• Pain
• Lifestyle

What is the Best Painkiller for Knee Pain?

Knee pain can make everyday tasks, like walking or climbing stairs, feel almost impossible. 

Whether you're dealing with severe pain from an injury or ongoing discomfort from arthritis, finding the right way to relieve knee pain is key to getting back to your normal routine. 

In this article, we’ll explore simple and effective pain management techniques to help you reduce pain and regain control of your life.

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What Causes Pain in the Knee?

Before comparing pain meds, it’s important to understand the common causes of knee pain:

• Inflammation occurs when the body reacts to injury, illness like arthritis or gout, or long-term strain on a joint. Damaged cells release chemicals that trigger pain and swelling.

• Nerve pain results from compression or damage to the nerves, often felt as burning, tingling, or pins and needles.

• Mechanical pain comes from wear and tear on the joint or surrounding structures, which can lead to inflammation over time.

Understanding these causes will help you choose the right pain medication.

What are the Best Painkillers for Knee Pain?

When it comes to medication, it’s difficult to say which is the ‘best’ for joint pain relief. Painkillers and other drugs should be tailored to each individual’s specific condition and needs. 

For example, someone with severe knee pain may require treatment but still needs to remain functional at work. While an opioid might effectively relieve this type of pain, it could cause drowsiness, hindering their ability to perform. 

When choosing pain medication, the aim is to find one that relieves pain while still allowing you to function normally.

Over-the-counter (OTC) painkillers

In the U.S., a wide range of painkillers can be purchased without a prescription. However, opioid painkillers are not available over the counter due to their high risk of addiction and overdose.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These medications are commonly used to reduce inflammation and pain. They are typically taken after meals to minimize the risk of stomach irritation or ulcers, especially with long-term use. 

Certain NSAIDs, like aspirin, can also interfere with platelet function, leading to bleeding issues. Additionally, prolonged use of NSAIDs has been linked to an increased risk of cardiovascular and cerebrovascular events, such as heart attacks or strokes.

Oral NSAIDs

Oral NSAIDs are pain relievers taken by mouth. They work by blocking substances called prostaglandins, which cause pain.

Prostaglandins are made in the body when cells are damaged. NSAIDs stop this process, helping to reduce pain.

There are two types of proteins involved in this process: 

• COX-1, which helps with blood clotting and protects the stomach lining, and 

• COX-2, which causes pain. 

Most over-the-counter NSAIDs block both COX-1 and COX-2, which can lead to side effects like stomach irritation or even gastrointestinal bleeding.

Examples of common OTC NSAIDs that block both COX-1 and COX-2 include:

• Naproxen sodium (Aleve)

• Aspirin 

• Ibuprofen (Advil) and diclofenac (Voltaren)

Topical NSAIDs

Topical NSAIDs come in the form of gels, liquids, or patches that are applied to the skin to provide pain relief in a specific area, such as the knees. 

They work in the same way as oral NSAIDs by reducing inflammation but are applied directly to the affected area. 

Because they are absorbed through the skin, they still enter the bloodstream and carry similar risks, such as stomach irritation or bleeding. 

A commonly used OTC topical NSAID is Voltaren, which is often recommended for knee arthritis.

Acetaminophen

Acetaminophen (Tylenol) is a popular OTC pain reliever that helps manage mild to moderate pain. 

When combined with stronger painkillers, such as NSAIDs or opioids, it can be particularly effective in reducing knee pain and inflammation associated with joint issues.

Prescription painkillers

These medications are typically reserved for cases where pain isn't relieved by over-the-counter options or when knee pain is due to a more complex underlying medical condition. Your doctor may prescribe these medications for joint pain relief at their discretion.

Stronger NSAIDs

Some NSAIDs specifically target COX-2 proteins, making them less likely to cause stomach issues. However, they have been associated with an increased risk of heart attacks and strokes. 

COX-2 selective NSAIDs, along with other prescription-strength NSAIDs, offer stronger relief for knee pain. In the U.S., the only available selective COX-2 inhibitor is celecoxib (Celebrex).

Opioids

Opioids are medications that affect nerves in the body, including the brain and spinal cord. 

In the brain, they activate reward pathways, causing feelings of pleasure. Opioids attach to certain receptors — mu, kappa, and delta — which become less sensitive over time, reducing pain signals and providing relief. 

Common examples of opioids include:

• Tylenol with codeine

• Hydrocodone (Vicodin)

• Tramadol

• Oxycodone (Oxycontin)

• Morphine

• Fentanyl

Corticosteroids

Steroids are powerful anti-inflammatory drugs that help reduce swelling and, in turn, alleviate pain. They are commonly injected directly into the knee joint, offering relief that can last anywhere from a few weeks to several months. 

Steroid injections can be used to treat various types of knee pain, including both mechanical and inflammatory conditions. 

Since steroids don't provide immediate relief, a local anesthetic is often administered alongside the injection for quick, short-term pain relief.

Disease-modifying antirheumatic drugs (DMARDs)

These drugs are not painkillers but medications designed to reduce inflammation linked to serious inflammatory arthritis conditions, such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. 

This medication works by suppressing or changing immune responses that cause inflammation and harm to the body.

When Should You Not Be Using Painkillers for Knee Pain?

Although painkillers are effective in managing knee pain, several other approaches can provide relief. Depending on your condition, your doctor may suggest one or more of the following treatments instead of pain medication:

Physical therapy

Physical therapy is an effective conservative approach to managing knee pain, including arthritis pain and chronic pain. 

Unless the knee issue is severe and requires surgery, physical therapy can provide significant relief. 

A physical therapist will work to reduce strain on your knees by strengthening the surrounding muscles, improving stability, and giving the joints some rest.

They may also focus on increasing flexibility to reduce muscle spasms and alleviate discomfort associated with knee pain.

Weight management

Excess weight can have a negative impact on your hips and knees, contributing to chronic pain. Being overweight places extra pressure on these joints, leading to strain and further stress on the knee joints. 

If weight is a concern, consider asking your physical therapist about hydrotherapy sessions. The buoyancy of water helps reduce the load on your joints while allowing you to perform exercises, offering relief without the need for additional pain medications.

Hot and cold therapy 

Hot and cold therapy can be highly effective for managing knee pain. Applying a cold compress to the painful area helps reduce pain, swelling, and inflammation, especially after activity or injury.

Cold therapy reduces swelling by constricting blood vessels and limiting blood flow to the affected area.

Using a heat pack also helps relax tight muscles, ease muscle tension, and reduce spasms around the knee. Heat therapy increases blood flow, promoting healing and providing soothing comfort for chronic pain. 

Alternating between hot and cold therapy can be a powerful way to relieve pain and improve mobility without relying heavily on pain medications.

Bracing or orthotics

Knee braces are a helpful tool to provide short-term support and stability to the joint, especially when trying to relieve joint pain. 

Soft knee guards, which can be found at your local drugstore, offer mild support and are useful for managing minor discomfort. 

For more severe joint injuries that require stronger stabilization, healthcare providers may recommend more rigid braces that offer greater protection and support. 

These braces help relieve joint pain by reducing pressure on the knee and limiting movement to prevent further injury during the healing process.

Massage therapy

Deep tissue release and massage can be highly effective for alleviating muscle tension, knots, and spasms that may be contributing to knee pain. 

By increasing blood flow to the affected area, massage therapy helps reduce inflammation and promote relaxation in the surrounding muscles. 

Regular massage sessions can enhance your flexibility and provide significant knee pain relief, especially when combined with other treatments like physical therapy or hot and cold therapy. 

This natural approach can help manage chronic pain and improve overall joint function.

Lifestyle modifications

Staying physically active is essential, even when dealing with knee pain. You can simply adjust your regular activities to suit your knees — focus on what you can do without putting extra strain on the joint.

Modifying your daily activities is also vital. Take steps to reduce the load on your joints by avoiding heavy lifting, high-impact sports, and excessive use of stairs.

When Should I See a Doctor for Knee Pain?

If you experience any of the following, schedule an appointment with your doctor:

• Your pain is unbearable, even after using OTC pain medication

• You have a serious injury to the knee

• You can’t put weight on your knee

• Your knee pain is accompanied by redness, swelling, fever, and severe discomfort, which may indicate septic arthritis, which is a medical emergency

Where Can I Learn More About Managing Knee Pain?

If you're finding it difficult to manage knee pain, LifeMD offers expert guidance on effective pain relief options.

Schedule an appointment with LifeMD and start your journey to better well-being, all from the comfort of your home.

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