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.
Plant- and animal-derived nutraceutical preparations have been used for hundreds and even thousands of years to obtain effective pain relief. Herbal medications are becoming increasingly popular because of their relatively few side effects. Nevertheless, there are problems associated with these dietary supplements, and their use requires knowledge of their biological action, clinical studies (both affirmative and negative), and potential interactions with other nutraceutical products and prescription medications.
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If you are using a topical anti-inflammatory there is a risk that your skin can become sensitive to light (photosensitivity). If you are using a preparation that contains ketoprofen you should cover the area of skin where ketoprofen has been applied (to protect it from sunlight). Also, you should not use a sunbed, or expose your skin to sunlight during treatment, and for two weeks after stopping.
Although it’s been available in Europe for many years, it was only approved for use in the United States in 2007. Also, other topical treatments (salicylates and capsaicin) have shown little potential in the past. And Arnica montana creams (Traumeel, for example) are extremely popular, but it’s unlikely that even full-strength arnica is medically potent, let alone when it is diluted down to traces.3
Note: The cream is hot to your skin and should be used with caution. The heat comes from capsicum (capsicum annuum) oleoresin a hot pepper. Try a small amount the first time at your inside wrist and wait a half hour to see how it feels. Do not bathe or shower after putting it on because that will only make you feel hotter. Let your body cool down first. Never put the cream near your eyes or mucous membranes such at the lower nose. Do not use on your private area. Wash your hands after you have rubbed the cream into your skin.

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When you have back pain, the best thing to do is rest until the pain subsides, right? Not necessarily. Too much rest can worsen certain types of back pain and decrease muscle strength — and strengthening and stretching the muscles may actually reduce or eliminate many types of back pain. Instead, start with gentle stretches and experiment to see how you can get moving without pain. Try going out for a slow, easy walk, and pick up the pace when you can. Remember, it's best to discuss your current fitness routine and any changes to it with your doctor to avoid aggravating your condition.
Try an over-the-counter pain reliever. Anti-inflammatory drugs such as aspirin, ibuprofen (Advil, Motrin, Nuprin), and naproxen sodium (Aleve, Anaprox, Naprosyn) can help reduce back pain. Acetaminophen (Actamin, Panadol, Tylenol) is another over-the-counter option for pain management. Be sure to check with your doctor or pharmacist about any interactions over-the-counter pain relievers may have with other medications you are taking. People with a history of certain medical conditions (such as ulcers, kidney disease, and liver disease) should avoid some medicines.
Spreading a medication on your skin is not the same thing as swallowing it. Because Voltaren Gel is applied to the skin, dramatically less medication reaches the bloodstream — only a tiny fraction of what you would get from oral usage.1516 It is safe to assume that cardiovascular risks of moderate topical use are negligible compared to oral diclofenac, because so much less medication is actually getting into general circulation, and that is what the evidence now shows.17 Multiple studies have concluded that topical NSAIDs are both effective and safe.181920

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.


Topical non-steroidal anti-inflammatories (often abbreviated to NSAIDs) are creams, gels, rubs, solutions or sprays that contain a nonsteroidal anti-inflammatory agent and are designed to be applied directly to the skin overlying a painful joint or area of bone. They are used to relieve pain and to treat symptoms of arthritis such as inflammation, swelling, and stiffness. Topical NSAIDs may also be used in the treatment of actinic keratosis (a precancerous patch of thick, scaly or crusted skin).
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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