Preliminary research suggests that hypnotherapy may be of some use in the treatment of low back pain. For instance, a pilot study published in the International Journal of Clinical and Experimental Hypnosis found that a four-session hypnosis program (combined with a psychological education program) significantly reduced pain intensity and led to improvements in mood among patients with chronic low back pain.

A key warning about using topical analgesics: don’t use them if you are also taking an oral NSAID—either prescription or over-the-counter—without telling your doctor. Taking too much of an NSAID can land you in the hospital with stomach bleeding or an ulcer flare-up. In fact, up to 100,000 Americans are hospitalized every year for NSAID-related gastrointestinal problems.
One concern about the use of products like Voltaren is that several conditions are less inflammatory in nature than they feel like. Patients usually assume that the “burning” pain of repetitive strain injuries like tendinitis is caused by inflammation, but in fact classic inflammation is largely absent, especially after initial flare-ups have died down (but pain is still carrying on). While it is possible, even likely, that tendinitis is still inflamed in some sense, it’s doubtful that they are inflamed in a way that NSAIDs are actually good for. The biochemistry of cranky tendons is rather complex and largely unknown. There’s probably some overlap between the biology of acute, classic inflammation and the subtler biology of chronic tendinitis, but no one really knows. So the value of Voltaren for tendinitis is unclear.
ASU is a vegetable extract made from the oil of avocados and soybeans that is said to slow the progression of osteoarthritis. It slows down the production of inflammatory chemicals in the body and thus the breakdown of cartilage in the joints. It has also been found to spur new cartilage cell growth. It is available in capsule form at a recommended 300 mg daily.
The main advantage of topical NSAIDs is the reduced exposure of the rest of the body to the product, which reduces the side effect profile. Given the toxicity of NSAIDs is related in part to the dose, it follows that topical treatments should have a better toxicity profile. Consequently, the cardiovascular risks of topical diclofenac, even in those with a high baseline risk of disease, should be negligible with the topical forms.
In contrast, the guidelines of the American Pain Society and American College of Rheumatology have in the past recommended topical methyl salicylate and topical capsaicin, but not topical NSAIDs. This reflects the fact that the American guidelines were written several years before the first topical NSAID was approved for use in the United States. Neither salicylates nor capsaicin have shown significant efficacy in the treatment of OA.
Acetylsalicylic acid works by irreversibly disabling the COX enzymes to block the cascade [Figure 1]. NSAIDs have evolved from blocking both COX-1 and COX-2 to selectively only blocking COX-2 in order to inhibit the inflammatory response and reduce the production of inflammatory prostaglandins and thromboxanes. The major push to develop the selective COX-2 inhibitors has been the recognition of significant complications associated with the nonselective COX-1 and COX-2 NSAIDs. Nonselective NSAIDs’ major side effects include significant gastrointestinal upset, gastritis, ulceration, hemorrhage, and even death. By locking COX-1, which also normally acts to protect the gastrointestinal mucosa, nonselective NSAIDs and aspirin can cause significant gastric tissue damage.[34,51,78,91,3,101,115]
I am 63 with osteoarthritis of my knee. I have struggled with pain relief and steroid injection hasn’t helped now waiting for new knee but need to control pain. I have just been recommended emu oil. I went to holland and Barrett and found Blue ease gel that has emu oil, capsicum and MSN amongst its ingredients. It does help the pain but skin burns (may have put too much on) how much will I need for a knee and will the burning sensation go away I have tried capsicum cream on prescription and that advised that burning sensation improves in a couple of weeks. From reading your advise re capsicum am I right in thinking that the burning sensation distracts the brain from the joint pain thanks
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.

7) The indoleamine 2,3-dioxygenase pathway controls complement-dependent enhancement of chemo-radiation therapy against murine glioblastoma. Li M, Bolduc AR, Hoda MN, Gamble DN, Dolisca SB, Bolduc AK, Hoang K, Ashley C, McCall D, Rojiani AM, Maria BL, Rixe O, MacDonald TJ, Heeger PS, Mellor AL, Munn DH, Johnson TS. J Immunother Cancer. 2014 Jul 7; PMID: 25054064


Enjoy essential oils. Essential oils have long been valued for their analgesic effects in many cultures. There are many ways to benefit from essential oils—some people inhale them (aromatherapy), others include several drops in their massage oil and enjoy as part of a therapeutic massage. Several oils in particular are thought to have an analgesic effect, including peppermint oil, rosemary, and lavender.
Products that create a feeling of heat on the skin can also help relieve discomfort by distracting you from pain signals. The Sombra Warm Therapy Natural Pain Relieving Gel provides controlled warming to ease conditions like arthritis, bursitis, fibromyalgia, or even a simple backache. The gel quickly absorbs into the skin and won’t stain clothing. It’s also free of artificial colors, fragrances or alcohol.
Limited bed rest. Once the mainstay of treatment for back pain, bed rest has fallen out of favor. Doctors now know it's better to keep moving, so that your muscles don't become stiff. Bed rest can still be useful relief from low back pain, particularly if your pain is so severe that it hurts to sit or stand. But try to limit it to a few hours at a time and for no more than one or two days.
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.
You are older than 65. “A lot of elderly patients can’t take oral NSAIDs because they have stomach or heart risk factors, and they can’t take narcotic analgesics because they could become so drowsy they could fall and break a bone,” says Roy D. Altman, MD, professor of medicine in the division of rheumatology and immunology at the University of California, Los Angeles.

"I don't use topical pain relievers often, but when I do I use a product called Biofreeze ($15; performancehealth.com). It's a menthol-based gel that soothes local aches and pains in much the same way that ice therapy works but with less skin irritation, and the ability to be mobile once it's applied. It's also the product physical therapists and massage therapists choose." — Yusuf Jeffers, Tone House coach
Chondroitin sulphate is produced naturally in the body to promote the formation of healthy cartilage, tendons and ligaments, and it is also an important component of joint synovial fluid. As you get older, your joint cells secrete less and less chondroitin and this has been linked with reduced cartilage quality and the start of degenerative changes.
15. Bromelain – This natural pain-reducer comes from the enzymes present in pineapple stems. Research shows that it reduces levels of prostaglandins, which are hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions marked by musculoskeletal tension (like TMJ syndrome), in addition to those suffering trauma-related inflammation. The enzyme also promotes healing in muscles and connective tissues.
Studies have shown that pycnogenol is 50–100 times more potent than vitamin E in neutralizing free radicals and that it helps to recycle and prolong the activity of vitamins C and E. Studies have shown pycnogenol to be effective in reducing blood pressure and reducing the risk of venous thrombosis by its effect on vascular endothelium. The usual dosage is 100–200 mg daily. Few side effects from the use of pine bark extracts have been reported, the most frequent being mild gastrointestinal effects such as diarrhea and upset stomach. Pycnogenol should not be taken by patients who are being treated with immunosuppressants or by those receiving corticosteroid drugs because it can enhance immune system function and interact with drugs that suppress the immune system.[46–84]

you should know that you should not apply sunscreens, cosmetics, lotions, moisturizers, insect repellents, or other topical medications to areas treated with diclofenac gel (Voltaren). If you have been prescribed diclofenac liquid (Pennsaid), wait until the area of application is completely dry before applying any of these products or other substances.


Magnesium is the fourth most abundant mineral in the body. Involved in over 300 biochemical reactions, it helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and preserves bones strength. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis.
It is a natural product which has been effectively used in the treatment of bone and muscle pain, in painful abnormalities resulting from spinal cord compression and as an analgesic medication following surgical interventions. It contains essential oils, alkaloid arnicine, glycosides, flavones, carotenes, mucilages and magnesia. Its main property is that it increases local blood flow due to its rubefacient effect, and its ability to relieve pain and improve muscle and nerve weakness. It is therefore very widely used for contusions, bumps, bruises, sprains, rheumatism, lower back pain, varicose veins, haemorrhoids and muscle pain.
NSAIDs don’t just damage your gut lining. They affect your gut bacteria, too. A study of regular users found that different NSAIDs caused different changes in gut bacteria.[5] Ibuprofen and arthritis drug celecoxib (Celebrex), for example, increased pathogenic Enterobacteriaceae, a family of bacteria that includes E. coli, Salmonella, and a number of lesser-known bacteria that contribute to eye, skin, respiratory, and urinary tract infections.[6]
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