Finding Relief: What’s the Best Painkiller for Knee Pain?

Sometimes knee pain is mild and goes away on its own, requiring no special treatment. But for persistent or moderate to severe knee pain, it’s important to see a doctor for evaluation. Some underlying issues can get worse on their own, and you may have better outcomes with earlier treatment.

For knee pain that doesn’t require immediate attention, here’s what you should know about painkillers and related options for knee pain relief.

Knee pain is generally understood as pain or discomfort in or around your knee joint. You may feel pain:

• Close to the skin surface above or behind your knee
• Deep inside your knee
• In more than one area of your knee or leg

There are many possible causes of knee pain, including:

• Arthritis
• Sudden injuries
• Overuse injuries
• Infections in the knee area

Osteoarthritis typically causes “more of a dull, achy pain that’s intermittent,” says Cara Hall, MD, a sports medicine specialist at Keck Medicine of the University of Southern California in Los Angeles. “People can feel that all over — it can be underneath the kneecap, deeper inside, or in the outer areas of the knee.”

Painkillers and related treatments for knee pain fall into a few general categories:

• Over-the-counter (OTC) medications
• Prescription medications
• Topical creams and gels
• Natural and complementary remedies (such as supplements or acupuncture)

There are two main categories of OTC oral painkillers (taken by mouth):

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Acetaminophen (Tylenol)

“Over-the-counter painkillers can be really effective for knee pain, especially wear-and-tear type pain,” or pain from overuse, says Dr. Hernandez. But acetaminophen, in particular, varies in effectiveness. “Some people say Tylenol doesn’t do a whole lot for them, but some people do find it effective for pain relief,” Hernandez adds.

“A common question is, can I take it every day?” says Hernandez. “If you’re going to do that, it’s good to talk closely with your primary-care physician to make sure your organs are functioning properly, and they can monitor that.”

If OTC options aren’t enough to control your knee pain, or if you can’t take them because of other health conditions, your doctor may prescribe medication.

Prescription options for knee pain include:

• Higher-strength nonsteroidal anti-inflammatory drugs (NSAIDs)
• Corticosteroid (steroid) injections

“Prescription NSAIDs are quite useful to decrease inflammation and help with pain” for some people, says Dr. Hall. She cautions that these drugs are not the best choice if you have a history of stomach ulcers, gastric bypass surgery, or high blood pressure.

Corticosteroids can be taken by mouth, but are more often injected into the knee area for knee pain. “I tend to avoid oral steroids. I prefer to deliver them directly to the area,” says Hall, due to the lower risks and potentially higher efficacy of this method.

Several creams, gels, and patches are available to reduce knee pain:

• NSAID gels and creams
• Lidocaine gel or patches
• Capsaicin cream or patches

Relief for knee pain often requires several different approaches. For many people, that includes physical therapy, typically a program of exercises and stretches.

Physical Therapy

“Physical therapy is amazing at building strength and increasing mobility, especially when it comes to overuse injuries that may occur because your body has a muscular imbalance,” says Hall.

Dietary Supplements

Acupuncture

Weight Loss and Nutrition

In people with overweight or obesity, weight loss can help with knee pain in osteoarthritis. “Losing a tiny amount of weight is a ton of weight off the knee,” says Hall.

Hernandez says that a healthy, nutrient-rich diet can also help with knee pain. Taken together, “Physical therapy, exercise, nutrition, and weight loss are just as important as some of the medications,” he says.

When deciding on an approach to treat knee pain, it’s important to take several factors into account:

• Known or suspected causes of your pain
• Pain severity
• Potential risks and side effects of treatments
• Other health conditions you have
• Guidance from a healthcare professional

Remember that while self-treating knee pain is appropriate in some situations, it’s critical to get a doctor’s evaluation for lasting or moderate to severe knee pain.

The Takeaway

• Knee pain can have many causes, including injuries, overuse, and arthritis.
• Over-the-counter medications can be effective for knee pain, but don’t take them indefinitely without a doctor’s input.
• Prescription treatments and physical therapy can be hugely beneficial for knee pain.
• There is evidence supporting certain dietary supplements for knee pain caused by osteoarthritis.