Traditional wisdom says that NSAID pain relievers only damage your gut lining if you take them every day for a long time, but recent research disagrees. High-level athletes with stress-related intestinal damage tried taking ibuprofen to improve muscle soreness and recovery. Ibuprofen ended up damaging their gut lining even further after just a couple weeks; it increased inflammation and made their original pain issues worse.[3] In fact, a single dose of aspirin can significantly increase your intestinal permeability.[4]
Perhaps you bent the wrong way while lifting something heavy. Or you're dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they've had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.
An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in the management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.
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.
Because drugs, unlike natural remedies for inflammation and pain, are created in a lab and our bodies are not equipped to digest and process them. Moreover, drugs are incredibly powerful which gives them the ability to offer fast relief of symptoms, like pain and inflammation. This is good for short-term use, but can be harmful over time. The body just can’t metabolize these drugs sufficiently to prevent them causing new damage and side effects.
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.
Joints are complicated structures that “rely on bone, muscle, and ligaments all working together to provide a full range of motion,” says Holly Lucille, a Los Angeles-based naturopath. Understanding the source of your joint pain or inflammation is important, she adds, in order to pinpoint the most effective remedy. It could be an autoimmune disease such as rheumatoid arthritis, but in other cases, food sensitivities can be the culprit.
“I use Relief cream on every client who comes in with any type of pain, and they all say they absolutely love the fragrance (as do I) and how it feels on their skin—in addition to how well it relieves their pain. It is the ONLY topical pain cream I would even think of using (and having on my hands) all day long, and with its non-irritating ingredients I can do so worry free. I have never had anyone I have used it on or sold it to complain of any type of negative skin reaction to the product, which I find amazing since with most ever other product of its kind you run a significant risk of experiencing secondary skin irritation. As you can imagine I couldn't be happier with Relief's amazing formulation and superior results!” *
Thank you for providing a list with creams that aren’t simply analgesic! Most lists are just full of creams that provide analgesic properties by blocking pain receptors. It doesn’t really help your body repair from damage or strain. I use a cell-regenerative, anti-inflammatory cream with analgesics and its completely natural. It has the MSM and Arnica. I apply it before I work out and after to help nurture and heal my muscles & joints as well provide pain relief. This way I recover faster and get into the gym quicker knowing my body is supported and I am not just exasperating a problem.
Although it is difficult to establish the mechanism of action of a plant due to the variety of its components, in vitro clinical trials have shown that the anti-inflammatory properties of arnica are based mainly on the inhibition of NF-kappa B transcription factor, which is a key part of the immunological and anti-inflammatory processes. This protein regulates the transcription of various inflammatory cytokines, such as interleukins, as well as that of the genes encoding COX-2 (an enzyme which favours inflammation).
Research has shown that the omega-3 polyunsaturated fatty acids are some of the most effective natural anti-inflammatory agents available.[12,23–25,27,50,85] With the discovery that vascular inflammation is the underlying cause of coronary artery disease, fish and fish oil supplements are now recommended by the American Heart Association for the prevention of this disease.[12,23–25,27,50,85] Countries that have the highest fish consumption also have a lower incidence of neurodegenerative disease and depression.[12,23–25,27,50,85] The biological basis for the effectiveness of fish oil in treating arthritis has been well documented with many positive clinical studies, when compared to traditional pharmaceutical anti-inflammatory agents.[12,23–25,27,50,85]
Whether or not research can prove that massage therapy helps, many people report that it relaxes them and eases chronic pain. In a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in the treatment of back pain. The study authors concluded that massage "might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education." The authors called for further studies that might help determine whether massage is a cost-effective treatment for low back pain.
Learning to keep your cool is as good for your back as it is for your mental health. When you're anxious, your body sets off the "fight or flight" response, which involves tensing your muscles so you're ready to spring into action. One European study revealed that people prone to negative thoughts and anxiety are more likely to suffer from back pain. Get calm now with these stress-busting solutions.
Music therapy is a low-cost natural therapy that may reduce some of the stress of chronic pain in conjunction with other treatments. Studies find that it may reduce the disability, anxiety, and depression associated with chronic pain. It is thought to help because it can shift attention away from the unpleasant sensations of pain, and it may cause the release of endorphins or changes in catecholamine levels.
Warning: The gel is for external use only. It is flammable therefore keep it away from heat or open flames. Check with your healthcare provider before using it if you have sensitive skin are pregnant or breastfeeding. Do not put it near your eyes or mucous membranes or apply to wounds, sores, scratched or imperfect skin. Do not use this product with other creams, sprays, liniments, or ointments. Never put a bandage over the area. Stop using if your skin becomes red, has a rash, or feels irritated. Never use with a heating pad on top of the area and always wash your hands after using. Contact your doctor if problems continue after use. Consult your pediatrician if your child is under 2-years-old. Keep out of the reach of children.
The exhibited pain cream of Penetrex brand comprises an evolved pain-relieving mechanism, which in effect is crafted by availing the highly effective ingredients of Cetyl Myristoleate or CMO and Methylsulfonylmethane or MSM. Whereas the first one enacts over the ground cause of all muscular and joint aches that is inflammation, the second one works over the physiological cells and fortifies them to fight pains. Other serviceable ingredients in the formulary include Arnica, Vitamin B6 and Choline. The pain cream is non-sticky and stain-free and vowed to gratis steroids and drugs. It is especially famous for dodging aches over knee, arm, calf, hip and wrist. The parent brand vends it in a 2oz volume pot.
Almost every person with fibromyalgia describes their muscles as tight and full of painful muscle knots called trigger points. After I was diagnosed with fibromyalgia during medical school, I tried many different styles of massage, but got no benefit until I found a specialized technique called myofascial release pioneered by John Barnes, PT. This form of massage therapy involves using very slow but sustained gentle pressure to separate tiny adhesions in the muscle tissue and fascia, and this lessens muscle tension and gently breaks up knots in the connective tissue (to learn more about the vital importance of fascia in fibromyalgia, read my previous blog post). Two European studies found that myofascial release therapy was effective for reducing fibromyalgia pain, and that it gave long-lasting pain relief even at one month and six months after the last session. To find a John Barnes-trained therapist skilled in this technique go to www.mfrtherapists.com.
The soothing sensation of a rollerball can add additional relief for some arthritis sufferers, and this version from Stopain is popular. The active ingredient is menthol, which provides a cooling effect. It also contains MSM and glucosamine as well as eucalyptus and peppermint oils in a non-greasy formula that won’t stain clothing. You can apply it up to four times a day, and customers say it works to alleviate pain quickly.
For arthritis relief, it is important to have proteolytic activity on the systemic level. Known as protease, this category of enzymes acts as a catalyst in the breakdown of proteins into peptides or amino acids. This helps control both systemic inflammation and inflammation resulting from soft tissue injuries, like those associated with both rheumatoid and osteoarthritis. Proteolytic enzymes also provide essential antioxidant and cardiovascular support. I will discuss two of the more potent ones here:

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Hi Paul, This is not a condition I’m very familiar with. I’ve done a bit of research for you and found that most people will regain up to 70-90% of their original strength and functional levels within two years. The same reference suggests that ‘Specific pain medications used to treat PTS include opiates and non-steroidal anti-inflammatory drugs (NSAIDs), which are usually used in combination. … After the acute phase, different medications such as gabapentin, carbamazepine, and amitryptiline may be used specifically to treat nerve pain.’ It’s possible that diclofenac gel will help the pain – this is the most effective topical NSAID available without prescription. Your doctor can prescribe other versions. Nerve pain is difficult to treat topically, although capsaicin cream (chilli extract) is prescribed to treat other forms of nerve pain eg related to shingles. Physio will help the nerves to recover – a medical herbalist may be able to suggest herbal creams that might promote nerve regrowth. Hope that helps.

Capsicum is an extract from the chilli or cayenne pepper which reduces pain by continuously stimulating nerve endings in the skin at a very low-level. This depletes nerve endings of neurotransmitter chemicals so they become less sensitive and pass on fewer pain messages to the brain. Those messages that are passed on tend to get screened out as they brain shuts off distracting, low-level irritation. Ingredients that do this are known as ‘counterirritants’. These effects also reduce sensation from underlying painful joints. See the best capsicum containing rubs at Amazon.co.uk or Amazon.com. Warning! These are HOT to use, but really relieve muscle and joint pain. Wash your hands thoroughly after use and do them rub your eyes by mistake during use.


Celebrex, Vioxx, and Bextra quickly became the mainstay for the treatment of chronic pain conditions related to inflammation.[71] Within a few years, an estimated 15–20 million people in the US were using selective COX-2–inhibiting NSAIDs on a long-term basis. These drugs became the most commonly used pharmaceutical agent with more than 70 million NSAID prescriptions written each year and 30 billion over-the-counter NSAID tablets sold annually. It was estimated that 5–10% of the adult population used NSAIDs, and among the elderly (a group at higher risk of nonselective NSAID-induced gastrointestinal complications), the use of these drugs was as high as 15%. The general acceptance of these drugs was due to the perceived lack of serious gastrointestinal side effects that had been associated with the nonselective class of NSAIDs.[26,119]

Schematic showing another inflammatory pathway that is activated by tissue injury. This is the NF-kB activation, in which once the protein is free as a result of tissue injury, it can enter the cell nucleus and activate the DNA to enhance the inflammatory response further by the production of additional cytokines, chemokines, and adhesion molecules (IKKB = IkB kinase)
Bark from the white willow tree is one of the oldest herbal remedies for pain and inflammation, dating back to ancient Egyptian, Roman, Greek, and Indian civilizations, as an analgesic and antipyretic agent. Because of the gastric side effects of aspirin, there has been a resurgence in the use of white willow bark for the treatment of inflammatory syndromes. The mechanism of action of white willow bark is similar to that of aspirin which is a nonselective inhibitor of COX-1 and COX-2, used to block inflammatory prostaglandins.[48]
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.
Even as you practice patience, a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can help ease the pain you're pushing through. The research behind medicine guidelines for lower back pain finds that these may give slightly better relief than acetaminophen (Tylenol). Over long periods, NSAIDs can cause gastrointestinal problems, so don't take them for more than 10 days without consulting your doctor.
LoveHemp CBD Body Salve  is an infusion of cannabidiol within a lovely base of organic coconut oil, beeswax and argan oil. It is scented with organic rosehip and geranium oil and has a soft, waxy texture at room temperature. A 50 ml pot contains 300mg cannabinoids and you only need to apply a small amount to relieve muscle aches, joint pain and skin irritation.
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 Penetrex® pain relief cream is a top choice for those suffering from arthritis, back pain, fibromyalgia, neck pain, sciatica, carpal tunnel syndrome, sore aching joints and muscles, tennis and golfer’s elbow, neuropathy, sports injuries, plantar fasciitis, strains, sprains, hip and shoulder pain, all pain and other inflammations. The advanced development cream comes in a 2-ounce jar with other sizes available. Eight years went into the development and creation of this fantastic cream. Penetrex is favored by people troubled with inflammation related injuries because it works!
You may already have tried exercise and over-the-counter (OTC) pain relievers you take by mouth. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Another option is to try one of the many OTC topical creams that can help relieve arthritis pain. Here’s the low-down on these products to help you decide which arthritis cream might be best for you.
Laugh more often. One study showed that social laughter actually increases pain tolerance.5 Laughing along with others was shown to have the highest positive impact. Laughter has many positive effects, including increasing circulation and oxygen, and raising your body's level of endorphins (the body's natural pain killers). There is a whole movement called "laughter yoga"—which helps people enjoy the many benefits of laughter without having to need a reason to laugh—it just focuses on laughing for its own sake.

With more than 23,000 reviews on Amazon, customers give Penetrex sky-high marks for effective pain relief. If it doesn’t work for you, it comes with a 100 percent, no-questions-asked, money-back guarantee. Formulated to fight inflammation, it contains a mix of ingredients including arnica, choline, glucosamine, Vitamin B6, and MSM. It’s not odor-free, but rather has a light scent that disappears quickly after you apply it. You can use it alone or in conjunction with heating pads, massagers, ice, and other therapies.

On September 30, 2004, Merck Research Laboratories announced the global withdrawal of rofecoxib (Vioxx), its primary selective COX-2–inhibiting NSAID.[52,90,122] Analysis of the results of the Adenomatous Polyps Prevention on Vioxx study (known as the APPROVe study) showed that there was double the risk of serious thromboembolic events, including myocardial infarction, which became apparent after 18 months of Vioxx treatment.[26] Selective COX-2 NSAID’s thrombotic mechanism of action is based on COX-1’s unopposed action to continued platelet synthesis of thromboxane. Thromboxane is a thrombogenic and atherogenic eicosanoid. Prostacyclin prevents formation of platelet clotting. By inhibiting COX-2 that blocks production of prostacyclin (PGI2) there is unopposed thromboxane which will increase the clotting risk. Thus, inhibiting prostacyclin led to the increased risk of thrombotic cardiovascular and cerebrovascular events.[5,26,73,123]

Menthol, Levomenthol, Eucalyptus, Camphor and Oil of Wintergreen are often added to topical joint treatments. These essential oils are absorbed into the skin and stimulate skin receptors to produce either a warm sensation or a cooling sensation as they numb the pain. They work by overwhelming nerve endings with these sensations so pain messages do not get passed on. This is known as a counter-irritant effect. Wintergreen is also a rich source of methyl salicylate, a natural anti-inflammatory painkiller related to aspirin. These essential oil creams and gels tend to have names such as Deep Heat or Deep Freeze to describe how they feel during use.


Voltaren® Gel (topical diclofenac) is a particularly safe and useful medicine. It’s an anti-inflammatory cream, so it can be applied only where you need it, instead of soaking your entire system with a medication, avoiding or dramatically reducing common side effects like indigestion, as well as some serious safety concerns associated with oral diclofenac. In the US, this drug is FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands,” but it probably also works for some other painful problems, such as some repetitive strain injuries and back pain. The evidence shows that it “provides clinically meaningful analgesia.” So this product actually works and gets a pass from skeptics and critics — a rare thing in the world of pain treatments!

Topical diclofenac gel (Voltarol) is highly effective for treating muscle and joint aches and pains. In fact, a direct comparison of topical non-steroidal anti-inflammatory diclofenac gel with an oral equivalent did not show any difference in their ability to reduce pain and stiffness. Data from 34 studies, involving over 7,600 people, suggests that the topical NSAID, diclofenac, is the most effective form of non-steroidal anti-inflammatory painkiller for applying to the skin to treat muscle and joint pain.

If you’re someone who experiences muscle and joint pain from time to time (or on a regular basis), you’ve probably tried quite a few options for pain relief. And you’re probably already using external pain relievers—the kind you apply directly to your skin for fast relief from sore muscles and joints. But have you thought of adding an external pain relief cream to the mix?
Zeng C, Wei J, Persson MS, et al. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br J Sports Med. 2018 Feb. PubMed #29436380. “Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population.” BACK TO TEXT

You never want to put a heating pad on top of the topical product after it’s on your skin. It can cause skin irritation and possible burns. If you apply a lotion or gel having methyl salicylate, do not start exercising. Your body can absorb too much of it from your increased blood circulation and that’s not good. Do not put on areas such as broken skin, rashes, dermatitis, eczema, or irritated area. Pregnant and breastfeed women should not use topical pain relievers without consulting their doctor. Babies should not use these products, nor young children.


Five updates have been logged for this article since publication (2009). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more Like good footnotes, update logging sets PainScience.com apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages.
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.
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).
My personal preference is regenerative injection therapy (RIT). This is a non-operative, therapeutic approach to pain reduction that involves multiple small injections into a joint to encourage the body to initiate healing methods. Through the process of concentrating and injecting specific substances, such as prolo, PRP, or stem cells at the site of injury, the process of regeneration and remodeling is facilitated and a robust healing response is achieved. 
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