Today, the most common conventional treatments for lower back pain relief are medications, including NSAIDS like aspirin and Tylenol, along with more potent prescription painkillers, such analgesics. These drugs can potentially cause adverse side effects in some patients and commonly don’t solve the underlying causes of lower back pain (such as poor posture, obesity or exercise-related strains). Some medications for back pains have even been tied to complications, such as liver damage or intestinal bleeding, when taken for long periods of time or in high doses.
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.

Nonsteroidal anti-inflammatory medications are one of the most commonly used types of medications for musculoskeletal conditions. NSAIDs can be effective for a wide variety of orthopedic conditions from arthritis, tendinitis, or other inflammatory conditions. Determining the best NSAID for your condition may depend on a number of different factors, and what works well for one individual may not be the best medication for another. There are possible side effects of different NSAID medications the patient should be aware of, and you should discuss with your physician if taking these medications for more than a short period of time.


NSAIDs have anti-inflammatory (reduce inflammation), analgesic (relieve pain) and antipyretic (lower temperature) effects. Although different NSAIDs have different structures, they all work by blocking cyclooxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation. Most NSAIDs inhibit both enzymes, although a few are available that mainly inhibit COX-2. The pain-relieving and anti-inflammatory effects of NSAIDs are mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.
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Nonsteroidal anti-inflammatory medications are one of the most commonly used types of medications for musculoskeletal conditions. NSAIDs can be effective for a wide variety of orthopedic conditions from arthritis, tendinitis, or other inflammatory conditions. Determining the best NSAID for your condition may depend on a number of different factors, and what works well for one individual may not be the best medication for another. There are possible side effects of different NSAID medications the patient should be aware of, and you should discuss with your physician if taking these medications for more than a short period of time.
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.
Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
Hi Brenda, The most effective painkilling gel is Voltarol which contains diclofenac, assuming your bad reaction to oral painkillers was not an allergy to NSAIDs. Another option to try is magnetic gloves, or a pain killing device such as Arc4Health, which can have quite miraculous painkilling effects. You should also ask your doctor to refer you to a pain clinic for specialist advice. I hope that helps. Best wishes, Sarah B

Hi Patricia, Sorry to hear about your experience. The patient information leaflet for diclofenac gel inside each pack advises that users should avoid applying on large areas of skin, that an amount ranging in size from a 1 penny to a 2 pence piece will usually be sufficient, and not to use it if you are already taking NSAID tablets. High blood pressure is not listed as a possible side effect, as this was not detected in clinical trials. As you say, diclofenac tablets and other oral NSAIDs are now associated with an increased risk of cardiovascular disease which is why the gel is considered a better option. I have coverd this in a post about ibuprofen increasing blood pressure here. Research looking into the long-term tolerability of topical diclogenac gel in people with an elevated risk of NSAID-related side effects, such as existing high blood pressure, type 2 diabetes, stroke and heart disease, suggests that the gel appears to be safe to use to treat osteoarthritis, even in these high risk groups. Having said that, everyone is different, due to the genes they have inherited, and you may have experienced an unusual, idiosyncratic reaction to the small amounts absorbed via the skin. It’s good that you or your doctor were monitoring your blood pressure to detect this. I have a website dedicated to lowering a high blood pressure, which includes lots of complementary approaches, that you may find helpful. Are you able to share the name of the herbal cream which you have found works better? Best wishes, Sarah B


Capsaicin produces highly selective regional anesthesia by causing degeneration of capsaicin-sensitive nociceptive nerve endings which can produce significant and long-lasting increases in nociceptive thresholds. Capsaicin potently activates transient receptor potential vanilloid 1, which is a main receptor underlying nociception. It also inhibits NF-kB, thus producing an anti-inflammatory effect. Capsaicin can cause a burning sensation when it comes in contact with human flesh, and also in the digestive tract. This herb is rarely used alone but is generally mixed into other natural anti-arthritic preparations. There are topical capsaicin formulations now available to treat post-herpetic neuralgia. Other uses have been studied for peripheral neuropathies and chronic musculoskeletal pain.[15,20,35,55,58,88,110]
I’ve just emphasized that Voltaren is mainly appropriate for shallow inflammation, but there is some evidence that Voltaren might be able to “reach deeper.” This is hardly the stuff of medical certainty yet, but researchers Huang et al found that Voltaren treated pain coming from deep inside the spine, right in the centre.6 They concluded that it could be a “convenient and safe clinical intervention” for a few types of back pain. An anti-inflammatory gel will likely fail with many kinds of back pain, but there’s also virtually no down-side to trying. See my low back pain tutorial for extremely detailed information about medications for back pain.

Did you know that the sensation of pain actually originates in your brain? Fortunately, we can actively alter the way our brain evaluates painful stimuli, helping to increase our pain tolerance and decrease painful symptoms.[12,13] Several techniques that aim to take more control over our minds and that relax the body can work wonders for pain control. Here are a few good examples:
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)
Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.

These creams can be quite effective for temporary pain relief on the muscle and joints. The creams would also come in handy when handling inflammations that may be brought forth by minor injuries, sunburn, skin rash and other severe conditions. Although doctors would prescribe most of these creams for their patients, more often than not individuals go for the OTC medications to deal with simple medical conditions. When making your purchase for this particular product it is important that you make a comparison between active ingredients and the inactive ingredients used in the formulation of the cream. At the end of the day, ensure that you choose a product that would not have dire side effects on your health. The cream you choose should help you deal with your particular problem in the best way possible and if possible you should make sure that you consult with your doctor before using any of these creams.
Pycnogenol inhibits TNF-α–induced NF-kB activation as well as adhesion molecule expression in the endothelium. Grimm et al, recently reported that oral intake of pycnogenol inhibited NF-kB activation in lipopolysaccharide-stimulated monocytes as well, thus decreasing the inflammatory response. It also statistically significantly inhibited matrix metalloproteinase-9.[46] This matrix-degrading enzyme is highly expressed at sites of inflammation, and contributes to the pathogenesis of various chronic inflammatory diseases.[96]
Vitamins are essential to health. Every natural thing that you eat contains the vitamins needed for growth, repair, bone density, pH balance and hormone regulation. The problem is that many people don’t have access to organic whole foods, so vitamin supplementation is important. When suffering from inflammation, pain and arthritis, the following vitamins may help.

Topical non-steroidal anti-inflammatories (often abbreviated to NSAIDs) are creams, gels, rubs, solutions or sprays that contain a nonsteroidal anti-inflammatory agent and are designed to be applied directly to the skin overlying a painful joint or area of bone. They are used to relieve pain and to treat symptoms of arthritis such as inflammation, swelling, and stiffness. Topical NSAIDs may also be used in the treatment of actinic keratosis (a precancerous patch of thick, scaly or crusted skin).


That said, why not try it? It’s almost certainly safer than popping ibuprofen! Although not tested and approved for reckless experimentation on any pain problem, obviously the entire point of Voltaren® Gel is to limit exposure to the active ingredient. So you might choose to experiment — taking full responsibility for your actions, of course, and not suing me if something goes horribly wrong, because of course I’m not actually recommending it. 😉 Seriously: just run it by your doctor.
You should always consult with a medical professional to get a diagnosis and consultant about treatments, but if they suggest an OTC cream as part of your treatment, there are some good ones to consider. You can find creams with various ingredients and in a variety of formats, including gels, roll-ons, and lotions. Some have a cooling effect, while others bring the heat, and there are scented and unscented options, so it all comes down to preference.

Resveratrol is available commercially as a dietary supplement capsule, generally from the P. cuspidatum source. The trans-resveratrol is the active form, and although there is not an established dosing range, the typical dose is from 50 to 500 mg daily. Any significant side effect or safety issues with resveratrol have not been established, but due to an experimentally shown anti-platelet effect, caution should be exercised when taking other prescription or herbal anti-platelet or coagulation altering products.[29,54,59,68,72,107,109]

Open the cream and gently use it on the affected area of your body, you will feel a tingling sensation which means it works. The best part is that the Pain Relief Cream gets quickly absorbed through your skin and leaves no traces of greasiness or stickiness. Another vital thing you need to know is that such creams nowadays. You just open the cream and apply it to the affected area of your body. There is also best pain relief spray out on the market which also helps you to feel tingling sensation and relief you from pain.
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably take your blood pressure and order certain tests to check your body's response to topical diclofenac (Pennsaid, Voltaren). Be sure to tell your doctor how you are feeling so that the doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.
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.
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:
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.
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.

Finally, the active ingredients within a pain relief cream interact with local nerve endings to damp down inflammation, reduce pain and swelling and ease stiffness. All these different actions make topical, rub-in creams and gels highly effective for treating painful joints, sore muscles and sport injuries. Here, I’ve reviewed what I believe are the best pain relief creams, sore muscle creams and pain relief gels.

If you’re sensitive to aspirin, or if you’re taking any over-the-counter (OTC) anti-inflammatory drugs (like aspirin, ibuprofen, or naproxen), you should avoid willow bark. You should also avoid taking it if you’re taking warfarin (Coumadin) or other anticoagulant treatments, as salicin could increase the risk of bleeding. Talk to your doctor before taking willow bark if you’re taking other anti-inflammatory or pain medications.
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