Ointments for stretching muscles

In order to choose an effective ointment when stretching the muscles, it must be taken into account that the external application should relieve the pain, remove swelling of the soft tissues over the stretch site, prevent or stop the inflammatory process. In the end, a truly effective ointment will help the injured muscle fibers return to their normal state.

[1], [2], [3]

Indications of the ointments when stretching the muscles

Carefully study the indications for the use of ointments offered in pharmacies, because they differ in their composition and therapeutic effects.

[4], [5], [6]

Release form

Included in the review of the names of ointments when stretching the muscles (in parentheses are the names of different manufacturers) are grouped according to the mechanism of their effect (warming up), and 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.

Heating ointments with stretching of muscles: Efkamon, Kapsikam, Espol, Nikofleks, Finalgon.

Anaesthetising ointments when stretching muscles: Bom-benge (Bengey), Ketoprofen (Ketonal, Fastum-gel, Phybofide, Flexen, etc.), Heparin ointment. Also included here are the analgesic properties listed above, warming up (locally irritating) remedies.

Anti-inflammatory ointments when stretched: Ibuprofen (Dolgit, Deep Relief, Brufen), Diclofenac (Diklak-gel, Diklovit, Diclouran, Voltaren emulgel, etc.), Nimesulid (Nimulid, Remisid).

For those who prefer Chinese ointments when stretching, it should be noted such tools as Tiger Balm (Tiger Balm) and Zheng Gu Shui (Zheng gu-shui).

With regard to such a thing as a sports ointment from stretching, then among the pharmacological agents of this group there is no "special" ointment intended solely for athletes.

A Vishnevsky ointment (Vishnevsky liniment) with stretching muscles is not used, because this ointment is antiseptic, and it is used for purulent wounds, abscesses and skin ulcers and superficial soft tissues.

[7], [8]

Pharmacodynamics

Pharmacodynamics of warming and anesthetic ointments depends on the ingredients in their composition. Efkamon ointment contains clove and mustard oil, camphor, bitter pepper extract (containing alkaloid capsaicin), menthol, methyl salicylate. Active substances of Bom-Benge ointment are methyl salicylate and menthol.

Ointment when stretching muscles Capsicum contains camphor, benzilnicotinate, vanillononamide (synthetic analog capsaicin) and turpentine oil (turpentine). The main ingredient of the Espoo ointment is capsaicin, which is also contained in the Nikoflex ointment (reinforced with the nicotinic acid derivative ethylnicotinate). A mechanism of action of the preparation Finalgon provides synthetic capsaicin (vanillylnonamide) and a nicotinic acid derivative 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 the cutaneous receptors of peripheral nerve fibers, which leads to a reflex response in the form of release of mediators that dilate capillaries, that is, blood circulation in damaged tissues is activated. Camphor narrows the capillaries and irritates the cutaneous thermoreceptors of the sympathetic nerve endings, distracting the neurotransmitters from the pain receptors.

When chemical interaction of capsaicin with sensory neurons of the skin type TRPV1 occurs, they are depolarized, and a signal about local increase in temperature is transmitted along the TRP-ion channels, causing a burning sensation and a reflex rush of blood to the capillaries of the skin to reduce it.

Methyl salicylate (methyl ester of salicylic acid) exerts a local irritant effect on the skin receptors, and, as NSAIDs, it acts anti-inflammatory - by indirect suppression of the expression of the enzyme COX.

Heparin ointment contains sodium heparin, which acts as a decongestant and anti-inflammatory agent, as well as analgesic benzocaine (anesthesin).

Analgesic and anti-inflammatory ointments when stretching the muscles Ketoprofen (Fastum-gel, etc.), Ibuprofen (Dip Rilif and others), Diclofenac (Diklak-gel, etc.), Nimesulide contain non-steroidal anti-inflammatory substances - derivatives of propionic acid (ketoprofen), phenylpropionic acid (ibuprofen), alpha-toluic acid (diclofenac sodium), para-aminobenzosulphanyl acid (nimesulide).

Their pharmacodynamics is the inhibition of COX enzymes, which are involved in the synthesis of mediators of the inflammatory reaction (prostaglandins). Anesthetic effects of ointments based on NSAIDs are provided by lowering the pressure on the interstitial nerve endings due to a reduction in the volume of intercellular exudate in damaged tissues. And nimesulide relieves pain by suppressing the activity of mast cells, as well as affecting the cytoplasmic receptors of steroid hormones.

Chinese ointments when stretching Tiger Balm and Zheng gu-shui help reduce pain and swelling due to the presence of camphor, menthol, and various plant extracts and essential oils in their composition.

[9], [10], [11], [12]

Pharmacokinetics

Pharmacokinetics ointments Efkamon, Kapsikam, Espol, Nikofleks, Finalgon, Heparin ointment in the instructions are not presented. And manufacturers of ointment Bom-benge report that the active substances of this drug in the systemic blood stream do not fall.

The non-steroidal anti-inflammatory substances of ointments Ketoprofen (Ketonal, Fastum-gel, etc.), Ibuprofen (Dip Rilif, etc.), Diclofenac (Diclac gel, Voltaren emulgel, etc.), Nimesulide penetrate well into the skin, but are absorbed into the blood in insignificant volumes: no more than 5-6% of the amount falling into the systemic circulation during oral administration of NSAIDs. For this reason, the nature of the metabolism of these agents in the form of ointments (and gels) in official instructions is not considered.

[13], [14]

Use of the ointments when stretching the muscles during pregnancy

Containing camphor ointments Efkamon and Capsicum, as well as Chinese ointments during stretching during pregnancy, is prohibited. Ointments that contain capsaicin or its analogue vanillononamide (Nikofleks, Espol, Finalang) are contraindicated in pregnant and lactating women.

As follows from official instructions, Heparin ointment and Bom-Benge ointment can be used during pregnancy if they are prescribed by a doctor. Although it is known that in pregnancy, methyl salicylate (like all salicylates) is not recommended.

Ointments when stretching muscles based on non-steroidal anti-inflammatory drugs to pregnant women can not be used.

Contraindications

These contraindications for the use of Efkamon, Espol, Nikofleks, Bom-Benge and Finalgon ointments are available: hypersensitivity to these drugs, inflammatory dermatological diseases and any skin damage.

Ointments with turpentine (Capsicum) should not be used for structural disorders of the liver and kidney parenchyma.

Ointment when stretching muscles Bom-Benge is contraindicated in children under 12 years old.

Heparin ointment can not be used for skin lesions, as well as for poor blood clotting and the presence of hematomas at the site of muscle strain.

Ointments containing NSAIDs (ketoprofen, ibuprofen, diclofenac, nimesulide) are not used with hypersensitivity to aspirin and any NSAIDs, with a history of bronchial asthma, skin lesions, and children under 6 years of age.

Manufacturers of Chinese ointments did not provide information on contraindications, although, based on their components, it can be concluded that the use of these remedies for skin diseases and injuries is inadmissible.

[15], [16], [17]

Side effects of the ointments when stretching the muscles

Ointments when stretching the muscles can have the following side effects:

Efkamon, Kapsikam, Nikofleks, Espol, Finalgon, Heparin ointment - skin allergic reactions at the site of application of drugs, angioedema may develop.

Ointments Ketoprofen, Ibuprofen, Diclofenac, Nimesulide - urticaria, subcutaneous effusions of blood from the subcutaneous capillaries, abnormal skin hyperemia. Such systemic side effects as nausea, headache, swelling, increased blood pressure, intestinal disorders, are rare.

[18], [19], [20], [21]

Dosing and administration

All ointments when stretching the muscles are applied topically, by applying to the skin. It should be borne in mind that ointments containing menthol, camphor or bitter pepper extract should not be rubbed into the skin.

Ointments Efkamon, Capsicum, Espol, Nikofleks, Bom-benge, Heparin ointment should be applied two to three times a day for 1-3 g, a bandage can be applied.

Finalgon ointment is supplied with an applicator, to which not more than 1.5 g of the drug is squeezed out and applied to the skin, gently rubbing into a painful place. It is permissible to apply the ointment for a maximum of three times during the day, the duration of use is 8-10 days.

Ointments with NSAIDs when applied easily rubbed into the skin (apply no more than three times a day), the application of the dressing is not recommended.

In the instructions to most ointments it is indicated that there were no reports of the consequences of exceeding the dose, or that their overdose is practically impossible.

[22], [23], [24], [25], [26]

Interactions with other drugs

Systemic absorption of active substances of these topical agents is negligible, so interactions with other drugs are considered unlikely. However, do not use any of these ointments at the same time as another external product at the same place.

[27], [28], [29], [30]

Storage conditions

Ointments when stretching the muscles should be stored in a cool place, protected from heat and light sources, at temperatures up to + 18 ° C. Ointments with NSAIDs require a temperature of + 15-25 ° C, Heparin ointment is stored at + 12-15 ° C.

[31], [32]

Shelf life

The shelf life of the ointments is indicated by the manufacturers on the packaging of the preparations.

[33], [34]