Diclofenac sodium 1% gel (Voltaren, also available as a generic). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day).  However, the total amount used on your body should not exceed 32 grams per day. A dosing card comes with the gel so you can measure the correct amount.
If your back pain hasn't resolved itself within four to six weeks, you'll want to make an appointment with your doctor. Your doc will examine your back and ask you to sit, stand, bend, walk, and lift your legs to see how your pain is affecting your mobility. You'll likely be asked to rate your pain on a scale of one to 10, and you may be sent for imaging tests like an x-ray or MRI. You might be asked to try one of these therapies:
Natural remedies, on the other hand, are made from the stuff of nature. This includes leaves, twigs, berries, bark, roots, vines, vitamins and minerals. They are natural substances that can’t be regulated by the FDA because they are technically foodstuffs. If you understood herbology you could, as many traditional cultures do, adjust your diet to include the herbals in your meals. However, for painful and chronic conditions, like arthritis, this would mean at every meal. Taking these ingredients as supplements to your diet is the way to go.
Back pain is a health concern for most people in the United States at some point in their lives and one of the most common reasons people miss work or visit the doctor. More than 80 percent of Americans will experience low back pain, and this health problem costs the United States over $100 billion each year, most of which is a result of lost wages. 

Some manufacturers inflate nutraceutical products’ claims and may not cite possible side effects and potential drug interactions. Bleeding complications are associated with white willow bark, ginger, garlic, and others. Therefore, such medicinal preparations are not without risk. Products such as omega-3 essential fatty acids (EFAs) (O3) do have strong scientific support to be considered as an alternative and/or complementary agent to NSAIDs. Published studies have shown the effectiveness of O3 to successfully treat spine-related pain.[71] Capsaicin, oil of camphor, and other natural topical preparations are commonly used for muscle soreness and local application for painful traumatic injuries.[12,16,80] The subsequent sections will review many of these products and discuss both their efficacy and safety issues. As with any drug or natural compounds, additional caution should be used when considering these treatments for children, pregnant or lactating mothers or any other clinical or disease condition that could increase possible risk of side effect or complication.
The original Aspirin, white willow bark contains salicin which, in the stomach, converts to salicylic acid—the primary component of Aspirin. Synthetically, it can irritate the stomach, but naturally through white willow bark, it is effective in relieving pain, inflammation and fever. The recommended dose is 1 to 2 dropperfuls of white willow bark tincture daily.

This essentially necessitates you to pick one balm, which is competent to treat a trivial throbbing at the ankle as well as work over an aspect as grave as Shin Splint. One articulate conversation with a M.D can authentically aid you to this end. Moreover, always strive to elect one such muscle rub salve that is nurtured with organic essential oils and moisturizing agents and renders a cooling sensation within an utmost short pace.

This cream uses a blend of essential oils. It smells nice and when you apply it, and it moisturizes the skin. By providing cooling relief for troubled areas, this product alleviates a lot of muscle discomfort, making it ideal for a variety of people, including athletes and anyone suffering from chronic pain. It’s a bit like Icyhot, except it is made with natural healing oils.


I use my Rogue Fitness Supernova ($40; roguefitness.com) for self-myofascial release (SMR). By applying pressure directly to sore muscles with my supernova, I am able to roll out knots (or adhesions) on the muscle. This allows the body to bring blood flow to troubled areas by transporting nutrients and oxygen to the muscles for faster repair." — Troy Brooks, YG Studios and founder TB Elite Fitness
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
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with topical diclofenac 1% and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.
Aloe barbadensis (organic aloe) leaf juice, Limnanthes alba (meadow foam) seed oil, mentha arvensis (menthol), capsicum (capsicum annuum) oleoresin, cinnamomum camphora (white camphor) essential oil, ocimum basilicum (sweet basil) essential oil, piper nigrum (black pepper) essential oil, anthemis nobilis (Roman chamomile) flower essential oil, chamomilla recutita (German chamomile) flower essential oil, cinnamomum zeylanicum (cinnamon) leaf essential oil, cymbopogon winterianus (citronella) essential oil, eucalyptus globulus (eucalyptus) leaf essential oil, helichrysum italicum (helichrysum) essential oil, zingiber officinale (ginger) root essential oil, citrus paradisi (pink grapefruit) essential oil, juniper communis (juniper) berry essential oil, cymbopogon flexuous (lemongrass) essential oil, mentha piperita (peppermint) essential oil, pinus sylvestris (pine) needle essential oil, ravensara aromatica (ravensara) essential oil, Rosmarinus officinalis (rosemary) leaf essential oil, mentha spicata (spearmint) essential oil, origanum vulgare (wild oregano) essential oil, glycerin, hamamelis virginiana (witch hazel), water, alcohol, phenoxyethanol, carbomertriethanolamine (TEA), and tetrasodium (EDTA)
When sudden changes occur in the weather or we overexert ourselves during physical activity, those of us who experience, or who already had, muscle and/or joint pain treat ourselves with the traditional prescriptions of conventional anti-inflammatories. There is a general tendency for us to take anti-inflammatories every time something hurts, as if they were water. Nevertheless, the damage caused to our bodies (liver, stomach, etc.) by anti-inflammatories is highly significant if these are abused. Symptomatic use of analgesics, such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs) is almost always the first treatment option, and ibuprofen is one of the most widely used anti-rheumatic drugs.

Physical therapists often recommend aquatic therapy — including exercises done in warm, therapeutic pools — for back pain. The buoyancy of the water helps alleviate strain on the joints to encourage strengthening and gentle stretching of the muscles. Even floating in warm water can help relax muscles and release tension as well as increase circulation, according to the Arthritis Foundation. With home whirlpool baths, try aiming the jets directly at your sore spots for a soothing underwater massage.


Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. "Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes," she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice -- take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
For a blast of cool pain relief, Biofreeze has been a go-to for arthritis sufferers for decades. Made with 4 percent menthol, this gel promises immediate relief from pain that’s long-lasting. It has a light green color, so you can see where you’re applying it, but it also comes in a colorless version as well. Both versions are greaseless and have a scent that’s designed to disappear after application.
China, Korea and Japan grow a vine known as Thunder God, which is one of the powerful natural relievers of arthritis, especially rheumatoid arthritis. It has properties that regulate the immune system and naturally reduce inflammation, thus being good for autoimmune diseases. One clinical trial carried out at the University of Texas Southwestern Medical Center discovered that roughly 80 percent of those patients who were given a high dose of the plant supplement found that their rheumatoid arthritis symptoms got better considerably making it well worth a try for those looking for natural remedies for inflammation and pain.
A combination of Boswellia and curcumin showed superior efficacy and tolerability compared with nonsteroidal diclofenac for treating active osteoarthritis. Boswellia typically is given as an extract standardized to contain 30-40% boswellic acids (300-500 mg two or three times/day). Boswellia has been well tolerated in most studies, although some people may experience stomach discomfort, including nausea, acid reflux, or diarrhea.[1–10,42,48,56,62,103,104]

Amanda has a Masters of Science in Nutrition from Syracuse University which equipped her with courses applied to licensure as a dietitian. She also worked as a Program Director for the Wellness and Fitness Department for the YMCA. She is well versed in physical fitness, with a certificate from the National Academy of Sports Medicine in physical fitness training. She has taught numerous fitness classes, including college courses in the Athletic Department, as an adjunct instructor, at the SUNY University at Buffalo. She currently resides with her husband in the NYC area, and loves to put her knowledge of anatomy and physiology to use by being active. Both her and her husband are self-declared "foodies."
Our writers spent 5 hours researching the most popular arthritis creams on the market. Before making their final recommendations, they considered 30 different creams overall, screened options from 20 different brands and manufacturers, read over 50 user reviews (both positive and negative), and tested 1 of the creams themselves. All of this research adds up to recommendations you can trust.
For example, water therapy is gentle on your body because the water supports the weight of your body and provides gentle resistance. The exercise is done in warm water, which is also soothing. There are many land-based exercise programs that can provide a gentle, endorphin-producing form of exercise, such as tai chi, or yoga programs designed for people with chronic pain conditions.
Natural remedies, on the other hand, are made from the stuff of nature. This includes leaves, twigs, berries, bark, roots, vines, vitamins and minerals. They are natural substances that can’t be regulated by the FDA because they are technically foodstuffs. If you understood herbology you could, as many traditional cultures do, adjust your diet to include the herbals in your meals. However, for painful and chronic conditions, like arthritis, this would mean at every meal. Taking these ingredients as supplements to your diet is the way to go.
The Biofreeze® pain relief gel is available in 16-, 32-, or 128-ounce bottles and is offered as the colorless or original green formula. The company has been making pain relief products for over 25 years. It is the #1 product that has been clinically used by professional healthcare hands-on providers, massage therapists, physical therapists, chiropractors, foot doctors (podiatrists), athletic coaches, instructors, and trainers. This is considered the best pain relief cream for muscle pain perfect for athletes. When professionals have over a hundred clients each week, the economical 128-ounce jug might be best for you for not running out. You always want it on hand for clients with sore aching body parts.
Diclofenac is also available as a 3% gel (Solaraze; generic) that is applied to the skin to treat actinic keratosis (flat, scaly growths on the skin caused by too much sun exposure). This monograph only gives information about diclofenac gel (Voltaren) and liquid (Pennsaid) for osteoarthritis. If you are using diclofenac gel (Solaraze, generic) for actinic keratosis, read the monograph entitled diclofenac topical (actinic keratosis).
Apply to the affected area and massage into the skin gently. Always wash your hands after you have finished rubbing the cream, gel or spray into the skin. This is to make sure that you avoid rubbing this medicine into sensitive areas of the body such as the eyes. Do not apply to skin that is broken, or near the eyes, nose, mouth, genital or bottom (anal) areas. Do not use plasters or bandages (dressings) on top of these medicines. Generally these medicines are applied to the skin 2-4 times a day. However, for specific advice for your medicine, see the leaflet that comes inside the packet.
The NF-kB molecule is a transcription factor that controls the transcription of DNA for the perpetuation of the inflammatory immune response. It acts as a switch to turn inflammation on and off in the body. NF-kB has the ability to detect noxious stimuli, such as infectious agents, free radicals, and other cellular injuries, and then directs DNA to produce inflammatory cytokines. The NF-kB proteins are localized in the cytoplasm of the cell and are associated with a family of inhibitory proteins known as inhibitor of kB (IkB).[43,119] The TNF-α, and especially IL-1b, can also directly stimulate enzymes known as matrix metalloproteinases, which break down extracellular collagen matrix, a hallmark of inflammatory joint disease.[32,76,77] The IkB proteins are normally bound to NF-kB and block their nuclear localization signal. A variety of provoking stimuli can degrade the IkB and result in the nuclear translocation of NF-kB to be free to activate DNA synthesis of inflammatory cytokines [Figure 2].

After reviewing data regarding various treatments for lower back pain, the Agency for Health Care Research and Quality concluded that those suffering from back pain should first try conservative/natural treatments and then consider other options for lower back pain relief if pain persists. Oftentimes low back pain sufferers can find relief naturally by making changes to their lifestyles (including sleep, physical activity, stress and body weight) before choosing more intensive care options.


Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.
tell your doctor if you have severe diarrhea or vomiting or think you may be dehydrated; if you drink or have a history of drinking large amounts of alcohol, and if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; heart failure; or kidney or liver disease.
"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
For cinnamon to be used in the diet to reduce pain, it should be in powdered form, and should be the Ceylon variety, not cassia. Cassia is the most common form and is less expensive, but toxicity can be of concern when cassia is consumed in large quantities. Ceylon cinnamon presents no toxicity risks and has more potent health benefits. (22) Ceylon cinnamon is the preferred supplemental form, and for best results, one should take approximately 1-2 teaspoons per day.
Rolfing not only relieves physical muscle pain rooted in your fascia, but also improves your emotional well-being and energy. Whether you’re an athlete looking to improve your game or someone suffering with TMJ pain, chronic back pain or spine pain, rolfing is something worth exploring. It’s a potent natural painkiller that impacts your neuromuscular system in a positive, pill-free way.
For those sore muscles and inflammation, peppermint oil and pine will relieve your aches and the chamomile and eucalyptus relieve tender feeling pain. For relieving the stress you are feeling, pink grapefruit, lemongrass, and spearmint oil will do that for you. These are all natural products providing you with vitamins A and C and antioxidants with the aloe vera providing moisture to your skin.
"I am a true believer in Biofreeze ($15; performancehealth.com). My football coach introduced me to it years ago. It's a topical cooling pain reliever that works very similarly to ice but since it's a gel, I can apply it before teaching classes and training clients to keep function in my muscles and joints. In addition to relieving muscle pain or soreness, it can be used to help arthritis and other muscular and joint discomforts too. " —Mat Forzaglia, The Fhitting Room instructor
After you apply diclofenac gel (Voltaren) or liquid (Pennsaid), you should not cover the treated area with any type of dressing or bandage and you should not apply heat to the area. You should not shower or bathe for at least 30 minutes after you apply the liquid (Pennsaid) and for at least 1 hour after you apply the gel (Voltaren). Do not cover the treated area with clothes or gloves for 10 minutes after you apply the gel (Voltaren), or until the liquid (Pennsaid) has dried if you are using the liquid.
Many of the 10 million Americans suffering from widespread muscle pain due to fibromyalgia look for non-prescriptions options for pain relief. As a physician with fibromyalgia myself, I want to share with you the most effective natural options that I include in my own pain relief “toolbox,” which includes anti-inflammatory herbs, topical creams, and a unique form of massage that breaks up painful muscle knots.
From tissue spasms to neurological aches and from shooting aches to twist, this best muscle rub cream of Living Well Nutraceuticals is lab-accredited to heal all patterns of pain. Its exquisiteness is essentially fortified by the presence of Cetyl Myristoleate or CMO that enacts in depth over swelled up muscles, tendons and joints and eradicates the very inflammation—the root cause of all pains. The best muscle rub cream also owns Methylsulfonylmethane or MSM, which again reaches into the body cells and opens those up to prevent the aches affecting physique. The ointment is moreover nurtured with cruxes of Belladonna and Rhus Tox and caters enduring soothe. It comes in a 3oz density tube.
When you think of a needle poking into your skin, the last thing you probably think about is natural pain relief. The truth is, though, that dry needling works by stimulating trigger points to reduce pain or disability. A 2007 study found dry needling significantly reduced shoulder pain by targeting a trigger point. Dry needling can also help deal with trigger points that reduce a person’s range of motion, which can lead to serious pain and musculoskeletal side effects.
When used together, menthol and methly salicylate create vasodilation (opening of the blood vessels) close to the surface of the skin.  Increased blood flow to the area of application is said to have pain-killing on the nerve receptors in the treated area.  When combined, these two ingredients also work together to form a class of treatment called counterirritants. Counterirritants work by tricking the body into feeling sensations other than pain. The menthol and methyl salicylate in muscle creams create conflicting feelings of warmth and cold. When the nervous system sends both of these sensations, at the same time, they compete with and ultimately block pain signals from travelling to the brain.  Together these ingredients, when delivered in muscle creams or sports balms, work to create a powerful 1-2 punch, killing pain and providing relief to aching muscles and joints.
Medications are not the only solution to control inflammation and discomfort. As we become increasingly aware and sensitive the possible side-effects of any medication, more patients and doctors alike are interested in non-pharmacologic methods to control inflammation. There are many ways that people address inflammation. Some have better scientific support than others, but most all are safe to try.
What makes a joint “amenable”? Is it mellow and easy-going? No, just accessible: a pain-killing gel is useful only for joints that aren’t covered by a thick layer of muscle (like the shoulder). The medication gets diluted as it penetrates deeper into tissue, and a meaningful amount can only get into joints if the joint is just under the surface of the skin.
If these aches and pains sound all too familiar, then there’s a whole host of safe and effective treatments available to get back pain relief and to then relieve arthritis pain – herbal remedies, special foods, over-the-counter medicines, exercises, and more (see our Arthritis Solutions Special Report for details). But the quickest and safest way to soothe arthritis pain is with a topical cream that contains:

Omega-3 EFA, found in fish oil, can directly reduce the degenerative enzymes, aggrecanase and matrix metalloproteinase, as well as IL-1, TNF-α, and COX-2, to reduce the inflammation in synovial cartilage. A recent study of 250 patients with cervical and lumbar disc disease, who were taking NSAIDs, revealed that 59% could substitute fish oil supplements as a natural anti-inflammatory agent for the NSAIDs.[71] The recommended dosage is a total of 1.5–5g of EPA and DHA per day, taken with meals.


From tissue spasms to neurological aches and from shooting aches to twist, this best muscle rub cream of Living Well Nutraceuticals is lab-accredited to heal all patterns of pain. Its exquisiteness is essentially fortified by the presence of Cetyl Myristoleate or CMO that enacts in depth over swelled up muscles, tendons and joints and eradicates the very inflammation—the root cause of all pains. The best muscle rub cream also owns Methylsulfonylmethane or MSM, which again reaches into the body cells and opens those up to prevent the aches affecting physique. The ointment is moreover nurtured with cruxes of Belladonna and Rhus Tox and caters enduring soothe. It comes in a 3oz density tube.
Still an excellent product. It remains effective for pain relief for about 5 hours with each application for me. Make sure to rub in a good thick portion for several minutes to the entire area of pain. Each jar of Synthaflex lasts about 18 days for me with applications twice each day. It remains the best external joint and muscle pain relief rub that I have ever used.
Nearly everyone suffers from some type of back pain at some point in their lives. But no matter when it appears or what may have caused it, back pain can be a real, well … pain to deal with. The good news? There are several simple things you can do to ease pain and keep your back in good condition. The following tips can help you get on the way toward feeling better.
Feverfew. Feverfew has been used for centuries to treat headaches, stomachaches, and toothaches. Nowadays it's also used for migraines and rheumatoid arthritis. More studies are required to confirm whether feverfew is actually effective, but the herb may be worth trying since it hasn't been associated with serious side effects. Mild side effects include canker sores and irritation of the tongue and lips. Pregnant women should avoid this remedy.
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