Best Anti-inflammatory Medications for Knee Pain

Knee pain can result from many conditions, including osteoarthritis, tendonitis, and sprains. These conditions can range in severity from a minor annoyance to disabling pain. Here are the best anti-inflammatory medications to help you obtain relief.

Key takeaways:
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    NSAIDs are the most effective anti-inflammatory medication for knee pain.
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    Diclofenac is considered the most effective NSAID for pain relief.
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    Glucosamine-chondroitin, turmeric, fish oil, and Vitamin E have anti-inflammatory properties and have been shown to help with chronic knee pain.
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    Glucosamine-chondroitin, turmeric, fish oil, and Vitamin E can take weeks to months to produce an effect and thus are not recommended for acute knee pain.
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    It is important to talk with your doctor before starting any new medication or supplement.

What are anti-inflammatory medications?

Anti-inflammatory medications inhibit specific enzymes in the body to help reduce the production of molecules that produce inflammation. These medications are typically the best at relieving discomfort and pain, allowing you to return to your routine quickly.

The best anti-inflammatory medications available belong to the class of drugs known as non-steroidal anti-inflammatory medications (NSAIDs). Other treatment options include natural anti-inflammatories such as glucosamine-chondroitin, turmeric, fish oils, and Vitamin E.

Non-steroidal anti-inflammatory medications (NSAIDs)

NSAIDs are very effective at reducing inflammation and relieving knee pain. They include two different groups: non-selective and selective NSAIDs.

Non-selective NSAIDs block both types of our body's cyclooxygenase (COX) enzyme. By blocking the COX-2 enzyme, these medications produce a potent anti-inflammatory effect resulting in pain relief. However, the blocking of COX-1 leads to the common side effects of these medications (i.e., stomach pain and ulcers).

The most commonly used NSAIDs include celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Advil, Motrin), and Naproxen (Aleve). Additional prescription NSAIDs are available but are less commonly used in the United States. However, if you have tried these listed medications and have not gotten the relief you want, talk to your physician about other options.

A review of high-quality studies identified diclofenac to be the most effective NSAID. In addition, diclofenac comes in a topical cream (Voltaren) that can provide local relief without the side effects seen with the oral forms. However, people are believed to respond differently to each medication, and trying different NSAIDs is advised to see which one works best for you.

Table 1. Dosing for most commonly used NSAIDs.

DrugTypical Single DoseMaximum daily dose
Celecoxib100 to 200 mg400 mg
Diclofenac50 to 100 mg (extended-release)150 mg
Naproxen250 to 500 mg1,000 mg
Ibuprofen400 to 800 mg1,200 mg

The side effects of NSAIDs include indigestion, stomach ache, stomach lining irritation, ulcers, and gastrointestinal bleeding. However, these side effects can be reduced by taking the medications with food and by taking a proton pump inhibitor (i.e., Prilosec).

High doses of NSAIDs have been associated with cardiovascular complications such as heart attacks and strokes. Although the risk is approximately 1%, caution should be used, especially if you have a history of cardiovascular issues. Of note, naproxen does not appear to increase the risk of cardiovascular complications.

Glucosamine-chondroitin

Glucosamine-chondroitin supplements have been suggested to provide relief of arthritis-related knee pain. However, studies evaluating these supplements have shown mixed results, and the benefit needs to be clarified.

These supplements can not be used for acute knee pain as they can take up to 8 weeks or more to produce an effect. In addition, if you are allergic to shellfish, you should avoid using these medications.

Overall, they can be tried for the long-term relief of osteoarthritis pain due to their relatively minor side effects (nausea, gas, bloating) and potential for relief.

Turmeric

Turmeric is a natural spice that has been used in homeopathic remedies for multiple health conditions for years. It contains a chemical known as curcumin that has anti-inflammatory properties that can be used to treat chronic knee pain.

Turmeric can be used topically but is most commonly taken as an oral supplement at a dose of 500–2,000 mg a day of curcumin. It may take up to 4 weeks to feel relief after starting turmeric; thus, it is not recommended for acute pain.

The side effects include worsening acid reflux, nausea, and headaches but are typically well tolerated.

Fish oil

Fish oils are rich in omega-3 fatty acids that have been shown to reduce inflammation and improve knee pain. These can be obtained through a diet rich in oily fish or supplements. It is recommended to take 1,000–3,000 mg of fish oil per day.

These are relatively well tolerated, with the most common side effect being a fishy aftertaste or burp.

Vitamin E

Vitamin E can reduce inflammation within the knee joint and reduce the symptoms of chronic knee pain. Taken at a dosage of 400 IU per day, has been shown to be beneficial in treating pain related to osteoarthritis. Additionally, Vitamin E supplementation is rarely associated with side effects.

The best treatment for acute knee pain is NSAIDs, with diclofenac being considered the most effective of the group. However, when it comes to chronic knee pain, there are additional options, including glucosamine-chondroitin, turmeric, fish oils, and Vitamin E. Due to the potential long-term use of these medications for chronic knee pain, these additional options can provide relief without the long-term effects of chronic NSAID use.

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