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.
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.
"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.)
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.
One of the products I like mixes bromelain, curcumin, and quercetin. This powerful trio provides enhanced support for maintaining a healthy inflammatory response to reduce pain. Another favorite is a blend that contains essential nutrients the body needs to repair and recover, along with potent herbal pain alleviators, including black cohosh, white willow bark, valerian, and devil’s claw. Lastly, I suggest a high-potency proteolytic enzyme product combined with rutin. This supports the body’s natural processes for tissue and joint recovery. The enzymes work synergistically with rutin to naturally boost muscle and tissue repair.
While there are mixed answers on how many servings of leafy greens one should eat each day for preventive effects, an overall eight to ten servings of vegetables and fruits daily is recommended for the best results. Of those, perhaps two to three servings of vegetables should be leafy greens. Leafy greens are rich in quercetin, a type of flavonoid that is responsible for broad anti-inflammatory benefits, as well as vitamin C, vitamin K, and essential minerals like magnesium. (15)
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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.
The NF-kB molecule is a transcription factor that controls the transcription of DNA for the perpetuation of the inflammatory immune response. It acts as a switch to turn inflammation on and off in the body. NF-kB has the ability to detect noxious stimuli, such as infectious agents, free radicals, and other cellular injuries, and then directs DNA to produce inflammatory cytokines. The NF-kB proteins are localized in the cytoplasm of the cell and are associated with a family of inhibitory proteins known as inhibitor of kB (IkB).[43,119] The TNF-α, and especially IL-1b, can also directly stimulate enzymes known as matrix metalloproteinases, which break down extracellular collagen matrix, a hallmark of inflammatory joint disease.[32,76,77] The IkB proteins are normally bound to NF-kB and block their nuclear localization signal. A variety of provoking stimuli can degrade the IkB and result in the nuclear translocation of NF-kB to be free to activate DNA synthesis of inflammatory cytokines [Figure 2].

In addition to the other methods and strategies discussed throughout my book, I recommend taking natural remedies that reduce pain and inflammation, protect joint health and promote healing without side effects. Below I offer an overview of 20 different supplements formulas or ingredients often found within such formulations. Read each, keeping in mind your specific condition and how some may be more effective for you than others.


"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.)

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

Often patients will experience a different response in treatment with a different medication. This could be why some medications have helped your symptoms while others do not have a significant effect. This is not unusual, and it is difficult to predict which medications will most benefit a given individual. The best way to determine which NSAID is best for you is to try different options. Often a physician will recommend one NSAID, and if adequate relief of symptoms is not obtained within several weeks of treatment, another NSAID can be tried.
Hi doctor brewer , I am 69 years old I have had a hip replacement to my left leg. I have no pain from my hip now, but I have pain in my left knee. I have been prescribed Neproxine 500mg one twice a day. I was also told to use some gel from over the counter@ pharmacist, what would you recommend to use .Is Movelat safe to use many thanks Bob SPROSON.
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Menthol, Levomenthol, Eucalyptus, Camphor and Oil of Wintergreen are often added to topical joint treatments. These essential oils are absorbed into the skin and stimulate skin receptors to produce either a warm sensation or a cooling sensation as they numb the pain. They work by overwhelming nerve endings with these sensations so pain messages do not get passed on. This is known as a counter-irritant effect. Wintergreen is also a rich source of methyl salicylate, a natural anti-inflammatory painkiller related to aspirin. These essential oil creams and gels tend to have names such as Deep Heat or Deep Freeze to describe how they feel during use.

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.

Because of the significant side effect profiles of steroidal and NSAID medications, there is a greater interest in natural compounds, such as dietary supplement and herbal remedies, which have been used for centuries to reduce pain and inflammation.[94] Many of these natural compounds also work by inhibiting the inflammatory pathways in a similar manner as NSAIDs. In addition to the COX pathway, many natural compounds act to inhibit nuclear factor-kB (NF-kB) inflammatory pathways.

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.


Apply to the affected area and massage into the skin gently. Always wash your hands after you have finished rubbing the cream, gel or spray into the skin. This is to make sure that you avoid rubbing this medicine into sensitive areas of the body such as the eyes. Do not apply to skin that is broken, or near the eyes, nose, mouth, genital or bottom (anal) areas. Do not use plasters or bandages (dressings) on top of these medicines. Generally these medicines are applied to the skin 2-4 times a day. However, for specific advice for your medicine, see the leaflet that comes inside the packet.


The most common cause of anemia is not getting enough iron in your diet but luckily, iron deficiencies are treatable. With an iron supplement for anemia, you can build your body’s iron levels and raise its red blood cell production over time. Not only can it relieve short-term symptoms like dizziness or lethargy, but the right iron supplement can treat anemia and prevent your body from developing it in the future.
A study involving 120 people with acute upper or lower back pain showed that rubbing in comfrey cream, three times a day for 4 to 6 days, reduced pain intensity by 95%, compared with just 38% reduction for inactive ‘placebo’ cream. Comfrey works quickly, providing good pain relief within an hour of application. In fact, researchers have found that comfrey cream is more effective than a prescribed, non-steroidal anti-inflammatory treatment (diclofenac gel) for treating ankle sprains.
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

"Dr. Teal's Epsom Salt ($5; target.com) is a must-have for my sore muscles. Aside from the fact that baths are relaxing and stress relievers, adding Epsom salt helps your body absorb and replenish magnesium levels that are depleted when you're stressed. Weekly Epsom salt baths are huge for my overall well-being!" —Anna Victoria, creator of the Fit Body Guides (Next, check out the sweat-proof makeup trainers can't live without.)


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.

Feverfew. Feverfew has been used for centuries to treat headaches, stomachaches, and toothaches. Nowadays it's also used for migraines and rheumatoid arthritis. More studies are required to confirm whether feverfew is actually effective, but the herb may be worth trying since it hasn't been associated with serious side effects. Mild side effects include canker sores and irritation of the tongue and lips. Pregnant women should avoid this remedy.
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