Acupuncture: Acupuncture may provide even more relief than painkillers, according to one 2013 review. In 11 studies of more than 1,100 people, this Chinese medicine staple improved symptoms of lower back pain better than simulated treatments and, yes, in some cases, NSAIDs. The needles appear to change the way your nerves react and may reduce inflammation around joints (which is only one of the therapy's benefits), says DeStefano.


Creams derived from natural products can also provide local relief for painful muscles in fibromyalgia. The best part is that topical treatments tend to be very well tolerated with few side effects. Arnica is an herb used since the 1500s to treat bruises, muscle pain, and inflammation. It is still used today as a natural treatment for muscle pain in many different topical remedies. One herbal homeopathic cream that I have found helpful is MyPainAway Fibro cream. It includes arnica to reduce muscle pain, echinacea to reduce inflammation, along with other herbs targeted to reduce nerve pain by improving microcirculation around pain-sensing nerves.
Homeopathic (diluted) herbal ointments featuring Arnica are claimed to be good medicine for muscle pain, joint pain, sports injuries and bruises, but their effectiveness is questionable. Known to most customers as an “herbal” arnica cream, most actually contain only trace amounts — too little to be a chemically active ingredient. Homeopathy involves extreme dilution of ingredients, to the point of completely removing them. Some other herbal ingredients may be less diluted and more useful. However, neither homeopathic or pure herbal creams of this type have produced results better than placebo in good quality modern tests. See Does Arnica Gel Work for Pain? A detailed review of popular homeopathic (diluted) herbal creams and gels like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation. BACK TO TEXT
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“When I was pregnant two years ago with my daughter I had extreme pain in my right shoulder. It went on for months. They did cortisone shots, prescribed Loratab (Hydrocodone and Acetaminophen), and were ready to operate on a pregnant gal the pain was so severe. Eventually the cortisone shots worked and the pain went away. I am now pregnant again and at about 28 weeks the pain was back. This time the pain was worse. The joint hurt so bad I couldn't pull the covers over me in bed. I could only sleep on one side, and NOTHING worked. My chiropractor recommended Relief cream. I was skeptical that a cream could ease my pain when the medical community had nothing that worked. In a total act of desperation I had my husband rub it into the shoulder one night. I slept better than I had in weeks. He rubbed it in the next night and the pain was completely gone. Here I am now 34 weeks pregnant and the pain has been completely gone for 6 weeks. My husband has also used it on his back (after trying everything else under the sun) with similar results. Thank you for a truly amazing product. We have shared this info with our family and friends!” *
“I had sciatic pain so bad that I went to a doctor for a 'series of three shots' (or so he said) for the pain, yet ten shots later the pain was still there. When a friend of mine gave me a tube of Relief pain cream that had a little left in it so I could give it a try I was so amazed at how effective it was in relieving my pain that I immediately called and ordered two tubes, and I will be asking my doctor to stock it—because I absolutely love this stuff!" *
There's a reason there are so many roll-ons on this list. They're super handy and easy to use. This CobraZol gel provides quick relief that lasts up to 10 hours. It's a good choice for both chronic and acute pain. This gel comes in a 2 oz format. Believe it or not, this stuff actually contains cobra venom. Venom apparently is thought to help de-active pain pathways and reduce pain. This roll-on is a great way to manage pain and help users wean off of more serious and potentially dangerous pain medications.
Most of these gels and creams won’t cure your ailment. You’ll probably run into countless negative reviews of products from people that complain that their pain is not gone. These types of products are not a cure. Pain relief creams and gels are a helpful way to reduce pain. With acute pain, these gels and creams help users get relief until treatment can occur. In the case of a sprained ankle or torn muscle, for instance, using this kind of medicine can be a good alternative to NSAIDs to help reduce pain. For chronic ailments like arthritis, these substances are merely a way to help sufferers cope with pain. They are a band-aid. Some aches and pains may be helped with further treatment but don’t expect miracles with these types of products. Just because they don’t completely remove pain doesn’t mean they aren’t helpful in some instances and for some people.

Think of Voltaren® Gel as “ibuprofen in a gel.” (It’s actually diclofenac, but ibuprofen is a much more familiar drug name in North America, where the product is still fairly new, and available only with a prescription in the US.) It’s a topical anti-inflammatory medication,NSAID“Non-steroidal anti-inflammatory drug,” usually pronounced “en-sed.” and FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands.” The evidence shows that it “provides clinically meaningful analgesia.”1 This is an appealing treatment idea that actually works reasonably well: what a pleasure to be able to say that!2
Prolotherapy treatments work by naturally promoting a minor inflammatory response near damaged connective tissue, promoting regeneration and the growth of new, healthier tissue in the process. These treatments have been used to effectively reduce or heal chronic musculoskeletal conditions of the back, such as herniated/bulging discs, arthritis, osteoarthritis or other chronic joint pains, and tendonitis that affects the lower body and causes compensations in the spine. (7) For the most benefits, it seems that prolotherapy works best when combined with other back pain treatments, such as spinal manipulation, exercise and in some cases medications when needed.

One concern about the use of products like Voltaren is that several conditions are less inflammatory in nature than they feel like. Patients usually assume that the “burning” pain of repetitive strain injuries like tendinitis is caused by inflammation, but in fact classic inflammation is largely absent, especially after initial flare-ups have died down (but pain is still carrying on). While it is possible, even likely, that tendinitis is still inflamed in some sense, it’s doubtful that they are inflamed in a way that NSAIDs are actually good for. The biochemistry of cranky tendons is rather complex and largely unknown. There’s probably some overlap between the biology of acute, classic inflammation and the subtler biology of chronic tendinitis, but no one really knows. So the value of Voltaren for tendinitis is unclear.
Can stomach problems cause lower back pain? The back is a sensitive part of the body, which has many nerves and organs nearby. This means that issues such as digestive conditions can occur at the same time as back pain. Back pain and bloating are common symptoms of injury, pregnancy, or gastrointestinal problems. Treatment depends on the cause. Learn more here. Read now
A 2015 Cochrane review of 61 studies involving nearly 8,400 people found that topical NSAIDs relieved pain from strains, sprains, and overuse injuries, but with less side effects than oral NSAIDs. Similarly, a 2006 review of four randomized trials found that topical diclofenac reduced knee pain due to osteoarthritis and was generally well tolerated. 

I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
NSAIDs don’t just damage your gut lining. They affect your gut bacteria, too. A study of regular users found that different NSAIDs caused different changes in gut bacteria.[5] Ibuprofen and arthritis drug celecoxib (Celebrex), for example, increased pathogenic Enterobacteriaceae, a family of bacteria that includes E. coli, Salmonella, and a number of lesser-known bacteria that contribute to eye, skin, respiratory, and urinary tract infections.[6]
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