The use of fish oil (in the form of cod liver oil), an omega-3 EFA, for the treatment of muscular, skeletal, and discogenic diseases, can be traced back to the late 18th century as detailed by Curtis et al.,[24,25] Unfortunately, because of the rapid onset of rancidity of this polyunsaturated oil when exposed to air, and hence its disconcerting odor, cod liver oil fell out of favor. With improved extraction techniques, such as using a protective nitrogen blanket and enhanced oxygen-free encapsulation methods, there is less chance of oxidation during the manufacturing process. The therapeutic benefits of fish oil can now be realized without the regurgitation and odor of previous products caused by peroxides and rancid tasting fish oil.[14]
All the aforementioned creams are exceptional in dealing with joint pains. Therefore, if you wish to deal with pain experienced on the back, knees, and elbow then any of the creams outlined above would do you some good. Even if you may not be a fun of using pain relief medications the ten distinctive anti-inflammatory creams that have been discussed earlier would make you develop a liking for these types of medication.
I use my Rogue Fitness Supernova ($40; roguefitness.com) for self-myofascial release (SMR). By applying pressure directly to sore muscles with my supernova, I am able to roll out knots (or adhesions) on the muscle. This allows the body to bring blood flow to troubled areas by transporting nutrients and oxygen to the muscles for faster repair." — Troy Brooks, YG Studios and founder TB Elite Fitness
Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.
Endorphins are hormones made naturally in your body. What most people don't know is that they can be just as strong as any manufactured pain medication. When endorphins are released in your body, they help block pain signals from registering with your brain. Endorphins also help alleviate anxiety, stress, and depression, which are all associated with chronic back pain and often make the pain worse.
The NSAIDs are also known to have adverse effects on kidney function.[31] Dehydration or preexisting chronic renal failure or disease, resulting in stimulation of the renin–angiotensin system, may predispose certain populations to acute renal failure through inhibition of prostaglandin synthesis, which can occur when taking NSAIDs.[31] The National Kidney Foundation asserts that approximately 10% of kidney failures per year are directly correlated to substantial overuse of NSAIDs.
"Herbals or other nutraceuticals that may help in some way — as well as those which may not actually help — do almost universally have the potential to harm through unwanted side effects, allergic reactions, and undesirable interactions with other substances and medicines," says Sam Moon, MD, MPH, associate director of education at Duke Integrative Medicine, a division of Duke University Medical Center in Durham, N.C. "Relative safety must be very carefully balanced against likely effectiveness."

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.


Resveratrol is a plant-based polyphenol molecule that is found in various concentrations of many different plant sources. The plant is called Japanese Knot weed or Polygonum cuspidatum, and the skins of red wine grapes are believe to have the most concentrated amounts of resveratrol. In plants, resveratrol is generally found in the plant skin and acts as a phytoalexin to protect the plant from infection, excessive UV radiation and aide in general plant defense. Resveratrol has also been found to have significant anti-mutation, anti-inflammatory, antoxidant and DNA protective actions, when consumed by animals and humans.
Despite what a majority of people may have been made to believe concerning the issue of anti-inflammatory creams and the pain-relieving creams the truth is that the two types of creams differ immensely. Pain relief creams serve the important function of disrupting the transmission of pain signals from different parts of the body to the brain thus allowing you to feeling a sense of temporary pain relief. However, most cream pain relievers would not have elements that would help reduce inflammation or swelling. Nevertheless, the anti-inflammatory creams and the pain relief creams both can be used for arthritis flare-ups and dealing with minor sports injuries. Nevertheless, for those people who may have never used these types of medications before or those who may not be sure of the type to use it is important to consult with the doctor before using such a product. Most all, never use the anti-inflammatory creams on a child or expectant mother unless who check in with your doctor.
Since the time of Hippocrates white willow bark has been in use as a natural means of reducing inflammation and pain, specifically associated with osteoarthritis and rheumatoid arthritis, as well as headache, backache, gout and PMS. The bark of the willow tree contains the chemical salicin, which has a similar effect in the body as acetylsalicylic acid (aspirin). But it’s better than aspirin, because it has none of the gastrointestinal side effects, and it naturally contains flavonoids (anti-inflammatory compounds found in plants).
Try massage therapy. Studies have shown that massage therapy not only helps with relaxation, but can also help diminish the body's perception of pain. A high quality therapeutic massage spurs blood flow, which in turn helps nourish and heal the soft tissues in throughout your body. Massage also releases endorphins, which are your body's natural analgesics. Massage therapy is defined as soft tissue—muscles, tendons, and ligaments—manipulation through hands-on massage by a qualified massage therapist. Like many complementary therapies, there is no substantial agreement in terms of how much massage therapy can help reduce pain, or which type of massage is best for which type of pain, so you may need to try more than one approach to find what works best for you.
This can vary depending on the reason for treating you, so speak with your doctor for advice. If you are using an anti-inflammatory for acute muscle pain, usually treatment lasts for as long as you have pain and inflammation. For example, a few days, or weeks. But if you are being treated for conditions like osteoarthritis, your doctor may advise you to use this medicine for the long term.
Rannou F, Pelletier JP, Martel-Pelletier J. Efficacy and safety of topical NSAIDs in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 2016 Feb;45(4 Suppl):S18–21. PubMed #26806189. “Topical NSAIDs have a moderate effect on pain relief, with efficacy similar to that of oral NSAIDs, with the advantage of a better risk:benefit ratio. In real-life studies, topical and oral NSAIDs demonstrate an equivalent effect on knee pain over 1 year of treatment, with fewer adverse events due to lower systemic absorption of topical NSAIDs compared with oral NSAIDs.” BACK TO TEXT

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.


The Inactive ingredients are aloe barbadensis leaf extract, arnica Montana flower extract, Actium lappa root (burdock) extract, boswellia carterii resin extract, calendula officinalis extract, carbomer, camellia sinensis (green tea) leaf extract, camphor, glycerin, ilex paraguariensis leaf extract, isopropyl alcohol, isopropyl myristate, melissa officinalis (lemon balm) leaf extract, silica, tocopheryl (vitamin E) acetate, triethanolamine, water, blue 1, and yellow 5. Ilex is a skin protectant for topical skin barrier gels and lotions designed to protect the skin from harmful irritants such as urine and feces. It usually contains good things such as corn starch, white petroleum jelly, and zinc oxide.
Acupuncture: Acupuncture may provide even more relief than painkillers, according to one 2013 review. In 11 studies of more than 1,100 people, this Chinese medicine staple improved symptoms of lower back pain better than simulated treatments and, yes, in some cases, NSAIDs. The needles appear to change the way your nerves react and may reduce inflammation around joints (which is only one of the therapy's benefits), says DeStefano.

For short-term pain relief, over-the-counter pain relievers including acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) are sometimes suggested. The most common NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Potential side effects of NSAIDs include stomach and liver problems. Talk to your doctor if you don't find relief after taking the recommended dose.


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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.

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. 
The NSAIDs are also known to have adverse effects on kidney function.[31] Dehydration or preexisting chronic renal failure or disease, resulting in stimulation of the renin–angiotensin system, may predispose certain populations to acute renal failure through inhibition of prostaglandin synthesis, which can occur when taking NSAIDs.[31] The National Kidney Foundation asserts that approximately 10% of kidney failures per year are directly correlated to substantial overuse of NSAIDs.
Deng ZH, Zeng C, Yang Y, et al. Topical diclofenac therapy for osteoarthritis: a meta-analysis of randomized controlled trials. Clin Rheumatol. 2016 May;35(5):1253–61. PubMed #26242469. “Topical diclofenac is effective in pain relief as a treatment of OA. It may also have a potential effect in function improvement, which needs further studies to be explored. Although, some adverse effects were observed in the application of topical diclofenac, none of them was serious.” BACK TO TEXT

Foam roller exercises are a form of self-myofascial release that, while kind of mildly painful at times, actually gets out those nagging muscle knots while helping you fix muscle imbalances that lead to poor posture and related musculoskeletal pain. It’s also an emerging treatment to reduce your risk of developing delayed muscle onset soreness, a common exercise-related pain that keeps people out of the gym. (6)


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]
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.
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.
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While leading the most vigorous life filled with project deadlines and domestic responsibilities and accomplishing success at all endeavors do you sometimes get compelled to lag behind other such active individuals given to the muscle pain agony? And does this dilemma affect you at a most recurring frequency at times when you are preparing for an office presentation or venturing out to complete household tasks? Be aware that in order to prevail as a most efficient professional and sincere family person putting forward causes of back pain or calf cramp or wrist soreness as reasons for not fulfilling your duties is the least enterprise that you can undertake.
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.
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.
Jackson, M., & Tummon Simmons, L. (2018, April 1). Challenging case in clinical practice: Improvement in chronic osteoarthritis pain with use of arnica oil massage, therapeutic ultrasound, and acupuncture — A case report [Abstract]. Alternative and Complementary Therapies, 24(2), 60–62. Retrieved from https://www.liebertpub.com/doi/abs/10.1089/act.2018.29152.mja?journalCode=act
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
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]
“I cannot even tell you how AMAZING this stuff is. I never do reviews, but this product most certainly deserves one. I have dealt with MANY injuries, I was in a bad car wreck, and I have had more surgeries than I could count on both hands. My main area of pain is my upper back and neck. I have bulging disks, cervical stenosis, degenerative disk disease that causes horrible spasms, swelling, tension, and PAIN. I also have cancer and several other issues that put my pain level over the top every day. I have seen neurosurgeons, all of whom say they will eventually need to operate. I have done absolutely every possible treatment other than a spinal fusion, have had probably 10 injections, and they even went and tried to burn the nerve endings throughout my entire cervical spine, yet nothing worked. I can't even begin to tell you the medications the doctors have tried, each of which help some, but you get to a point where you don't want to constantly take medications forever. One day I was at my spine doctor's office and they had a bottle of Relief pain cream on the counter. While I was waiting there I asked the staff some questions about Relief and thought "yea, yea, but can I try it?" So, I put some on, and thought, "HOLY COW! What is this! Whatever this is, it's amazing!" Then and there I literally bought the rest of the supply they had on-hand because I couldn't believe how much it helped relieve my pains and aches. That night, I couldn't sleep because I was in so much pain, and none of my medications were helping. I felt like I was dying. So again, I put on some Relief cream and it helped soooo much. Since that day I never, ever, go anywhere without Relief! I will use this pain cream forever and continue to tell everyone I know about it because it truly works! I'm so glad I randomly tried this stuff at the doctor's office because I finally found something that gives true RELIEF!!” *
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.
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.

A combination of Boswellia and curcumin showed superior efficacy and tolerability compared with nonsteroidal diclofenac for treating active osteoarthritis. Boswellia typically is given as an extract standardized to contain 30-40% boswellic acids (300-500 mg two or three times/day). Boswellia has been well tolerated in most studies, although some people may experience stomach discomfort, including nausea, acid reflux, or diarrhea.[1–10,42,48,56,62,103,104]
After an injury, first rest, ice the area, use compression, and elevate the area. The acronym to help you remember is RICE. Rest the area. Ice the area 4 times a day for 10 to 15 minutes. If it looks better, compress the area with an Ace-type elastic bandage. To reduce swelling, ice helps, and so does elevating the area above your heart. When the swelling is down but you still have mild pain, apply a topical cream or gel according to the package directions. If it has worsened, consult your doctor.
"I'm really big on heat, since it draws blood to the spot that is heated. I am a huge fan of ThermaCare Heatwraps ($8; drugstore.com) since you can just wrap or tape them on and go about your life (I really like and recommend using one at night if you have a knot, or an especially tight spot)." —Heidi Kristoffer, creator of CrossFlowX (Got PMS cramps? Kristoffer shares the best yoga poses to ease aches and bloating.)

How much do you have to use at once and how often? Is it easy to apply too much? Generally, roll-on applicators are the best choice for reducing waste since it’s hard to put on too much when using them. It is also important to note that if you need deep muscle penetration roll-ons often don’t provide the same effect as hand rubbing gel or cream into the affected area. So be sure to keep that factor in mind as you review these products.
Glucosamine is one of the most-studied supplements around the world for relief of arthritis symptoms and joint health. Sulfur is produced naturally in the body and is an essential component to joint health. Glucosamine sulfate is a type of glucosamine that is most useful in the support of joint mobility and pain relief because it absorbs well. Conversely, glucosamine chondroitin does not absorb in an amount significant enough to create enough of a change to make taking it worthwhile. Glucosamine sulfate works as well as NSAIDs for some people but without the negative effects to the gastrointestinal tract or liver.
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
3. Menthol, Eucalyptus and Mint Oils. Pain relieving creams containing either one or a combination of menthol, camphor, eucalyptus, spearmint, wintergreen or peppermint are thought to work by "confusing" nerve signals into feeling heat and cold sensations instead of pain.  Popular brands include Mentholatum Deep Heating Rub® and Icy Hot® (which may contain methyl salicylate too).  While many pain sufferers say these products work, its' relief is temporary at best.  These pain relief creams have to be reapplied frequently and tend to have strong fragrances.

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.


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.
People with sensitive skin, infants, children, pregnant women, and seniors might be at a higher use using these products. People with kidney problems or kidney failure in the past shouldn’t try an Ibuprofen cream. If you take aspirin, prescribed blood thinners such as Coumadin (warfarin) or have bleeding of the gastrointestinal tract, consult your healthcare provider before using these topical pain products. Do not use salicylates that cause blood to be thinner.
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.
Within the cartilage around your joints is a chemical known as chondroitin. Chondroitin is naturally produced by the body. As you age, your natural supply starts to plummet. And a loss of chondroitin from cartilage is linked to a major cause of joint pain. Moreover, through wear and tear the joint cartilage breaks down, resulting in the condition of Osteoarthritis. We can’t regenerate cartilage on our own, but we can take a supplement called chondroitin sulfate which, studies show, can help slow down this degenerative process and help naturally reduce arthritic pain. Chondroitin sulfate is made from the cartilage of cows and other animals, and is often used in combination with other products including glucosamine and manganese.
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