NSAID medications have potential side effects, even though many of these medications can be obtained over-the-counter. Some of the side effects are minor, other certainly worrisome. Some people may be more prone to side effects given other medical conditions. For that reason, NSAID medication should be used with caution. If there is ever a question of whether or not it is safe for you to take these medications, and you should discuss this with your doctor. Anyone taking NSAID medications for more than a few days should have a discussion with her physician about the potential for side effects.


For those amenable joints, though, Voltaren® Gel delivers a good dose of medication directly to the joint, while sparing the gastrointestinal tract from the harshness of NSAIDs — which are actually known as “gut burners,” and many people just can’t stomach ibuprofen. A gel almost completely eliminates the risks associated with digesting the stuff.4
Topical treatments: One potential concern with dietary supplements is that some may interfere with medications you’ve been prescribed to treat back pain or other health conditions. For this reason, Grossman suggests topical treatments: “Gels and creams can be very helpful and won't interfere with supplements or medications,” she explains. “They're generally inexpensive, too.”

These proinflammatory cytokines result in chemoattractant for neutrophils and help them to stick to the endothelial cells for migration. They also stimulate white cell phagocytosis and the production of inflammatory lipid prostaglandin E2 (PGE2). NSAIDs’ ability to interfere with the production of prostaglandin during the inflammatory cascade is the major mechanism cited for the anti-inflammatory success of these medications [Figure 1].[112]

The good news is that myofascial release is also something we can do for ourselves! A recent study showed that a regular program of self-myofascial release lowered pain intensity and lessened stiffness. To start, you can simply lie on the floor and place a small, soft ball (around the size and density of a large orange) under any tight and painful muscle areas. Then allow your body to sink onto and around the ball for a few minutes to provide the right amount of sustained pressure to allow the fascia to release. Learn how to self-myofascial release with this Myofascial Self Care Video Course that was developed by a pair of myofascial release therapists, and is is a great way to do MFR treatment at home.

1., 2., and 3. Ginger, Turmeric, & Holy Basil – This set of herbs forms a sort of trinity in Ayurvedic medicine. All of them have anti-inflammatory properties. Turmeric (a curry ingredient) contains curcumins which ease inflammatory conditions like rheumatoid arthritis and psoriasis, according to the Methodist Research Institute in Indianapolis. “Each herb has its own scientific database of evidence,” says James Dillard, MD, author of The Chronic Pain Solution.


The first generic (cheaper) equivalent of Voltaren® Gel entered the marketplace in 2016, produced by Amneal Pharmaceutical. It should be widely available now. Both products are still prescription-only in the US, but fortunately they are over-the-counter almost everywhere else (there’s a rack of tubes of Voltaren by the till at my neighbhourhood drugstore).
“I use Relief cream on every client who comes in with any type of pain, and they all say they absolutely love the fragrance (as do I) and how it feels on their skin—in addition to how well it relieves their pain. It is the ONLY topical pain cream I would even think of using (and having on my hands) all day long, and with its non-irritating ingredients I can do so worry free. I have never had anyone I have used it on or sold it to complain of any type of negative skin reaction to the product, which I find amazing since with most ever other product of its kind you run a significant risk of experiencing secondary skin irritation. As you can imagine I couldn't be happier with Relief's amazing formulation and superior results!” *
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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!
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.
However, it probably does not work well for deeper tissues in most cases. For instance, there’s evidence that it doesn’t work at all for the muscle soreness that follows unfamiliar exercise intensity,7 probably because it can’t be absorbed far enough into thick muscle tissue — but oral NSAIDs do have a modest effect on that kind of pain89 (one of the only things that does).

Low and lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist. Unfortunately, almost everyone, at some point during life will experience low back pain that may travel downward into the buttocks and sometimes into one or both lower extremities. The most common cause is muscle strain often related to heavy physical labor, lifting or forceful movement, bending or twisting into awkward positions, or standing in one position too long.
The US governmental agencies, through the FDA and others, routinely inspect the manufacture of vitamins or supplements made in this country, as they do for any other food product.[30,63,74] Contaminants, such as the recently discovered high lead content found in various Ayurvedic preparations that were made by an Indian manufacturer and imported into the US,[30,61,63,74,102] are generally thought to be uncommon, but can be a concern when purchasing imported supplements.
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

11. Aquamin – Derived from red seaweed, aquamin is a powerful pain reducer, too. In a study published in Nutrition Journal, of 70 volunteers, Aquamin users reduced arthritis pain by 20% in a month and had less stiffness than patients taking a placebo. Helping to diminish inflammation and helps to build bone, aquamin is rich in both calcium and magnesium, too.
Bark from the white willow tree is one of the oldest herbal remedies for pain and inflammation, dating back to ancient Egyptian, Roman, Greek, and Indian civilizations, as an analgesic and antipyretic agent. Because of the gastric side effects of aspirin, there has been a resurgence in the use of white willow bark for the treatment of inflammatory syndromes. The mechanism of action of white willow bark is similar to that of aspirin which is a nonselective inhibitor of COX-1 and COX-2, used to block inflammatory prostaglandins.[48]
Laugh more often. One study showed that social laughter actually increases pain tolerance.5 Laughing along with others was shown to have the highest positive impact. Laughter has many positive effects, including increasing circulation and oxygen, and raising your body's level of endorphins (the body's natural pain killers). There is a whole movement called "laughter yoga"—which helps people enjoy the many benefits of laughter without having to need a reason to laugh—it just focuses on laughing for its own sake.

Stay well hydrated. It is common knowledge that drinking enough water throughout the day is good for you, but did you know it can also help reduce pain? For people with back conditions, staying well hydrated helps the intervertebral discs stay healthy. Drinking enough water also helps reduce stiffness, it helps your blood carry healing nutrients and oxygen throughout the structures of you body, and helps flush toxins out of your muscles and other soft tissues. It will help prevent constipation (a side affect of many pain medications).
In October 2007, diclofenac sodium 1% gel (Voltaren Gel) became the first topical NSAID for OA therapy approved in the United States following a long history of use internationally. Topical diclofenac sodium 1% gel delivers effective diclofenac concentrations in the affected joint with limited systemic exposure. Clinical trial data suggest that diclofenac sodium 1% gel provides clinically meaningful analgesia in OA patients with a low incidence of systemic AEs.
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If you have an attack of lower-back pain that is severe, continuous and not improving, assessment and treatment by a health care professional who focuses on the back or other musculoskeletal problems may help. These practitioners may use both active and passive techniques to help you feel better. Examples of passive techniques that may be used to get you moving include:
"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.)

"My go-to muscle soothing product is Topricin Pain Relief Cream ($17; topicrin.com) as it is a combination of 11 homeopathic ingredients proven to be safe for your skin. I typically apply it to my lower back (where I've had trauma) before I go running and again before bed. I'm a believer!" —Kira Stokes, creator of The Stoked Method (Try her 30-day plank challenge to score tighter abs, faster.)
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.
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]
A muscle pain relief cream will alleviate aches and pains associated with sore muscles, injuries, inflammation, and more! The best muscle pain relief cream is the one that suits your unique needs. Some offer heating or cooling sensations, while others are odorless or made with natural oils to produce pleasant scents. A pain relief cream can also reduce arthritis discomfort! With plenty of creams to choose from, we've rounded up the top creams. You're sure to find the one that meets your needs in this list.

One way to increase the effectiveness of Biofreeze is to add it to a massage! And what do professional massage therapists use in their practice regularly? Creams and oils to help their hands glide across the skin and focus on relieving pain. External pain relief creams can be used as a part of your at-home massage to not only enhance your comfort, but to soak in and relieve any residual pain.
Some manufacturers inflate nutraceutical products’ claims and may not cite possible side effects and potential drug interactions. Bleeding complications are associated with white willow bark, ginger, garlic, and others. Therefore, such medicinal preparations are not without risk. Products such as omega-3 essential fatty acids (EFAs) (O3) do have strong scientific support to be considered as an alternative and/or complementary agent to NSAIDs. Published studies have shown the effectiveness of O3 to successfully treat spine-related pain.[71] Capsaicin, oil of camphor, and other natural topical preparations are commonly used for muscle soreness and local application for painful traumatic injuries.[12,16,80] The subsequent sections will review many of these products and discuss both their efficacy and safety issues. As with any drug or natural compounds, additional caution should be used when considering these treatments for children, pregnant or lactating mothers or any other clinical or disease condition that could increase possible risk of side effect or complication.
Chiropractic care involving spinal manipulation appears to reduce symptoms and improve function in patients with chronic low back pain, acute low back pain, and sub-acute low back pain, according to a research review published in the Journal of Manipulative Physiological Therapeutics. In their analysis of 887 documents (including 64 clinical trials), the review's authors concluded that combining chiropractic care with exercise is "likely to speed and improve outcomes" and protect against future episodes of back pain.
Still an excellent product. It remains effective for pain relief for about 5 hours with each application for me. Make sure to rub in a good thick portion for several minutes to the entire area of pain. Each jar of Synthaflex lasts about 18 days for me with applications twice each day. It remains the best external joint and muscle pain relief rub that I have ever used.
There is now an option to your pain relief that works within minutes without harsh drugs or chemicals and is all-natural! Introducing the Luminas Pain Relief Patch, a new approach to pain management that gets to the source of inflammation and suffering. This fast pain relief patch comes with no side effects, mess, or odor – just effective pain relief that you can feel.
Diclofenac is an extremely popular drug — again, we’re talking oral here — and it is associated with serious cardiovascular risks: “There is increasing regulatory concern about diclofenac. … Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage.”14 This has been in the news quite a bit, and NPR had a hit in 2013 with this headline: “World's Most Popular Painkiller Raises Heart Attack Risk.”
Comfrey root has a long history of traditional use to heal wounds and fractures when applied as a poultice, and was commonly known as ‘knit bone’. Modern research shows that comfrey contains two main active ingredients: allantoin which promotes tissue regeneration, and rosmarinic acid which damps down inflammation and reduces pain. Comfrey root cream is a popular and effective treatment for joint pain, sprains and strains.
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.
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.
Whether you’re a runner looking for a quick solution to cure your muscle soreness or someone with chronic pain, a topical pain gel or cream is a great temporary relief option. These excellent products work very well and have given many runners relief from pain during the recovery process from various types of injuries. Bringing quick relief to sore or aching muscles requires a cream or gel which has the ability to be quickly absorbed and reaches deep into your tissue to help muscle pain.
I use Tiger Balm ($5; walmart.com). It's kind of the old-school stalwart in the game. With active ingredients of menthol and camphor it can provide some relief to muscle aches, and has been studied to improve blood flow, especially when used during massage." — Joe Holder, S10 Training and Nike running coach (Reboot Your Workout Routine with Holder's moves that tap into every muscle.)
While most people are only looking to relieve the immediate symptoms of the pain, this will only provide temporary relief.  Addressing the underlying mental/emotional, chemical and physical stressors that are causing the chronic inflammation and pain is the ultimate goal.  This process takes time and deep introspection along with trusted holistic health care providers.
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