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
Hi Brenda, The most effective painkilling gel is Voltarol which contains diclofenac, assuming your bad reaction to oral painkillers was not an allergy to NSAIDs. Another option to try is magnetic gloves, or a pain killing device such as Arc4Health, which can have quite miraculous painkilling effects. You should also ask your doctor to refer you to a pain clinic for specialist advice. I hope that helps. Best wishes, Sarah B
"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.)
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. 
Funny how things like this slip through the cracks. I communicate with patients and professionals locally and abroad more or less all day every day, study and research musculoskeletal pain problems obsessively, and am more or less constantly immersed in answering the question, “What can you do for body parts that hurt?” And yet I didn’t hear about this stuff for a good year after it had already hit the shelves.
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.
Anti-inflammatory painkillers are a group of medicines that are used to ease muscle pains, sprains, strains and arthritis. They can be taken by mouth (tablets, capsules or liquids), injected, or applied to the skin. When they are applied to the skin they are called topical anti-inflammatory painkillers. Sometimes they are called 'topical non-steroidal anti-inflammatory drugs' (NSAIDs), or just 'topical anti-inflammatories'.

Patient information articles published in both the Journal of North American Spine Society and the Journal of the American Medical Association found evidence that spinal manipulations were safe, effective, drugless forms of professional treatment for both acute (short-term or sudden) and chronic low back problems in adults. (2, 3) Egoscue, another type of postural therapy protocol that focuses on fixing musculoskeletal misalignments, may also be able to help reduce and prevent back pain.
The only side effect most of these products have is odor. Some of them were reviewed as being neutral to actually smelling good, while others were reported to have quite a strong smell you might not like. A lot of this has to do with the nature of the ingredients in pain relieving treatments. Mentholated ingredients give natural relief, but they do tend to have a strong odor that accompanies them.
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Diclofenac topical gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining of the joints) in certain joints such as those of the knees, ankles, feet, elbows, wrists, and hands. Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain.

MSM is a potent sulfur naturally found in plants, animals and humans that helps rebuild the connective tissue in your joints and is a powerful natural remedy for inflammation and pain. What’s more, MSM has the unique ability to improve cell permeability. This allows harmful toxins to flow out, while allowing health boosting nutrients to flow in to feed your joints, cartilage and connective tissue. It is used for hundreds of symptoms related to a myriad of health diseases and conditions, and is especially effective as a natural remedy for relieving inflammation for improved joint function, and pain associated with joint inflammation, osteoarthritis, rheumatoid arthritis, osteoporosis and tendonitis. One study published in the Journal of AntiAging Medicine found that MSM provides an 80 percent greater reduction in pain compared to the placebo.
Various studies have also shown that NSAIDs can delay muscle regeneration and may reduce ligament, tendon, and cartilage healing.[4,13,77] Specifically, NSAIDs are believed to wipe out the entire inflammatory mediated proliferative phase of healing associated with WBC actions (days 0–4). A study of the effects of NSAIDs on acute hamstring injuries was done in humans by Reynolds et al.,[93] and these investigators concluded that patients who used NSAIDs did not experience a greater reduction of pain and soft-tissue swelling when compared with the placebo group. Interestingly enough, the authors noted that the NSAIDs’ group had worse pain associated with severe injuries compared with the placebo group.

With more than 23,000 reviews on Amazon, customers give Penetrex sky-high marks for effective pain relief. If it doesn’t work for you, it comes with a 100 percent, no-questions-asked, money-back guarantee. Formulated to fight inflammation, it contains a mix of ingredients including arnica, choline, glucosamine, Vitamin B6, and MSM. It’s not odor-free, but rather has a light scent that disappears quickly after you apply it. You can use it alone or in conjunction with heating pads, massagers, ice, and other therapies.
A lot of people who read this are going to want to try it on their low back pain, neck pain, and/or other kinds of muscle pain. Will it work? The only honest answer is, “Who knows?” I have no clinical experience with this yet, and certainly it’s unstudied. It might be worth trying, in moderation, with the full awareness that there’s every possibility that it could be a waste of time and money.

Cold and heat therapies. It's best to use cold compresses or an ice pack, not heat, immediately following a back injury, since this can alleviate pain by numbing the area and prevent or reduce swelling. About 48 hours after the onset of back pain, though, applying heating pads or a hot-water bottle to your back may be helpful. The warmth soothes and relaxes aching muscles and increases blood flow, which helps the healing process. Keep in mind that heat therapy is only helpful for the first week.
Rutin is a flavonoid composed of the flavonol quercetin and the disaccharide rutinose. Rutin is found naturally in a variety of plants, and dietary sources include black tea and apple peels. Rutin’s natural anti-inflammatory potential is attributed mainly to its powerful antioxidant activity. Rutin also helps maintain the levels of reduced glutathione, which is a powerful biological antioxidant. The combination of these activities helps to minimize the cellular damage and resulting inflammation caused by the various oxidative processes.
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Learning to keep your cool is as good for your back as it is for your mental health. When you're anxious, your body sets off the "fight or flight" response, which involves tensing your muscles so you're ready to spring into action. One European study revealed that people prone to negative thoughts and anxiety are more likely to suffer from back pain. Get calm now with these stress-busting solutions.
It may be tempting to quit exercising when you're suffering from back pain, but it's essential to keep yourself moving. Pilates is one great option. In a 2014 European Journal of Physical Rehabilitation Medicine study, researchers found an improvement in pain, disability, and psychological health in chronic low-back pain patients who took five hourlong Pilates classes a week for six months. Meanwhile, people who remained inactive experienced further worsening of their pain. Similarly, a Medicine and Science in Sport and Exercise study revealed that taking either Pilates or a general exercise class twice a week for six weeks both improved pain and quality of life.
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).

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.

The effect of NSAIDs on the GI tract is actually indirect: it’s not because the medicine comes into direct contact with the walls of the GI tract, but because the medication, once it is in the bloodstream, affects the behaviour of cells in the lining of the gut. So it’s actually just a matter of dosage. If you were to smear a diclofenac gel all over your body, you would absorb enough of it that it would be a “gut burner” too! BACK TO TEXT
“I was first introduced to Relief by my Chiropractor after I pulled a muscle. Later my son, while playing hockey, received a very nasty hit during a game and was given Biofreeze as part of his recovery process. I can tell you Relief is 10x better—he was still in pain after using the Biofreeze, so I grabbed the Relief and he could not believe the difference. Now we are a Relief ONLY household. I am spreading the word to all the other hockey mom’s on the quality of your product and how well it works. Thank you for creating Relief and keep up the good work.” *

Also, many painful factors in neck, back and muscle pain are deep inside the body — probably much deeper than Voltaren® Gel can “reach.” For instance, if your low back pain is coming from the facet joints — small joints deep in the spine, under a thick layer of muscle — chances are that a topical treatment simply doesn’t stand a chance of having an effect.
The cream is affordable, effective, and gives wonderful results. You will want to use products that keep you that way. The hot cream is available in a large 8.8-ounce orange jar with either a silver metal or white plastic lid and the contents are always the same. It is 100% natural and 87% organic. It will firm up and tone your skin and remove that stubborn cellulite. Additionally, it warms up your aching and sore muscles for relief from that pain. Another benefit is that by firming up and reducing fat, you can be as trim as you want to be.
As part of your exercise routine, you may want to consider doing yoga regularly for lower back pain relief. One study of over 960 people with low back pain found that those who completed a 12-week yoga program experienced greater improvements in back function and reduced pain compared to controls who did not participate. (4) There’s even evidence that mindfulness meditation, often practiced in some form with yoga, can also help people deal with chronic back pain more effectively. (5)

Of course, the biggest benefit of the Luminas Pain Patch is the fact that it is fast pain relief. Your pain relief starts as soon as that patch adheres to the skin. You’ll start feeling a difference right away, with pain dissipating in minutes on the areas that are giving your problems. There’s no waiting around like traditional drugs, waiting for your body to break it down and enter your system. In addition to fast pain relief, there are other significant benefits to the Luminas Paint Patch:

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.
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
studies and meta-analyses report a strong relationship between chronic pain and abnormalities in glucose metabolism. Insulin resistance and abnormal blood sugar pave the way for inflammatory pathways, resulting in chronic pain. Magnesium deficiency is another that comes to mind. Magnesium helps to block the brain’s receptors of glutamate, a neurotransmitter that may cause your neurons to become hypersensitive to pain. Intestinal integrity is one that many people don’t think to connect to their pain. However, high-quality food choices are crucial for managing pain due to the way they influence gut health. Substances in grains may increase intestinal permeability, allowing undigested food particles, bacteria, and other molecules to enter the bloodstream, which can influence inflammation and chronic pain.
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

I have had an Osteo Arthritic left knee for 12 years since a car accident. I have had surgery on it twice. I have Cortisone Injections in it every 90 days. I am 62.. I also have been diagnosed with Rheumatoid Arthritis and SLE Systemic Lupus which means that I have long periods of fatigue and my autoimmune system does not function properly. My left knee will need replacement in 2 to 3 years. Long story short......I needed a good external rubbing cream for my knee joint to manage world class pain. So far ......Synthaflex Joint Cream has been the best product that I have purchased and used. I rubbed it in with a paper towel because it has the old fashioned peppermint heat feel....so you do not want it on your hands. Keep it away from your face and your eyes because it will burn. It is a white cream. It takes effect instantly and lasts with my usage for about 5 hours. I use it twice per day. It has worked so well since I received it last week that I am getting ready to order two more jars tonight. I will post updates over the coming months but as of week one I strongly recommend this product. I have far less pain walking and no pain sitting or resting so far.
It contains arnica, a wonderful pain reliever used by many massage therapists, vitamin B6 that makes red blood cells that produces neurotransmitters, homocysteine levels, and also makes the hormones serotonin and norepinephrine; it has pyridoxine; choline bitartrate cetyl myristoleate; MSM (methylsulfonlmethane) that helps with scars, stretch marks, and pain; and has glucosamine, and boswellia serrata.

Turmeric root contains just 2% to 5% curcumin, so when reaching for a supplement, be sure you’re buying curcumin, not powered turmeric root. Curcumin is not easily absorbed by the digestive tract, so choose high-potency curcuminoids and combine with oil, since curcumin is fat-soluble. Black pepper extract (piperine), though not Bulletproof, has also been shown to increase curcumin’s bioavailability by 2000%.[13] However, some newer, high-tech curcuminoid formulas have been shown to offer the same potency levels without the use of piperine.[14]
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