Medication For Knee Pain | How To Choose The Right Drug?

Written By on July 25, 2022 — Medically Reviewed By Mitch Torres (PT)

person taking some medications

Achy joints are caused by a host of different things and popping random pills may not be beneficial. You need to know what’s causing the problem to know what medication for knee pain will help you the most.

Now, common drugs for knee pain are either pain-relievers or anti-inflammatories. Supplements are a more natural route, as some of them can promote joint health.

We’ll discuss each one of these medications, and which knee problems can benefit from them. Here’s a list of what we will cover, tap on the bullets below to jump to the sections:

Medications according to the disease

Arthritis

Arthritis is the inflammation of the joint and one of the most common causes of pain. There are many types, but the ones that are most likely to cause severe knee pain are (1, 2, 3):

Osteoarthritis

Knee osteoarthritis is the wear and tear of the cartilage in that joint. It has a high risk of causing chronic pain.

There are several medications recommended to treat knee osteoarthritis. Acetaminophen is one of them because it has minimal side effects. It’s generally preferred for mild to moderate pain, but guidelines recommend using NSAIDs as they are more effective. (3)

For severe symptoms, there are stronger medications available, usually injected corticosteroids. These provide short-term pain relief and can improve your joint function, but may speed up the degeneration if used repeatedly. (3)

Your healthcare provider may prescribe opioids if you cannot tolerate first-line medications or have diseases in which these drugs are contraindicated. Even though they improve pain and joint function, their usefulness is limited in the long run. (3)

Learn more: 11 medications for knee osteoarthritis.

Rheumatoid arthritis (RA)

This is an autoimmune condition that affects many joints. The throbbing pain usually starts in the small joints of the hands. There’s also swelling and stiffness, especially in the mornings and after a period of inactivity. (2)

Over-the-counter NSAIDs may provide relief in mild RA. But if these drugs don’t help you, your doctor may prescribe disease-modifying antirheumatic drugs (DMARDs). This is to prevent the further progression of the disease. (2)

Gout

In gout, sodium urate crystals accumulate in the knee. This leads to red, hot, painful, and swollen joints. (1)

Oral medications prescribed for acute gout are NSAIDs, corticosteroids, and colchicine. For severe cases, your doctor may recommend injecting cortisone or an interleukin-1 antagonist (eg. canakinumab) can also be used. (4)

Chronic knee pain due to gout can be relieved by xanthine oxidase inhibitors like allopurinol, and febuxostat. Other commonly used medications are (4):

  • Uricosuric agents – probenecid, benzbromarone.
  • Selective inhibitor of URAT1 transporter – lesinurad.
  • Pegloticase.

Traumatic knee injury

someone with a bruised knee

Knee pain may be a result of injuries like a sprained ligament or a torn meniscus. Both can cause a popping feeling at the moment of injury, as well as swelling of varying degrees.

Now, mild to moderate knee pain from an injury can be relieved by acetaminophen and over-the-counter NSAIDs like aspirin, ibuprofen, and naproxen. (5)

However, keep in mind that most injuries won’t improve with medication alone, regardless of their severity. Please go to the doctor to determine if you need physical therapy or other treatment strategies.

Tendonitis

NSAIDs may provide some pain relief in the early stages of tendonitis. Corticosteroids may help as well but in chronic stages. (6)

And as with other knee injuries, you’ll need other treatments to manage tendonitis and fully recover.

Bursitis

A vast majority of knee aches due to bursitis will heal on their own. Nevertheless, for pain relief, acetaminophen and NSAIDs are preferred. Corticosteroid injections, sometimes with a local anesthetic, may also ease the symptoms. (7)

But if it’s septic bursitis, you’ll need antibiotics to get rid of the infection.

This can help: 7 best treatments for knee bursitis.

Patellofemoral pain syndrome (PFPS)

Also known as runner’s knee, this condition is a broad term used to describe anterior knee pain. It’s more common in people who practice running or jumping sports. The pain is mild to moderate in severity and occurs after prolonged periods of sitting. (1)

PFPS is usually relieved by rest. If needed, you can take over-the-counter analgesics, such as acetaminophen. For continued pain, prescription NSAIDs may be required. (8)

Baker’s cyst

condition is also known as a popliteal cyst

This condition is also known as a popliteal cyst. Here, the pain comes on slowly and has a mild to moderate intensity. (1)

The pain and swelling associated with a Baker’s cyst can be relieved with acetaminophen and over-the-counter or prescription NSAIDs. But for advanced diseases, your doctor may recommend a cortisone injection. (9)

Medications according to the desired effects

Apart from the cause of knee pain, you also want to know the effect you’re looking for:

To relieve pain

Acetaminophen

Acetaminophen is an analgesic drug used to relieve mild to medium-intensity joint aches. It can also be used to treat moderate to severe pain when used along with opiates. (10)

Conditions that may benefit from acetaminophen include (11):

  • Mild to moderate knee pain in osteoarthritis.
  • Knee injuries.
  • Bursitis.
  • Runner’s knee.
  • Baker’s knee.

Because acetaminophen does not control inflammation, it is less effective for rheumatoid arthritis and other inflammatory conditions.

Opioid analgesics

Also called narcotics, opioids provide relief by changing the brain’s perception of pain. They are used to treat moderate to severe pain. (12)

Chronic knee pain may benefit from opioids. But a huge drawback is that these medications have a very high risk of overuse, overprescription, and misuse. This is why it’s best to avoid them when possible. (12)

To manage inflammation

Steroids

Corticosteroids or steroids reduce inflammation and suppress the immune system. This in turn helps ease symptoms such as pain swelling and stiffness. They can be taken in the form of pills or injections. (13)

Conditions that benefit from oral and injectable steroids tend to have a chronic component, like knee osteoarthritis, rheumatoid arthritis, or gout.

NSAIDs

NSAIDs are drugs that block a specific group of enzymes called cyclo-oxygenase (or COX). They may further be grouped according to their preference for COX-1 and COX-2 enzymes. (14, 15)

They are available as over-the-counter (OTC) or prescription medication. Both will help with pain, but prescription NSAIDs are stronger, and thus more likely to help with inflammation. (14)

Most knee problems benefit from NSAIDs. The ones available over the counter include:

  • Aspirin.
  • Ibuprofen.
  • Naproxen.

NSAIDs available only with a doctor’s prescription are (14):

  • Diclofenac.
  • Celecoxib.
  • Indomethacin.
  • Fenoprofen.

Medications that alter immune responses

Disease-modifying antirheumatic drugs (DMARDs) work by depressing your immune system. As such, they are mainly used for autoimmune diseases like (2, 15):

  • Rheumatoid arthritis.
  • Psoriatic arthritis.
  • Ankylosing spondylitis.
  • Systemic lupus erythematosus.

General joint health

Maybe you don’t have major knee problems, but want to prevent them from happening. In this case, certain supplements may help. Some can protect the cartilage from degenerating, while others fight free radicals. (16)

Common supplements to promote knee health include (16):

Check this out: Top supplements for knee pain – the ultimate list.

Other medications – Injectables

Sometimes oral medications may not help ease symptoms. In such cases, medications can be directly injected into the joints.

Some common injectable medications are:

Hyaluronic acid

It may reduce pain caused by osteoarthritis by providing better lubrication and shock absorption. It may also reduce inflammation and friction in the joints, thereby easing stiffness.

Hyaluronic acid is also linked to the prevention of bones and cartilage loss. (17)

Local anesthetics

Injection of local anesthetics like lidocaine can help reduce the intensity of pain. They are also associated with anti-inflammatory activity. Sometimes they are injected into the joints before a steroid injection to ease the discomfort.

Lidocaine provides short-term and immediate pain relief. But the effects wear off after a few hours, so it may not be suitable for chronic painful conditions. (18)

Botox

These use a bacterial toxin called onabotulinumtoxinA. The injection temporarily prevents the muscle from moving. Limited research on botox shows it may be helpful in chronic pain due to knee osteoarthritis. (19)

At-home remedies for knee pain

Before taking anything, it’s best to try some home remedies. These are safe and can be extremely effective:

Try this out: Top home remedies for knee pain.

FAQs

What is the best medication for knee pain?

This depends on the cause of knee pain, but NSAIDs help in most cases.

Can you prevent knee pain?

You can’t prevent knee pain 100%, but you can reduce your risk of having it by keeping a healthy weight, exercising, and making healthy lifestyle choices.

Conclusion: Medication to relieve knee pain

The best medication for knee joint pain will depend on the cause and the intensity of your symptoms. Some people may find relief with simple analgesics like Tylenol, or NSAIDs like ibuprofen.

For more serious conditions, doctors prescribe stronger medications or injected drugs.

Finding the right medication is crucial as knee pain can be distressing. Schedule an appointment with your physical therapist if it persists or worsens.

Resources

  1. Calmbach, Walter L, and Mark Hutchens. “Evaluation of patients presenting with knee pain: Part II. Differential diagnosis.” American family physician vol. 68,5 (2003): 917-22.
  2. Chauhan K, Jandu JS, Goyal A, et al. Rheumatoid Arthritis. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  3. Yu, Shirley P, and David J Hunter. “Managing osteoarthritis.” Australian prescriber vol. 38,4 (2015): 115-9.
  4. Engel, Bettina et al. “Treatment Options for Gout.” Deutsches Arzteblatt international vol. 114,13 (2017): 215-222.
  5. Evans J, Nielson Jl. Anterior Cruciate Ligament Knee Injuries. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  6. Almekinders, L C, and J D Temple. “Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature.” Medicine and science in sports and exercise vol. 30,8 (1998): 1183-90.
  7. Williams CH, Jamal Z, Sternard BT. Bursitis. [Updated 2022 May 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  8. Gaitonde, David Y et al. “Patellofemoral Pain Syndrome.” American family physician vol. 99,2 (2019): 88-94.
  9. Leib AD, Roshan A, Foris LA, et al. Baker’s Cyst. [Updated 2022 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  10. “Acetaminophen.” Drugs.Com.
  11. Painkillers for rheumatoid arthritis. [Updated 2020 May 20]. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.
  12. “Narcotic Analgesics.” Drugs.Com.
  13. “Glucocorticoids.” Drugs.Com.
  14. “Nonsteroidal Anti-Inflammatory Drugs.” Drugs.Com.
  15. Benjamin O, Goyal A, Lappin SL. Disease-Modifying Anti-Rheumatic Drugs (DMARD) [Updated 2021 Jul 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
  16. Liu, Xiaoqian et al. “Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.” British journal of sports medicine vol. 52,3 (2018): 167-175.
  17. Rutjes, Anne W S et al. “Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis.” Annals of internal medicine vol. 157,3 (2012): 180-91.
  18. Eker, H Evren et al. “The efficacy of intra-articular lidocaine administration in chronic knee pain due to osteoarthritis: A randomized, double-blind, controlled study.” Anaesthesia, critical care & pain medicine vol. 36,2 (2017): 109-114.
  19. Hsieh, Lin-Fen et al. “Effects of Botulinum Toxin Landmark-Guided Intra-articular Injection in Subjects With Knee Osteoarthritis.” PM & R : the journal of injury, function, and rehabilitation vol. 8,12 (2016): 1127-1135.

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Author
Sony Sherpa (MD)
Sony Sherpa is a board-certified clinical doctor and currently, she is working as a medical officer in the emergency department of a renowned hospital. With a medical degree completed at a young age, she writes medical articles with accuracy owing to her medical knowledge and thorough background research.

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