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.
Long term and/or large oral doses of NSAIDs can be extremely dangerous, even lethal. They “nuke” your entire system with much more active ingredient than you really need, all of it absorbed through the digestive tract and distributed through your entire circulatory system. These drugs can and do cause complications at any dose, and are linked to heart attacks and strokes and ulcerations of the GI tract. For example, Diclofenac …

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.
Wasabi is another spicy food with natural painkilling properties. Scientists are studying the isothiocyanates in wasabi as potential pain relievers. Researcher from University of California San Francisco made a recent discovery suggesting that isothiocyanates could block an inflammation receptor, making it a potentially important natural painkiller. (2)
Glucosamine is one of the most-studied supplements around the world for relief of arthritis symptoms and joint health. Sulfur is produced naturally in the body and is an essential component to joint health. Glucosamine sulfate is a type of glucosamine that is most useful in the support of joint mobility and pain relief because it absorbs well. Conversely, glucosamine chondroitin does not absorb in an amount significant enough to create enough of a change to make taking it worthwhile. Glucosamine sulfate works as well as NSAIDs for some people but without the negative effects to the gastrointestinal tract or liver.
Creams derived from natural products can also provide local relief for painful muscles in fibromyalgia. The best part is that topical treatments tend to be very well tolerated with few side effects. Arnica is an herb used since the 1500s to treat bruises, muscle pain, and inflammation. It is still used today as a natural treatment for muscle pain in many different topical remedies. One herbal homeopathic cream that I have found helpful is MyPainAway Fibro cream. It includes arnica to reduce muscle pain, echinacea to reduce inflammation, along with other herbs targeted to reduce nerve pain by improving microcirculation around pain-sensing nerves.

As I write in this month’s Harvard Men’s Health Watch, these so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. “In those areas, the medication can penetrate closer to the joint,” says Dr. Rosalyn Nguyen, a clinical instructor in physical medicine and rehabilitation at Harvard Medical School.
“I recently started using Relief in my practice after being introduced to the product by a friend. My patients tell me they prefer Relief to the other analgesic gel because Relief works better, lasts longer, and there is no stickiness or unpleasant scent after using the cream. In addition to the patient response, I use Relief in my office because Corganics provides a high quality product with great customer service. Relief has been a great addition to my practice.” *
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.
Topical anti-inflammatories work in the same way but, instead of having an effect on all of the body, they only work on the area to which you have applied them. When they are applied they are taken into (absorbed into) your skin. They then move deeper into areas of the body where there is inflammation (for example, your muscle). They relieve pain and reduce swelling affecting joints and muscles when rubbed into the skin over the affected area. Using a topical preparation means that the total amount of anti-inflammatory in your body is very low. This in turn means that you are much less likely to have a side-effect to this medicine.
Pain, heat, redness, and swelling (dolor, calor, rubor, tumor) are the classic manifestations of the inflammatory process. Abnormalities of the joints of the spine, associated muscles, tendons, ligaments and bone structural abnormalities can all result in pain and need for neurosurgical consultations. Typically, patients will not require immediate surgical intervention, and therefore require treatments to reduce pain and enhance quality of life activities.[71]
Finally, the active ingredients within a pain relief cream interact with local nerve endings to damp down inflammation, reduce pain and swelling and ease stiffness. All these different actions make topical, rub-in creams and gels highly effective for treating painful joints, sore muscles and sport injuries. Here, I’ve reviewed what I believe are the best pain relief creams, sore muscle creams and pain relief gels.
For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trials, the report's authors found "encouraging evidence" suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.

Various randomized, placebo-controlled studies comparing white willow bark with nonsteroidal agents have shown an efficacy comparable to these agents and aspirin. Salicin from white willow bark is converted to salicylic acid by the liver and is considered to have fewer side effects than aspirin. However, it is costlier than aspirin, and should not be used in children (to avoid the risk of Reye’s syndrome), or in patients with peptic ulcer disease, poorly controlled diabetes, hepatic or renal disorders, or other conditions in which aspirin would be contraindicated. The usual dose of white willow bark is 240 mg/day.[18,19,33,41,64,69,99,100]

"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.)


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.
Enjoy essential oils. Essential oils have long been valued for their analgesic effects in many cultures. There are many ways to benefit from essential oils—some people inhale them (aromatherapy), others include several drops in their massage oil and enjoy as part of a therapeutic massage. Several oils in particular are thought to have an analgesic effect, including peppermint oil, rosemary, and lavender.
Still an excellent product. It remains effective for pain relief for about 5 hours with each application for me. Make sure to rub in a good thick portion for several minutes to the entire area of pain. Each jar of Synthaflex lasts about 18 days for me with applications twice each day. It remains the best external joint and muscle pain relief rub that I have ever used.

In the case of topical creams, many individuals may suffer from allergies that they weren't even aware of until they encounter a negative reaction. These reactions can range in severity from mild skin irritation to more severe issues such as inflammation and increased pain. Remember to check all the ingredients for any topical medication you buy in order to avoid potential allergens and irritants.


Wasabi is another spicy food with natural painkilling properties. Scientists are studying the isothiocyanates in wasabi as potential pain relievers. Researcher from University of California San Francisco made a recent discovery suggesting that isothiocyanates could block an inflammation receptor, making it a potentially important natural painkiller. (2)
Limited bed rest. Once the mainstay of treatment for back pain, bed rest has fallen out of favor. Doctors now know it's better to keep moving, so that your muscles don't become stiff. Bed rest can still be useful relief from low back pain, particularly if your pain is so severe that it hurts to sit or stand. But try to limit it to a few hours at a time and for no more than one or two days.
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.

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.
Many readers assume that “skeptics” will always favour mainstream and pharmaceutical treatments like Voltaren, but nothing could be further from the truth. Indeed, some skeptics are leading the charge against bad pharmaceutical industry science and practices (and a great example is Ben Goldacre’s new book, Bad Pharma: How drug companies mislead doctors and harm patients). Pharmacist Scott Gavura of Science-Based Pharmacy was certainly skeptical about topical NSAIDs like Voltaren when he first tackled the topic early in 2011.13 “When I recently noticed a topical NSAID appear for sale as an over-the-counter treatment for muscle aches and pains … I was confident it would make a good case study in bad science.”

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
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
NSAID medications have potential side effects, even though many of these medications can be obtained over-the-counter. Some of the side effects are minor, other certainly worrisome. Some people may be more prone to side effects given other medical conditions. For that reason, NSAID medication should be used with caution. If there is ever a question of whether or not it is safe for you to take these medications, and you should discuss this with your doctor. Anyone taking NSAID medications for more than a few days should have a discussion with her physician about the potential for side effects.
Water, Menthol, MSM, Glycerin, Dipropylene Glycol, Celadrin, Camphor, Cetearyl Alcohol / Cetearyl Glucoside, Beeswax, Microcrystaline Wax, Butylglycerin, Kyounin Yu, Macadamia, Integrifolia Seed Oil, Glyceryl Stearate / PEG-100 Stearate, Dimethicone, Hyaluronic Acid, Portulaca Oleracea Extract, Allantoin, Licorice Root Extract, Arginine, Carbomer, Lavender Oil, Peppermint Oil, Disodium EDTA, Polyacrylate-13/Polyisobutene / Plysorbate 20
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
Collagen—particularly Type II collagen—is the main structural building block of joint cartilage. The human body is made up of 60 percent Type II collagen, and Hydrolyzed Type II collagen contains the amino acids found in human cartilage. Your body uses these amino acids to create new collagen—and repair your cartilage and connective tissue throughout your body. Hydrolyzed Collagen Type II also contains Hyaluronic Acid, which lubricates your joints and makes it an effective natural remedy for inflammation.

Glutathione is a natural protein found within every cell in the body and consists of the amino acids Glutamic acid, L-cysteine, L-glycine. It is produced by the liver and is also found in fruit, vegetables and meats like mutton, lamb and beef. It is the most powerful antioxidant in the body and helps protect cells from free radical damage and oxidative stress, thereby improving cellular health and strengthening the immune system. As such, in addition to a host of other diseases, L-glutathione is useful in the natural treatment of rheumatoid arthritis.
Biofeedback. You can learn to control your body’s responses to pain triggers. In biofeedback, through sensors connected to your body, a machine will show how thoughts and actions can affect your autonomic nervous system. This controls the heart, lungs, stomach and intestines, as well as the release of stress hormones. Learning how to control breathing and heart rate will allow you to control other physical reactions, such as pain.
For a blast of cool pain relief, Biofreeze has been a go-to for arthritis sufferers for decades. Made with 4 percent menthol, this gel promises immediate relief from pain that’s long-lasting. It has a light green color, so you can see where you’re applying it, but it also comes in a colorless version as well. Both versions are greaseless and have a scent that’s designed to disappear after application.
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
The use of non-steroidal anti-inflammatory drug (NSAID) medication is still the mainstay of most classically taught clinicians for joint and spine related inflammatory pain, despite their commonly known side effects [Table 1]. NSAID mechanisms are primarily through interaction with proinflammatory cytokines interleukin (IL)-1a, IL-1b, IL-6 and tumor necrosis factor (TNF-α). Increased concentrations of TNF-α are believed to cause the cardinal signs of inflammation to occur.[44]

In as much as your doctor would prescribe these types of medication for you, whenever you shop for an Over The Counter cream such as the ones outlined above you would be left with minimal choice to make aside from the fact that you would be required to make comparisons based on the price of the product, its brand and the types of ingredients used in formulating the cream. These types of cream would play a very significant role in enabling you to effectively deal with cases of bruises, skin inflammation as well as muscle and joint pains. The most effective anti-inflammatory cream qualities are the ones that would be readily absorbed into the skin for enhanced action. The cream can be your best friend if it happens that you may be unwilling to take pills. Besides, most of these creams do not have side effects as long as they are used as instructed.
Hi Shelie, Sorry to hear about your fracture. Comfrey cream is traditionally used to boost healing and is known as ‘knitbone’. It contains allantoin – a substance which is also beneficial for Raynaud’s. As described in my post, a trial showed rapid reduction in pain, and more effectiveness than for diclofenac gel in reducing symptoms associated with ankle sprain. A cream will sink in better than an ointment if you are working as a seamstress. Best wishes, Sarah B

Its active ingredients include eucalyptus oil and tea tree oil, but nothing that will heat up your skin or provide the icy, cooling sensation that some other arthritis creams do. It comes in a roller-ball format, which you use to massage the product into the skin. Devoted fans say it’s the best pain-relief cream on the market, and they love that it doesn’t come with a lingering medicinal scent.
For those amenable joints, though, Voltaren® Gel delivers a good dose of medication directly to the joint, while sparing the gastrointestinal tract from the harshness of NSAIDs — which are actually known as “gut burners,” and many people just can’t stomach ibuprofen. A gel almost completely eliminates the risks associated with digesting the stuff.4
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.
Medications are not the only solution to control inflammation and discomfort. As we become increasingly aware and sensitive the possible side-effects of any medication, more patients and doctors alike are interested in non-pharmacologic methods to control inflammation. There are many ways that people address inflammation. Some have better scientific support than others, but most all are safe to try.
In summer 2018 I had my first personal experience with dramatic relief from Voltaren Gel (topical diclofenac). It’s not the first time I have found it useful, but it was the first time it was amazing. I’d been having some unexplained knee pain intermittently for several weeks when it kicked up a notch or two and became constant and even started waking me up at night. When I finally remembered to try Voltaren Gel — I’m not sure what took me so long — things were bad enough that it was going to be obvious if it worked. And it was! After many days of constant discomfort ranging from 3-6 on a 10-scale, it just ended: half an hour after applying the stuff, I simply didn’t have that problem anymore. Hallelujah! It’s been weeks since then with no relapse. Although the pain was not terrible, this is actually one of the clearest examples of pain relief from any treatment that I’ve ever enjoyed.

Are you in pain? You don’t have to reach for over-the -counter pain killers, or even the heavy pharmaceutical hitters prescribed by your doctor; there are literally hundreds of natural pain killers waiting for you in the abundance of nature. You can count on plants and herbs to alleviate everything from arthritis pain, to headaches, to burns – read on to find out more.
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.

Hi Bob, Naproxen is an anti-inflammatory (NSAID) that is working from the inside, so ideally you want a cream or gel that works in a different way to gain opimum benefits (otherwise I would recommend Voltarol Pain Relief Gel which contains another NSAID called diclofenac). Movelat contains salicylic acid, which is a weaker NSAID than Naproxen so it may not provide much additional relief. I find Celadrin cream works well. Hope your pain improves soon. Best wishes, Sarah B
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.
8. Capsaicin (Capsicum) – Found in hot chile peppers, this natural remedy does wonders for pain. Capsaicin, the active pain-reducing ingredient, temporarily desensitizes nerve receptors called C-fibers which cause the pain response. Capsaicin also diminishes soreness for 3 to 5 weeks while the C-fibers regain sensation. A single 60-min application in patients with neuropathic pain produced effective pain relief for up to 12 weeks. Patients at the New England Center for Headache decreased their migraine and cluster headache intensity by applying capsaicin cream to their nasal passages.
Resveratrol is a plant-based polyphenol molecule that is found in various concentrations of many different plant sources. The plant is called Japanese Knot weed or Polygonum cuspidatum, and the skins of red wine grapes are believe to have the most concentrated amounts of resveratrol. In plants, resveratrol is generally found in the plant skin and acts as a phytoalexin to protect the plant from infection, excessive UV radiation and aide in general plant defense. Resveratrol has also been found to have significant anti-mutation, anti-inflammatory, antoxidant and DNA protective actions, when consumed by animals and humans.
In contrast, the guidelines of the American Pain Society and American College of Rheumatology have in the past recommended topical methyl salicylate and topical capsaicin, but not topical NSAIDs. This reflects the fact that the American guidelines were written several years before the first topical NSAID was approved for use in the United States. Neither salicylates nor capsaicin have shown significant efficacy in the treatment of OA.
A type of enzyme extracted from pineapple stems, bromelain reduces levels of prostaglandins, which are hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions associated with musculoskeletal tension (such as TMJ syndrome), as well as those suffering trauma-related inflammation. What's more, the enzyme may promote healing in muscles and connective tissues.
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