Nonsteroidal anti-inflammatory medications are one of the most commonly used types of medications for musculoskeletal conditions. NSAIDs can be effective for a wide variety of orthopedic conditions from arthritis, tendinitis, or other inflammatory conditions. Determining the best NSAID for your condition may depend on a number of different factors, and what works well for one individual may not be the best medication for another. There are possible side effects of different NSAID medications the patient should be aware of, and you should discuss with your physician if taking these medications for more than a short period of time.
PharmacyTimes.com [Internet]. Fudin J. Should Topical NSAIDs Have Strict Heart Risk Warnings?; 2018 March 10 [cited 18 Jun 12]. Although this article’s title implies concerns about topical NSAID safety, it ends up answering that concern with very reassuring data, and it turns into a piece suggesting that the FDA needs to make it clearer that only oral NSAIDs are of concern, while topical is an extremely safe alternative! “ … all topical vehicles of diclofenac delivery result in only a small fraction of the diclofenac that actually reaches the systemic circulation compared with the oral route.” BACK TO TEXT
Capsaicin creams are another topical option for pain relief. These contain the active component in chili peppers that cause a burning sensation. I know its sounds like this would cause more pain, but in fact the low levels of capsaicin in these creams block pain by temporarily depleting the nerves of certain chemicals that transmit pain impulses. Application of this cream three times daily was shown to significantly improve pain scores for fibromyalgia in one study done in Spain.
Uncaria tomentosa and Uncaria guianensis are Peruvian herbs derived from woody vines with small claw-like thorns (hence the vernacular name, cat’s claw) at the base of the leaf, which allow the plant to climb to heights of up to 100 ft. Traditionally, the bark of cat’s claw is used to treat arthritis, bursitis, and intestinal disorders. The active ingredients appear to be polyphenols (flavonoids, proanthocyanidins, and tannins), alkaloids, and sterols. Various studies indicate that this Peruvian herb induces a generalized reduction in proinflammatory mediators.
The omega-3 fatty acids found in abundance in fish oil derived from cod, trout, herring, salmon and other coldwater fish are proven natural remedies to reduce inflammation. Research from Cardiff University in Great Britain found that cod liver oil not only relieves pain, but also stops and even reverses the damage caused by osteoarthritis and rheumatoid arthritis. Omega-3s help morning stiffness, regenerate joint tissue and have been shown to also aid in autoimmune disease like RA, lupus and psoriasis.
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.
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.
Foam roller exercises are a form of self-myofascial release that, while kind of mildly painful at times, actually gets out those nagging muscle knots while helping you fix muscle imbalances that lead to poor posture and related musculoskeletal pain. It’s also an emerging treatment to reduce your risk of developing delayed muscle onset soreness, a common exercise-related pain that keeps people out of the gym. (6)

The use of fish oil (in the form of cod liver oil), an omega-3 EFA, for the treatment of muscular, skeletal, and discogenic diseases, can be traced back to the late 18th century as detailed by Curtis et al.,[24,25] Unfortunately, because of the rapid onset of rancidity of this polyunsaturated oil when exposed to air, and hence its disconcerting odor, cod liver oil fell out of favor. With improved extraction techniques, such as using a protective nitrogen blanket and enhanced oxygen-free encapsulation methods, there is less chance of oxidation during the manufacturing process. The therapeutic benefits of fish oil can now be realized without the regurgitation and odor of previous products caused by peroxides and rancid tasting fish oil.[14]


NSAIDs such as topical diclofenac (Pennsaid, Voltaren) may cause swelling, ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who use NSAIDs for a long time, are older in age, have poor health, smoke, or drink alcohol while using topical diclofenac. Tell your doctor if you have any of these risk factors and if you have or have ever had ulcersor bleeding in your stomach or intestines, or other bleeding disorders. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). If you experience any of the following symptoms, stop using topical diclofenac and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool,or black and tarry stools.
I am in my mid 50’s and was recently diagnosed with arthritis in both my knees. My left knee was the absolute worse. Seems squats and lunges are the worst for arthritic knees and my worst pain followed these exercises. Since then I have gotten a personal trainer so that I won’t hurt myself trying to workout. Anyway, I am a 5k runner and I want to continue. But let me tell you guys about the topical regimen that I am using that I employed just short of going to get a cortisone injection. Magnesium Oil, MSM lotion and organic silica gel. I got all of these products from an on-line source of organic foods, products and such. I absolutely love their products and these 3 products have made my knee feel like I never was diagnosed with arthritis, and I’ve been following this morning and night application of the 3 products for a little over two weeks now. Let me tell you, I couldn’t sleep at night because of the pain. Now it’s the difference between night and day. I hope this helps someone
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.
A 2008 study published in the journal Spine found "strong evidence that acupuncture can be a useful supplement to other forms of conventional therapy" for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found "moderate evidence that acupuncture is more effective than no treatment" in relief of back pain.

After reviewing data regarding various treatments for lower back pain, the Agency for Health Care Research and Quality concluded that those suffering from back pain should first try conservative/natural treatments and then consider other options for lower back pain relief if pain persists. Oftentimes low back pain sufferers can find relief naturally by making changes to their lifestyles (including sleep, physical activity, stress and body weight) before choosing more intensive care options.

Few people need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn't responded to other therapy.
There is a large amount of natural products on the market with anti-inflammatory properties which contain arnica, such as sports massage creams combining arnica and other natural plant extracts (devil’s claw, calendula, St John’s wort and peppermint oil, among others, as well as PHYSIORELAX FORTE PLUS cream) for symptomatic relief of joint and muscle pain. However, we must be well informed about the quality and origin of the extracts used in any creams, gels and ointments purchased at pharmacies, herbal shops and specialised phytotherapy shops, so that we use the best quality product possible.
I’ve just emphasized that Voltaren is mainly appropriate for shallow inflammation, but there is some evidence that Voltaren might be able to “reach deeper.” This is hardly the stuff of medical certainty yet, but researchers Huang et al found that Voltaren treated pain coming from deep inside the spine, right in the centre.6 They concluded that it could be a “convenient and safe clinical intervention” for a few types of back pain. An anti-inflammatory gel will likely fail with many kinds of back pain, but there’s also virtually no down-side to trying. See my low back pain tutorial for extremely detailed information about medications for back pain.
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions or back problem. SpineUniverse does not provide medical advice, diagnosis or treatment. Use of the SpineUniverse.com site is conditional upon your acceptance of our User Agreement
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.
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.
Those who have tried using this Neosporin product say that cuts and scrapes heal within three days when this ointment is applied and that pain subsides quickly. To properly use the ointment, be sure to first clean the affected area with mild soap or saline water. Apply the Neosporin and then use a bandage to properly protect the area while it heals.
Topical glucosamine cream and gel can significantly reduce the pain of knee osteoarthritis within 4 weeks. One study involving a glucosamine cream found that 100% of those with arthritis of the shoulder gained benefit. Of those with arthritis of the ankle, wrist or elbow, glucosamine cream reduced pain in 75% of people, and it worked in 58% of those with knee osteoarthritis.
10. Cherries – Due to the presence of compounds called anthocyanins—the same phytonutrients that give cherries their rich ruby hue – you can count on cherries to tamp down pain. Muraleedharan Nair, PhD, says, “They block inflammation and they inhibit pain enzymes, just like aspirin, naproxen, and other nonsteroidal anti-inflammatories.” Cherries are said to have the highest anti-inflammatory content of any food, making them great for remedying issues such as arthritis.
Inflammatory disorders specifically respond well to the natural collagen-containing gelatin that is found in true bone broth. (24) Bone broth and meat stock are different, since bone broth extracts nutrients from the bones, such as gelatin, minerals, and amino acids, whereas stock only contains nutrients from the meat. While both can be healthy, stock contains no pain-relieving properties.
Dealing with back pain is frustrating to say the least. Aches and stiffness can keep you from enjoying your favorite activities. But you can change that with pain relief cream for back pain. From cooling menthol gels to odorless creams that target inflammation, there are plenty of options to address even the most pressing back problems. You can’t go wrong with any of the creams on this list, so choose your favorite and forget the back pain.
While these are not the only risks NSAID medications, they are somewhat more common, and some of the more worrisome, side effects. It is always safest to have a discussion with your physician if you have any concerns about the risk of taking these medications. It is important to understand that even in healthy people without underlying medical conditions, there is always the risk associated with any medication. The benefits of taking an anti-inflammatory medication need to be balanced with the possible risks of taking the medication.
An ancient mind-body practice, meditation has been found to increase pain tolerance and promote management of chronic pain in a number of small studies. In addition, a number of preliminary studies have focused specifically on the use of meditation in the management of low back pain. A 2008 study published in Pain, for example, found that an eight-week meditation program led to an improvement of pain acceptance and physical function in patients with chronic low back pain. The study included 37 older adults, with members meditating an average of 4.3 days a week for an average of 31.6 minutes a day.

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.
I use my Rogue Fitness Supernova ($40; roguefitness.com) for self-myofascial release (SMR). By applying pressure directly to sore muscles with my supernova, I am able to roll out knots (or adhesions) on the muscle. This allows the body to bring blood flow to troubled areas by transporting nutrients and oxygen to the muscles for faster repair." — Troy Brooks, YG Studios and founder TB Elite Fitness
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.
Back pain can interrupt your day or interfere with your plans. In fact, there’s an 84 percent chance that you will develop low back pain in your lifetime. But back pain isn’t always something you can ignore or wait for it to resolve on its own. Thankfully, there are several ways to treat back pain at home. These remedies include everything from herbs to massages. Keep reading to see how you can ease your back pain.
The benefits of heat therapy are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals. Some find that wearing a heat wrap, such as those from ThermaCare, is best because it releases a low level heat for several hours and can be worn under clothes so you can remain mobile. You can also combine the benefits of aromatherapy and a heat by adding an essential oil to the hot pack; you can experiment by making your own microwaveable heating pad at home and adding different essential oils to see what works best for you.

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.
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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
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Lower back pain can be mild to very severe depending on its underlying causes, how long it’s been left untreated and the state of someone’s overall health. The University of Maryland Medical Center states that several important risk factors for lower back problems include family history of back pain, smoking or using tobacco, being overweight or obese, being female, being anxious or depressed, and either doing too much physical work or living a sedentary lifestyle.
If you’re someone who experiences muscle and joint pain from time to time (or on a regular basis), you’ve probably tried quite a few options for pain relief. And you’re probably already using external pain relievers—the kind you apply directly to your skin for fast relief from sore muscles and joints. But have you thought of adding an external pain relief cream to the mix?

Prolotherapy has been used to treat back pain for more than 50 years, according to a report by the Cochrane Database of Systematic Reviews. (6) Prolotherapy, including the specific type called PRP or dextrose/glucose prolotherapy treatments, use platelet-rich plasma and sometimes stem cells taken from your own body that contain growth factors that help heal damaged tissues.
Inflammatory disorders specifically respond well to the natural collagen-containing gelatin that is found in true bone broth. (24) Bone broth and meat stock are different, since bone broth extracts nutrients from the bones, such as gelatin, minerals, and amino acids, whereas stock only contains nutrients from the meat. While both can be healthy, stock contains no pain-relieving properties.
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. 
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