As I write in this month’s Harvard Men’s Health Watch, these so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. “In those areas, the medication can penetrate closer to the joint,” says Dr. Rosalyn Nguyen, a clinical instructor in physical medicine and rehabilitation at Harvard Medical School.
Gels are less messy than creams because they tend to be less greasy. Water-based gels are also hydrating for the skin. Creams may be more difficult to get off your hands when you’re done applying but are good for massaging affected areas. However, some people feel that creams provide additional hydration and that the increased time it takes to rub most creams in actually allows it to penetrate deeper into the sore muscles and tissues. It really comes down to personal preference.
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.
Talking about your back pain with a therapist may bring some relief. In a UK study, back pain sufferers who had 90 minutes of group cognitive behavioral therapy a week for six weeks reported less pain during the treatment. (Cognitive behavioral therapy focuses on solving problems by changing thoughts and behavior.) A year later, 59% said their pain was totally cured, compared to just 31% in the group that did not go through therapy.
Over the past two decades, evidence has emerged to demonstrate that topical versions of NSAIDs are well absorbed through the skin and reach therapeutic levels in synovial fluid, muscle, and fascia. … For chronic conditions like osteoarthritis, the data are of fair quality and are persuasive. On balance, there’s good evidence to show that topical NSAIDs are clinically- and cost-effective for short term (< 4 weeks) use, especially when pain is localized.

Side effects from topical medications include redness, itching, and other skin irritation. They are generally mild—and uncommon. The cause of skin irritation is often the material used to make the cream or gel, not the NSAID, says Dr. Joanne Borg-Stein, medical director of the Harvard-affiliated Spaulding-Wellesley Rehabilitation Center in Massachusetts. When that happens, it’s possible for a pharmacist to create a preparation with ingredients that are less irritating to your skin.
While most people are only looking to relieve the immediate symptoms of the pain, this will only provide temporary relief.  Addressing the underlying mental/emotional, chemical and physical stressors that are causing the chronic inflammation and pain is the ultimate goal.  This process takes time and deep introspection along with trusted holistic health care providers.
Comfrey root has a long history of traditional use to heal wounds and fractures when applied as a poultice, and was commonly known as ‘knit bone’. Modern research shows that comfrey contains two main active ingredients: allantoin which promotes tissue regeneration, and rosmarinic acid which damps down inflammation and reduces pain. Comfrey root cream is a popular and effective treatment for joint pain, sprains and strains.

The first is that inflammation-lowering NSAIDs destroy your gut lining. Check the bottle of ibuprofen or aspirin in your medicine cabinet. You’ll see it right on the label: “NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach and/or intestine.”[1] Long-term low-dose aspirin use is particularly likely to cause ulcers and tear holes in your intestine.[2]

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