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.
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]
The InstaNatural™ pain relief gel is ohhh soo cooling for your sore aching back, chest, neck, elbows, arm muscles, knees, and arthritic conditions. Arthritis makes your bones ache and skin tender at that area. This will relax you and make you feel more comfortable. Arthritis stiffness is indeed very painful, especially in the fingers. This might provide relief to rheumatoid arthritis sufferers too, a more significant and painful condition. It performs well for tendonitis, carpal tunnel syndrome, sciatica, tennis elbow, golfer’s elbow, plantar fasciitis, fibromyalgia, and more aches and pains. The 2-ounce jar of gel will not stain your skin or clothes.
How it works: A misaligned spine can cause muscle tension (read: pain). Both physical therapy and chiropractic treatment improve spinal alignment. Physical therapists strategically stretch and strengthen the muscles that help hold the spine in place. Chiropractors manipulate the spine to relieve areas of tension on the muscles. Consult your primary-care doctor for a referral.

tell your doctor if you have severe diarrhea or vomiting or think you may be dehydrated; if you drink or have a history of drinking large amounts of alcohol, and if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; heart failure; or kidney or liver disease.


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.
The most often neglected method to control inflammation that I see in my patients is rest. Not only does this mean resting from athletics, but often this means allowing an injured body part to rest from normal activities which may prolong inflammation. We live busy lives that may not allow for rest, but ignoring the signs of inflammation may prolong the problem. Therefore, look for ways to rest your injured body part to allow the inflammation to subside and the recovery process to unfold.
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.
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.
Homeopathic (diluted) herbal ointments featuring Arnica are claimed to be good medicine for muscle pain, joint pain, sports injuries and bruises, but their effectiveness is questionable. Known to most customers as an “herbal” arnica cream, most actually contain only trace amounts — too little to be a chemically active ingredient. Homeopathy involves extreme dilution of ingredients, to the point of completely removing them. Some other herbal ingredients may be less diluted and more useful. However, neither homeopathic or pure herbal creams of this type have produced results better than placebo in good quality modern tests. See Does Arnica Gel Work for Pain? A detailed review of popular homeopathic (diluted) herbal creams and gels like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation. BACK TO TEXT
To minimize your risks for a skin reaction, Cowling recommends doing a skin test before starting any topical pain reliever and washing your hands immediately after applying. Also don’t use topicals on any areas of the body where you have an open wound or broken skin, even a scratch. If you develop severe itching, redness, swelling or any other signs of a worsening skin reaction, contact your doctor. 
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.
“For most people, it means their back hurts,” says Richard A. Deyo, MD, MPH,the Kaiser-Permanente Endowed Professor of Evidence-Based Medicine in the department of family medicine at Oregon Health & Science University in Portland. “But it’s often impossible to know the precise anatomical cause of back pain because the back has so many sources of pain.”

Aspirin is now believed to target both the NF-kB and COX pathways. These agents inhibit the NF-kB pathway in endothelial cells and block NF-kB activation to inhibit leukocyte recruitment.[114,115,116] NSAIDs have also been found to inhibit both the COX system and the NF-kB pathway. Immunosuppressant drugs also reduce nuclear expression of NF-kB.[39,70,75] Research now indicates that blocking the activation of NF-kB along with other inflammation mediators [Table 2] is the major mechanism for reducing inflammation by natural compounds.
Carun Active Hemp Ointment is an infusion of cannabidiol CBD in petroleum jelly, hemp seed oil and olive oil, and is scented with a blend of natural lemon, peppermint and lavender essential oils. This ointment contains CBD at a strength of 3% (a 100ml pot contains 300mg CBD) and has a soft, melting texture at room temperature. Carun Active Hemp Ointment is available from Amazon.co.uk. A wide range of CBD ointments and creams are also available on Amazon.com some of which combine CBD with Arnica for additional healing benefits.

Meditation has been proven to reduce chronic pain in several scientific studies. Research from Duke University found that people suffering from chronic back pain saw significant reductions in pain and psychological distress after practicing a form of meditation that focuses on releasing anger. In another study, meditators experienced a 40% reduction in pain intensity.
Studies have shown that the gel from this medicinal plant is able to relieve the pain and improve joint movement and stiffness in individuals with arthrosis in the fingers at the same level as ibuprofen. It demonstrates that arnica is an effective alternative to the use of NSAIDs (such as ibuprofen) against this type of conditions, as arnica also prevents the gastric irritation caused by treatment with ibuprofen. Its use is therefore particularly recommended in individuals with stomach problems.

When anti-inflammatories are taken by mouth they work by blocking (inhibiting) the effect of chemicals (enzymes) called cyclo-oxygenase (COX) enzymes. COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces pain and inflammation.
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.
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.

Physical therapists often recommend aquatic therapy — including exercises done in warm, therapeutic pools — for back pain. The buoyancy of the water helps alleviate strain on the joints to encourage strengthening and gentle stretching of the muscles. Even floating in warm water can help relax muscles and release tension as well as increase circulation, according to the Arthritis Foundation. With home whirlpool baths, try aiming the jets directly at your sore spots for a soothing underwater massage.
To minimize your risks for a skin reaction, Cowling recommends doing a skin test before starting any topical pain reliever and washing your hands immediately after applying. Also don’t use topicals on any areas of the body where you have an open wound or broken skin, even a scratch. If you develop severe itching, redness, swelling or any other signs of a worsening skin reaction, contact your doctor. 
"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
We looked at both gels and creams to create our top ten list. How did we evaluate consistency? We looked at whether the substances stained, went on greasy, or were otherwise messy to deal with. Did users like the feel of the gel or cream on their skin? Why or why not? We also looked at whether formulas were quick drying and whether they left a residue. When it came to ingredients, we wanted to select as many options as possible with natural ingredients that were easily recognizable.
Water, Menthol, MSM, Glycerin, Dipropylene Glycol, Celadrin, Camphor, Cetearyl Alcohol / Cetearyl Glucoside, Beeswax, Microcrystaline Wax, Butylglycerin, Kyounin Yu, Macadamia, Integrifolia Seed Oil, Glyceryl Stearate / PEG-100 Stearate, Dimethicone, Hyaluronic Acid, Portulaca Oleracea Extract, Allantoin, Licorice Root Extract, Arginine, Carbomer, Lavender Oil, Peppermint Oil, Disodium EDTA, Polyacrylate-13/Polyisobutene / Plysorbate 20

Hi Peggy, It’s not a treatment with which I am familiar. Looking at the incredients, Blue Ice contains alcohol which will cool by evaporating, an aspirin-like substance (methyl salicylate), magnesium (muscle relaxant) and capsicum which has a pain killing action by depleting nerve endings of nerve chemicals. It looks like it is effective for muscle and joint pain and has good reviews but I can’t speak from personal experience. Hope that helps, Sarah B
No, the lower back pain isn't in your head. But what is in your head could be making it worse. "Fear, anxiety, and catastrophizing can amplify pain," says Mackey. "People often get swept up in thoughts like This will never get better." Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Cognitive-behavioral therapy helps you recognize and reframe negative thoughts. Deep breathing can help, too, as can simply shining a light on dark thoughts. "Start by accepting that you have pain," Mackey says. "Then say to yourself, It will get better."
Chondroitin sulphate chains bind to hyaluronic acid to form ‘springy’ molecules that increase the strength and elasticity of cartilage, making it more resilient. Chondroitin also acts as a signal to inhibit the enzymes responsible for breaking down cartilage, and to increase the production of collagen. Chondroitin is therefore an ideal complement to glucosamine and the two are often combined in joint and muscle pain relief creams.
Long term and/or large oral doses of NSAIDs can be extremely dangerous, even lethal. They “nuke” your entire system with much more active ingredient than you really need, all of it absorbed through the digestive tract and distributed through your entire circulatory system. These drugs can and do cause complications at any dose, and are linked to heart attacks and strokes and ulcerations of the GI tract. For example, Diclofenac …
As runners and athletes many of experience pain and discomfort here and there. So, it's important we stock up on over the counter options that will help us deal with these issues. After evaluating our list, we have decided to add two more products--Arnicare and Blue Emu. Both of these come highly rated and will help relieve your pain and get you ready for your next day of training.
Luminas fast pain relief patch is incredibly easy to use. You simply apply the patch on the troublesome area or a flat area of skin close to it if the pain is in a joint like the elbow or knee. That’s all you need to do to be on your way to being pain-free for up to 24-hours. You don’t need to worry about it coming off in the shower, bath, or pool either. You’re covered!
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.
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.
After you apply diclofenac gel (Voltaren) or liquid (Pennsaid), you should not cover the treated area with any type of dressing or bandage and you should not apply heat to the area. You should not shower or bathe for at least 30 minutes after you apply the liquid (Pennsaid) and for at least 1 hour after you apply the gel (Voltaren). Do not cover the treated area with clothes or gloves for 10 minutes after you apply the gel (Voltaren), or until the liquid (Pennsaid) has dried if you are using the liquid.
Massage: There's an upside to your discomfort: It's a legit excuse to get a weekly massage. One study found that people who did had less lower back pain and disability after 10 weeks, compared with the control group—and general relaxation rubdowns worked just as well as structural massage targeted at specific parts of the body. Osteopathic and chiropractic therapies—in which joints and muscles get stretched and repositioned—have been shown to work, too. In a study published in the Annals of Family Medicine
Homeopathic (diluted) herbal ointments featuring Arnica are claimed to be good medicine for muscle pain, joint pain, sports injuries and bruises, but their effectiveness is questionable. Known to most customers as an “herbal” arnica cream, most actually contain only trace amounts — too little to be a chemically active ingredient. Homeopathy involves extreme dilution of ingredients, to the point of completely removing them. Some other herbal ingredients may be less diluted and more useful. However, neither homeopathic or pure herbal creams of this type have produced results better than placebo in good quality modern tests. See Does Arnica Gel Work for Pain? A detailed review of popular homeopathic (diluted) herbal creams and gels like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation. BACK TO TEXT
For example, water therapy is gentle on your body because the water supports the weight of your body and provides gentle resistance. The exercise is done in warm water, which is also soothing. There are many land-based exercise programs that can provide a gentle, endorphin-producing form of exercise, such as tai chi, or yoga programs designed for people with chronic pain conditions.
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.
Many patients have told me they find celadrin cream effective for rapid relief of painful joints. It appears to work best when you apply it all around the joint – for example in a continuous band around the front, sides and back of a knee. One patient, who had two arthritic knees, told me he performed a personal experiment in which he applied celadrin cream around one knee but not the other. He was amazed at the difference in the treated knee which, within hours, became less painful and more mobile. Needless to say, he soon started applying it to both knees!

Last year, I suffered a severe attack of gouty arthritis. I was crying in pain and tried several pain killers without any effect. Then, I consulted my doctor. He told me to not take any pain killers and prescribed Generic Colchicine 0.5mg no rx instead. And thankfully, the pain started subsiding. I would like to recommend this medicine to all patients suffering from gouty arthritis.
Aquatic therapy is essentially physical therapy in a pool. Instead of using weights for resistance, patients use the resistance of the water. Studies show it may help alleviate lower back pain. In one 2013 study, sedentary adults who underwent aquatic therapy five times a week for two months saw reductions in pain and increases in quality of life. One smaller study found that aquatic therapy also helped pregnant women who were experiencing aching lower backs.
Try taking one 250-milligram capsule of valerian four times a day. Some scientists claim that this herb’s active ingredient interacts with receptors in the brain to cause a sedating effect. Although sedatives are not generally recommended, valerian is much milder than any pharmaceutical product. (Valerian can also be made into a tea, but the smell is so strong-resembling overused gym socks-that capsules are vastly preferable.)
The use of non-steroidal anti-inflammatory drug (NSAID) medication is still the mainstay of most classically taught clinicians for joint and spine related inflammatory pain, despite their commonly known side effects [Table 1]. NSAID mechanisms are primarily through interaction with proinflammatory cytokines interleukin (IL)-1a, IL-1b, IL-6 and tumor necrosis factor (TNF-α). Increased concentrations of TNF-α are believed to cause the cardinal signs of inflammation to occur.[44]
As a doctor I’ve tried, recommended and prescribed many pain-relieving creams and gels to treat painful joints, backache, sore muscles, strained tendons and sprained ligaments. Medical guidelines even recommend that doctors prescribe topical creams and gels to treat mild to moderate joint pain. The best pain relief creams and gels are often just as effective as oral painkillers, but with much less risk of side effects. When I experience muscle or joint pain, I prefer to use a pain relief cream myself.

SAMe is one of the natural chemicals made within the body that science has been able to duplicate in a lab, and make into a supplement. Studies have shown SAMe supplementation to be comparable to the pain-relieving effects of Celebrex by the second month of taking the product, without the side effects. The SAMe chemical has a role in pain, depression, liver disease and has been shown effective when used for relieving the symptoms of osteoarthritis, fibromyalgia, bursitis, Alzheimer’s disease, multiple sclerosis (MS), migraine headache, depression and more, making it a great natural remedy for inflammation.
Back pain is one of the most common reasons why people visit a health care provider. The good news is that the pain often goes away on its own, and people usually recover in a week or two. Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only won’t help but it may, in fact, actually delay your recovery. Here’s why:
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.
Capsaicin. The main ingredient of hot chili peppers, capsaicin is also one of the most effective ingredients for topical pain relief.It can be helpful for joint pain and for diabetic nerve pain. When first applied, capsaicin creams cause a warm tingling or burning sensation. This gets better over time. You may need to apply these creams for a few days up to a couple of weeks before you notice relief from pain.
This is a good option for anyone suffering from minor arthritis pain or sore muscles. It has no odor and is perfect for rubbing into the back to relieve backaches and pain. This product does not use any heating or cooling feature, so it is perfect for someone who wants a smell-free pain relief cream without a lot of added features. People have been using this cream for decades, and many continue to prefer it.
If these aches and pains sound all too familiar, then there’s a whole host of safe and effective treatments available to get back pain relief and to then relieve arthritis pain – herbal remedies, special foods, over-the-counter medicines, exercises, and more (see our Arthritis Solutions Special Report for details). But the quickest and safest way to soothe arthritis pain is with a topical cream that contains:

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.
About “tendinitis” versus “tendonitis”: Both spellings are considered acceptable these days, but the first is technically correct and more formal, while the second is an old misspelling that has only achieved respectability through popular use. The word is based on the Latin “tendo” which has a genitive singular form of tendinis, and a combining form that is therefore tendin. (Source: Stedmans Electronic Medical Dictionary.) BACK TO TEXT
Omega-3 EFA, found in fish oil, can directly reduce the degenerative enzymes, aggrecanase and matrix metalloproteinase, as well as IL-1, TNF-α, and COX-2, to reduce the inflammation in synovial cartilage. A recent study of 250 patients with cervical and lumbar disc disease, who were taking NSAIDs, revealed that 59% could substitute fish oil supplements as a natural anti-inflammatory agent for the NSAIDs.[71] The recommended dosage is a total of 1.5–5g of EPA and DHA per day, taken with meals.
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.
The most commonly used drugs to treat chronic pain conditions include opioids (morphine), nonsteroids (salicylates such as aspirin and ibuprofen), antidepressants, antiepileptics and anti-nerve growth factor inhibitors.   All of these drugs have awful side effects and addictive tendencies.  In fact, prescription and over the counter pain medications are the fastest growing drug addiction in North America (1).
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