic acid ethyl nicotinate). And the mechanism of action of the drug Finalgon is provided by synthetic capsaicin (vanillyl nonamide) and a derivative of nicotinic acid in the form of butoxyethyl ether, which causes the effect of hypersensitization of epidermal cells. Benzyl nicotinate is an antispasmodic substance that reduces vascular and muscle tone.
Menthol and camphor stimulate cutaneous receptors of peripheral nerve fibers, which leads to a reflex response in the form of release of mediators that expand capillaries, i.e. blood circulation in damaged tissues is activated. Camphor narrows capillaries and irritates cutaneous thermoreceptors of sympathetic nerve endings, diverting neurotransmitters from pain receptors.
When capsaicin chemically interacts with TRPV1 sensory neurons in the skin, they are depolarized and a signal is transmitted via TRP ion channels about a local increase in temperature, which causes a burning sensation and a reflex rush of blood to the skin capillaries to reduce it.
Methyl salicylate (methyl ester of salicylic acid) has a local irritant effect on skin receptors and, like NSAIDs, has an anti-inflammatory effect by indirectly suppressing the expression of the COX enzyme.
Heparin ointment contains sodium heparin, which acts as an anti-edematous and anti-inflammatory agent, as well as the analgesic substance benzocaine (anesthesin).
Pain-relieving and anti-inflammatory ointments for muscle strains Ketoprofen (Fastum-gel, etc.), Ibuprofen (Deep Relief, etc.), Diclofenac (Diclak-gel, etc.), Nimesulide contain non-steroidal anti-inflammatory substances - derivatives of propionic acid (ketoprofen), phenylpropionic acid (ibuprofen), alpha-toluic acid (diclofenac sodium), para-aminobenzosulfanilic acid (nimesulide).
Their pharmacodynamics consist of inhibiting COX enzymes, which participate in the synthesis of inflammatory reaction mediators (prostaglandins). The analgesic effect of NSAID-based ointments is provided by reducing the pressure on the intra-tissue nerve endings due to a reduction in the volume of intercellular exudate in tissues damaged by stretching. And nimesulide relieves pain by suppressing the activity of mast cells, as well as by affecting the cytoplasmic receptors of steroid hormones.
Chinese ointments for stretch marks Tiger Balm and Zheng Gu Shui help reduce pain and swelling due to the presence of camphor, menthol, as well as various plant extracts and essential oils in their composition.
Pharmacokinetics
The pharmacokinetics of the ointments Efkamon, Kapsikam, Espol, Nikoflex, Finalgon, Heparin ointment are not presented in the instructions. And the manufacturers of the ointment Bom-benge report that the active substances of this product do not enter the systemic bloodstream.
Non-steroidal anti-inflammatory substances of ointments Ketoprofen (Ketonal, Fastum-gel, etc.), Ibuprofen (Deep Relief, etc.), Diclofenac (Diclak-gel, Voltaren emulgel, etc.), Nimesulide penetrate the skin well, but are absorbed into the blood in small amounts: no more than 5-6% of the amount entering the systemic bloodstream with oral administration of NSAIDs. For this reason, the nature of the metabolism of these agents in the form of ointments (and gels) is not considered in the official instructions.
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Dosing and administration
All ointments for muscle strains are applied locally, by applying to the skin. It should be borne in mind that ointments containing menthol, camphor or hot pepper extract are not recommended to be rubbed into the skin.
Ointments Efkamon, Kapsikam, Espole, Nikoflex, Bom-benge, Heparin ointment should be applied two to three times a day, 1-3 g each, a bandage may be applied.
Finalgon ointment is supplied with an applicator, on which no more than 1.5 g of the preparation is squeezed out and applied to the skin, lightly rubbing into the painful area. It is permissible to use the ointment a maximum of three times a day, the duration of use is 8-10 days.
When applied, ointments containing NSAIDs are lightly rubbed into the skin (use no more than three times a day); applying a bandage is not recommended.
The instructions for most ointments indicate that there have been no reports of consequences from overdosing, or that overdosing is virtually impossible.
Use of ointments for sprained muscles during pregnancy
Camphor-containing ointments Efkamon and Kapsikam, as well as Chinese ointments for stretching during pregnancy are prohibited. Ointments containing capsaicin or its analogue vanillyl nonamide (Nikoflex, Espole, Finalgon) are contraindicated for pregnant and lactating women.
As follows from the official instructions, Heparin ointment and Bom-Benge ointment can be used during pregnancy if prescribed by a doctor. Although it is known that methyl salicylate (like all salicylates) is not recommended for use during pregnancy.
Ointments for muscle strains based on non-steroidal anti-inflammatory drugs should not be used by pregnant women.
Contraindications
The indicated contraindications for the use of Efkamon, Espol, Nikoflex, Bom-Benge and Finalgon ointments are the presence of: hypersensitivity to these drugs, inflammatory dermatological diseases and any damage to the skin.
Ointments with turpentine (Capsicam) should not be used in case of structural disorders of the liver and kidney parenchyma.
The ointment for muscle strains Bom-Benge is contraindicated for children under 12 years of age.
Heparin ointment should not be used in case of skin damage, poor blood clotting or the presence of hematomas at the site of muscle strain.
Ointments containing NSAIDs (ketoprofen, ibuprofen, diclofenac, nimesulide) are not used in cases of hypersensitivity to aspirin and any NSAIDs, in cases of bronchial asthma in the anamnesis, in cases of skin damage, and in children under 6 years of age.
Manufacturers of Chinese ointments did not provide any information regarding contraindications, although, based on their components, one can conclude that these products are not suitable for use in cases of skin diseases and injuries.
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Side effects of ointments for sprained muscles
Ointments for muscle strains can have the following side effects:
Efkamon, Kapsikam, Nikoflex, Espole, Finalgon, Heparin ointment - skin allergic reactions at the site of application of the drugs, possible development of angioedema.
Ketoprofen, Ibuprofen, Diclofenac, Nimesulide ointments - urticaria, subcutaneous hemorrhages from subcutaneous capillaries, abnormal hyperemia of the skin. Systemic side effects such as nausea, headache, edema, increased blood pressure, intestinal disorders are rare.
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Interactions with other drugs
Systemic absorption of the active ingredients of these topical agents is insignificant, so interactions with other drugs are considered unlikely. However, any of the listed ointments should not be used simultaneously with another topical agent on the same site.
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Storage conditions
It is recommended to store ointments for muscle strains in a cool place, protected from heat and light sources, at a temperature of up to +18°C. Ointments with NSAIDs require a temperature of +15-25°C, Heparin ointment is stored at +12-15°C.
Attention!
To simplify the perception of information, this instruction for use of the drug "Ointments for muscle strains" 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.