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
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.
Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010, January). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29–36. Retrieved from https://www.sciencedirect.com/science/article/pii/S0022399909000944
Many athletes and arthritis patients swear capsaicin creams reduce their pain and they love the deep warming sensation they provide. This heat may be associated with relaxation, which reduces their pain response. Researchers have concluded that capsaicin creams may reduce nerve and osteoarthritis pain in some patients (when compared to placebo), but they aren't very effective in reducing muscle pain.  Best results are achieved in joints that are close to the skin, like those in the hands or knee.
Although it is normal to experience some pain and soreness when running or while engaging in similarly intense forms of physical activity, pain that persists long after you exercise is usually indicative of a greater problem. Be sure to consult with a medical professional before turning to any topical creams and gels; they can help you diagnose the source of your pain and may recommend alternate treatment options.
You may get pain relief from nonprescription medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve). Or your doctor can prescribe a stronger medication if those don’t work. But you may have side effects or the medications might not provide complete relief for you. Here are other proven methods you can try to soothe arthritis pain in addition to pills and medical treatments.
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.
"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.)
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
Turmeric can be consumed in a variety of forms, including as a spice added to foods or drinks and encapsulated for those who are not tolerant of the signature spicy taste. Two to three teaspoons of turmeric daily can help to provide therapeutic levels of relief and preventive benefits with little side effects. Note: Turmeric absorbs best when taken in combination with black pepper (approximately 1/4 teaspoon of black pepper for every 1 teaspoon of turmeric). (17)

I’m often asked which is the strongest ibuprofen gel. If you’re looking for the best muscle pain relief, however, I recommend diclofenac gel rather than ibuprofen gel. Research shows that diclofenac gel (Voltarol) is stronger and more effective than even a strong ibuprofen gel. If you still prefer to use an ibuprofen gel, however, you can find them on Boots.com.
"Arnicare Gel ($8; target.com) had me at first application. It not only works great to help relieve any muscle pain and swelling, but it also has no scent and isn't greasy. I can apply it at night or even before a workout." —Derek DeGrazio, celebrity trainer, Barry's Bootcamp Miami Beach (See his Barry's Bootcamp-Inspired Abs, Butt, and Core Workout.)
In one study of 28 women with osteoarthritis pain, half of the women listened to a 10 to 15 minute recorded script twice daily that guided them through muscle relaxation techniques. Women in the guided imagery group showed statistically significant improvements in their pain levels and mobility within 12 weeks, versus women in the control group who did not see any improvements.4
When sudden changes occur in the weather or we overexert ourselves during physical activity, those of us who experience, or who already had, muscle and/or joint pain treat ourselves with the traditional prescriptions of conventional anti-inflammatories. There is a general tendency for us to take anti-inflammatories every time something hurts, as if they were water. Nevertheless, the damage caused to our bodies (liver, stomach, etc.) by anti-inflammatories is highly significant if these are abused. Symptomatic use of analgesics, such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs) is almost always the first treatment option, and ibuprofen is one of the most widely used anti-rheumatic drugs.
Capsaicin cream, also called capsicum cream, is available in drug stores, health food stores, and online. A typical dosage is 0.025% capsaicin cream applied four times a day. The most common side effect is a stinging or burning sensation in the area. If possible, wear disposable gloves (available at drugstores) before applying the cream. Be careful not to touch the eye area or open skin. A tube or jar of capsaicin cream typically costs between $8 and $25.
Five updates have been logged for this article since publication (2009). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more Like good footnotes, update logging sets PainScience.com apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages.
Cognitive Behavioral Therapy (CBT). In CBT, a psychotherapist helps you identify problematic behaviors (like becoming less active or doing fewer fun activities in response to pain), negative thoughts (about self, others and the future) and feelings (depression, guilt, anxiety). This can increase your awareness of how problematic patterns develop and help you understand the connection between thought patterns and feelings. You are then trained in pain coping skills, such as relaxation techniques, imagery, and goal setting, encouraging you to have an active role in managing and controlling pain. CBT can increase your ability to control pain while acknowledging that there may be occasionally flares beyond your control.
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.
Maybe. They may not completely get rid of your monster headache but they may help relieve some of the aches that come with them. Some people who experience migrains also have neck and shoulder pain and topical pain relief gels and creams may help to lessen this symptom. Some migraine sufferers use roll-ons on the forehead or back of the head to induce a cooling or heating sensation to help cope with the pain.

Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.
Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador Retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.
Diclofenac sodium 1% gel (Voltaren, also available as a generic). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day).  However, the total amount used on your body should not exceed 32 grams per day. A dosing card comes with the gel so you can measure the correct amount.
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