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.
Different creams and gels combine different pain-relieving ingredients for a greater, synergistic effect. The most effective natural ingredients are arnica, cannabidiol CBD oil, glucosamine, chondroitin, celadrin, comfrey root, capsicum, MSM and Green-lipped mussel extracts. The most effective pharmaceutical pain relief gel are those containing diclofenac, which is a stronger version of ibuprofen.
Cetyl myristoleate (CMO) is a fatty acid, an ethylated esterified fatty acid derived from bovine tallow oil. Though it is similar to fish oil, it is made specifically to help joints through its action as a cellular lubricant. Clinical studies show CMO to be an effective natural anti inflammatory compound that promotes healthy joint function. It increases joint flexibility and range of motion by lubricating the joint at a cellular level. It works to decrease inflammation specifically in the joints and lubricate their movement. In other words, it increases the fluids that cushion the space between the joint bones. CMO is reported to effect change at the cellular level, within the cell membranes themselves. It assists in the reduction and prevention of breakdown in joint cartilage. This can be especially helpful for those suffering degenerative osteoarthritis. The Journal of Rheumatology reported on a double-blind study of patients with chronic knee osteoarthritis where the CMO group saw significant improvement while the placebo group saw none. In fact, the scientists were so impressed with the results they concluded CMO “may be an alternative to the use of non-steroidal anti-inflammatory drugs for treatment of osteoarthritis.”
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. 
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.

The processes used to prepare herb-derived compounds pose complications when it comes to determining the quantity and concentration of the products.[30,63,102] The preparation processes are not standardized, and therefore, the extraction process and the type of plant used may affect the true concentration of the product. In addition, there is a lack of uniformity within and between manufacturers. Although dietary supplements are not held to the same rigorous testing and standards as pharmaceutically derived medications in the US, there are many regulations that still control their manufacture because these are food products.
The use of both over-the-counter and prescription nonsteroidal medications is frequently recommended in a typical neurosurgical practice. But persistent long-term use safety concerns must be considered when prescribing these medications for chronic and degenerative pain conditions. This article is a literature review of the biochemical pathways of inflammatory pain, the potentially serious side effects of nonsteroidal drugs and commonly used and clinically studied natural alternative anti-inflammatory supplements. Although nonsteroidal medications can be effective, herbs and dietary supplements may offer a safer, and often an effective, alternative treatment for pain relief, especially for long-term use.
Hi Pauline, sorry to hear about your knee. Yes, capsaicin/capsicum cause stimulation of nerves endings so their chemicals are depleted and they reduce the level of pain messages they send on. The brain also naturally dismisses persistent signals. Some people do find it irritating, however, but better than the traditional treatments that mimic this action -bee stings and nettles! Best wishes, Sarah B
For centuries, natural anti-inflammatory compounds have been used to mediate the inflammatory process and often with fewer side effects. We have briefly reviewed several of the most commonly used plant- and animal-derived natural compounds that may possess similar effectiveness in treating the inflammatory reaction seen in both chronic and sub-acute pain syndromes encountered in a typical neurosurgical practice. Ongoing experiments and clinical trials should be continued to guide and provide their scientifically based effectiveness to reduce inflammation and promote wellness.
The active ingredients in fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), enhance the conversion of COX to prostaglandin E3. A natural anti-inflammatory agent, prostaglandin E3 competitively inhibits the effects of the arachidonic acid conversion to prostaglandin E2, a highly inflammatory substance. Prostaglandin E3 also inhibits the synthesis of TNF-α and IL-1b, both of which are inflammatory cytokines. The EPA and DHA can inhibit the 5-LOX pathway, which converts arachidonic acid to inflammatory leukotrienes, by competitive inhibition as well. When EPA and DHA are incorporated into articular cartridge chondrocyte cell membranes, there is a dose-dependent decrease in the expression and activity of the proteoglycan-degrading aggrecanase enzymes.[12,23–25,27,50,85]
Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown efficacy in patients with osteoarthritis (OA) pain but are also associated with a dose-dependent risk of gastrointestinal, cardiovascular, hematologic, hepatic, and renal adverse events (AEs). Topical NSAIDs were developed to provide analgesia similar to their oral counterparts with less systemic exposure and fewer serious AEs. Topical NSAIDs have long been available in Europe for the management of OA, and guidelines of the European League Against Rheumatism and the Osteoarthritis Research Society International specify that topical NSAIDs are preferred over oral NSAIDs for patients with knee or hand OA of mild-to-moderate severity, few affected joints, and/or a history of sensitivity to oral NSAIDs.

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1. Capsaicin. Capsaicin creams and gels are made from chili peppers.  They cause a mild to moderate burning sensation thought to alter nerves' ability to interpret pain by lowering the presence of a neurotransmitter called Substance P. Brand names including Capzasin and Zostrix are marketed for arthritis, backache, and other joint and muscle pains.  These creams aren't generally associated with any adverse side effects though some patients may feel the heat more intensely than others.
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.
Maybe. They may not completely get rid of your monster headache but they may help relieve some of the aches that come with them. Some people who experience migrains also have neck and shoulder pain and topical pain relief gels and creams may help to lessen this symptom. Some migraine sufferers use roll-ons on the forehead or back of the head to induce a cooling or heating sensation to help cope with the pain.
Omega 3 fatty acid supplements are one of the most powerful ways to reduce oxidative stress and inflammation which are the underlying markers we see on labs with individuals who are suffering with chronic pain.   Omega 3’s help provide better cell membrane receptor activity and suppress genetic transcription factors associated with inflammation and pain.
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One of the problems with pain relief creams is that application can become messy. It can be difficult to keep the cream contained to the area of skin that needs treating, and if you get the product on your hands, it’s easy to accidentally rub it into the eyes, which can be painful! To the rescue: Roll-on formulas, like Outback All-Natural Pain Relief, which allow for hands-free and targeted pain relief. The product contains just four ingredients: tea tree oil, vanilla, eucalyptus, and olive oil. The ingredients ease pain by reducing inflammation.
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
Back pain can interrupt your day or interfere with your plans. In fact, there’s an 84 percent chance that you will develop low back pain in your lifetime. But back pain isn’t always something you can ignore or wait for it to resolve on its own. Thankfully, there are several ways to treat back pain at home. These remedies include everything from herbs to massages. Keep reading to see how you can ease your back pain.

Meditation and mindfulness. Mindfulness meditation, which focuses on awareness of the present moment, can reduce the way we perceive pain. In one study, only four days of training led to a 40% reduction in pain rating and a 57% reduction in pain-unpleasantness.[14] This kind of meditation can help you to control back pain, fibromyalgia, and migraines. Read more about meditation and mindfulness for pain control here.
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