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This can vary depending on the reason for treating you, so speak with your doctor for advice. If you are using an anti-inflammatory for acute muscle pain, usually treatment lasts for as long as you have pain and inflammation. For example, a few days, or weeks. But if you are being treated for conditions like osteoarthritis, your doctor may advise you to use this medicine for the long term.
The only side effect most of these products have is odor. Some of them were reviewed as being neutral to actually smelling good, while others were reported to have quite a strong smell you might not like. A lot of this has to do with the nature of the ingredients in pain relieving treatments. Mentholated ingredients give natural relief, but they do tend to have a strong odor that accompanies them.
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Hi Carol, Sorry to hear you are in such pain. Hopefully the results of the x-ray will show a way forward to solve the problem. You may benefit from physiotherapy to prevent frozen shoulder, or gentle chiropractic manipulation to correct misalignments of tiny joints – this certainly helped my other half who experienced a similar problem. A topical treatment containing capsaicin may help by damping down nerve generated pain. Magnetic therapy and using a heatlamp are other non-drug approaches which have been shown to improve circulation and boost healing of shoulder problems. Anti-inflammatories such as omega-3, turmeric or rosehip are other options. I hope you feel more comfortable soon. Best wishes, Sarah B
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.
Whether the pain that someone experiences is activity related, leftover from an old injury, or due to a chronic inflammatory condition, bone broth in the diet can help to reduce chronic pain and flares. This is due to the presence of collagen in bone broth, which can help to alleviate joint problems and repair pain that originates from the digestive tract. (23)
The available science includes a 2011 study published in Arthritis Care & Research, which found that a 10-week tai chi program reduced pain and improved functioning in people with long-term low back pain symptoms. The study involved 160 adults with chronic low back pain, half of whom participated in 40-minute-long tai chi sessions 18 times over the 10-week period.

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)


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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.
To minimize your risks for a skin reaction, Cowling recommends doing a skin test before starting any topical pain reliever and washing your hands immediately after applying. Also don’t use topicals on any areas of the body where you have an open wound or broken skin, even a scratch. If you develop severe itching, redness, swelling or any other signs of a worsening skin reaction, contact your doctor. 
Diclofenac is an extremely popular drug — again, we’re talking oral here — and it is associated with serious cardiovascular risks: “There is increasing regulatory concern about diclofenac. … Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage.”14 This has been in the news quite a bit, and NPR had a hit in 2013 with this headline: “World's Most Popular Painkiller Raises Heart Attack Risk.”

Bark from the white willow tree is one of the oldest herbal remedies for pain and inflammation, dating back to ancient Egyptian, Roman, Greek, and Indian civilizations, as an analgesic and antipyretic agent. Because of the gastric side effects of aspirin, there has been a resurgence in the use of white willow bark for the treatment of inflammatory syndromes. The mechanism of action of white willow bark is similar to that of aspirin which is a nonselective inhibitor of COX-1 and COX-2, used to block inflammatory prostaglandins.[48]

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.


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.
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.
While adding turmeric as a spice to foods tastes good, it has to be eaten in pretty large quantities to get a medicinal effect, as our gut does not absorb it well. The maximum pain relief effects are usually found with supplements that contain curcumin optimized for absorption (such as curcumin phosphatidylcholine complex). I like Meriva by Thorne Research, typical dosage of 500-1000mg twice daily. Although curcumin is much safer than anti-inflammatory medications, it does have some mild blood-thinning effects, so make sure to ask your health care provider before starting supplementation.
That said, why not try it? It’s almost certainly safer than popping ibuprofen! Although not tested and approved for reckless experimentation on any pain problem, obviously the entire point of Voltaren® Gel is to limit exposure to the active ingredient. So you might choose to experiment — taking full responsibility for your actions, of course, and not suing me if something goes horribly wrong, because of course I’m not actually recommending it. 😉 Seriously: just run it by your doctor.
I purchased this because it was less expensive than Penetrex and I'd thought I'd try it out.. Unfortunately, compared to Penetrex, at least for me, I do not feel that it is worth the savings. I'm using it for Plantar Fasciitis and Osteoarthritis in my knees. Although it does provide some pain relief, the duration is limited to a couple hours, whereas Penetrex lasts for up to half a day. However, SynthaFlex does offer a little more relief, albeit very temporarily, for my Osteoarthritis than Penetrex does. It is not nearly as effective for my Plantar Fasciitis pain. Ultimately, if I have to apply it many times throughout the day, it is not cost effective in comparison.
Different creams and gels combine different pain-relieving ingredients for a greater, synergistic effect. The most effective natural ingredients are arnica, cannabidiol CBD oil, glucosamine, chondroitin, celadrin, comfrey root, capsicum, MSM and Green-lipped mussel extracts. The most effective pharmaceutical pain relief gel are those containing diclofenac, which is a stronger version of ibuprofen.

For example, water therapy is gentle on your body because the water supports the weight of your body and provides gentle resistance. The exercise is done in warm water, which is also soothing. There are many land-based exercise programs that can provide a gentle, endorphin-producing form of exercise, such as tai chi, or yoga programs designed for people with chronic pain conditions.


you should know that you should not apply sunscreens, cosmetics, lotions, moisturizers, insect repellents, or other topical medications to areas treated with diclofenac gel (Voltaren). If you have been prescribed diclofenac liquid (Pennsaid), wait until the area of application is completely dry before applying any of these products or other substances.
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.

We looked at both gels and creams to create our top ten list. How did we evaluate consistency? We looked at whether the substances stained, went on greasy, or were otherwise messy to deal with. Did users like the feel of the gel or cream on their skin? Why or why not? We also looked at whether formulas were quick drying and whether they left a residue. When it came to ingredients, we wanted to select as many options as possible with natural ingredients that were easily recognizable.


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.
1. Capsaicin. Capsaicin creams and gels are made from chili peppers.  They cause a mild to moderate burning sensation thought to alter nerves' ability to interpret pain by lowering the presence of a neurotransmitter called Substance P. Brand names including Capzasin and Zostrix are marketed for arthritis, backache, and other joint and muscle pains.  These creams aren't generally associated with any adverse side effects though some patients may feel the heat more intensely than others.
When people experience a minor headache, muscle tension or other pain, they readily reach for over-the-counter drugs like ibuprofen and acetaminophen—the most commonly used drugs in the U.S. But regular use of these drugs can lead to long-term side effects like intestinal damage, liver failure and more, recent research reveals. Before popping the pills, consider these alternative remedies for natural pain relief.
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