Topical non-steroidal anti-inflammatories (often abbreviated to NSAIDs) are creams, gels, rubs, solutions or sprays that contain a nonsteroidal anti-inflammatory agent and are designed to be applied directly to the skin overlying a painful joint or area of bone. They are used to relieve pain and to treat symptoms of arthritis such as inflammation, swelling, and stiffness. Topical NSAIDs may also be used in the treatment of actinic keratosis (a precancerous patch of thick, scaly or crusted skin).
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No, the lower back pain isn't in your head. But what is in your head could be making it worse. "Fear, anxiety, and catastrophizing can amplify pain," says Mackey. "People often get swept up in thoughts like This will never get better." Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Cognitive-behavioral therapy helps you recognize and reframe negative thoughts. Deep breathing can help, too, as can simply shining a light on dark thoughts. "Start by accepting that you have pain," Mackey says. "Then say to yourself, It will get better."
Think of Voltaren® Gel as “ibuprofen in a gel.” (It’s actually diclofenac, but ibuprofen is a much more familiar drug name in North America, where the product is still fairly new, and available only with a prescription in the US.) It’s a topical anti-inflammatory medication,NSAID“Non-steroidal anti-inflammatory drug,” usually pronounced “en-sed.” and FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands.” The evidence shows that it “provides clinically meaningful analgesia.”1 This is an appealing treatment idea that actually works reasonably well: what a pleasure to be able to say that!2
Warm bath. Taking a warm bath can bring immediate pain relief to sore and stiff joints. If you have respiratory or cardiac problems that may keep you from using warm water therapy, or if you are older than 70 (as we age, our bodies do not regulate heat as well), check with your doctor before trying this method. If only your hands or feet are affected, you may try soaking them in a tub with warm water.
How it works: When back muscles hurt, the pain is usually caused by inflamed tissue. Cold reduces the swelling and discomfort, says Jason Highsmith, a neurosurgeon in Charleston, South Carolina. As soon as you feel pain, apply cold several times a day, 10 minutes at a time, for about three days. A bag of frozen peas works, or try a cold pack, like an Ace Reusable Cold Compress ($10 at drugstores).
A study involving 172 people with osteoarthritis of the knee compared the use of a arnica gel with a prescribed, nonsteroidal anti-iflammatory gel (the NSAID piroxicam) with 1g of gel applied three times a day for 4 weeks. The results showed a pain reduction of 16.5 in the arnica gel group versus only 8.1 in the NSAID gel group and the researchers concluded that the Arnica gel was at least as effective and as well tolerated as the NSAID gel. A similar trial involving over 200 people with osteoarthritis of the hands showed that arnica gel was just as effective as an NSAID (ibuprofen) gel in reducing pain and improving hand function.
Stretch. Don't sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. "Because most of us spend a lot of time bending forward in our jobs, it's important to stand up and stretch backward throughout the day," Reicherter says. Don't forget to also stretch your legs. Some people find relief from their back pain by doing a regular stretching routine, like yoga.
For arthritic pain in the hands and knees, capsaicin is your best bet if you want to go the natural route. Otherwise topical NSAIDs work well, too. If you are taking any medications for your arthritis, be sure to talk to your healthcare provider before using any creams and gels and make sure there are no ingredients in them that could interact with your medication.
Massage. Various forms of body work can provide temporary pain relief. You can try full-body Swedish massage for stress relief and relaxation; deep-tissue massage, which uses pressure and slow strokes on deeper muscle tissue to release knots and relieve tension; or myofascial release, which uses long, stretching strokes to relieve tension around the connective tissue of the muscles.
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.
Cayenne pepper is also a potent candida killer. Scientists found it’s active against 16 different fungal strains, including candida, a common internal infection linked to joint pain, among other candida symptoms. (1) Cayenne also provides external pain relieve. Capsaicin, an important natural painkiller found in cayenne, helps treat muscle soreness, tension and even skin infections. Look for it in natural painkilling creams.
Endorphins are hormones made naturally in your body. What most people don't know is that they can be just as strong as any manufactured pain medication. When endorphins are released in your body, they help block pain signals from registering with your brain. Endorphins also help alleviate anxiety, stress, and depression, which are all associated with chronic back pain and often make the pain worse.
Within the cartilage around your joints is a chemical known as chondroitin. Chondroitin is naturally produced by the body. As you age, your natural supply starts to plummet. And a loss of chondroitin from cartilage is linked to a major cause of joint pain. Moreover, through wear and tear the joint cartilage breaks down, resulting in the condition of Osteoarthritis. We can’t regenerate cartilage on our own, but we can take a supplement called chondroitin sulfate which, studies show, can help slow down this degenerative process and help naturally reduce arthritic pain. Chondroitin sulfate is made from the cartilage of cows and other animals, and is often used in combination with other products including glucosamine and manganese.
Also, many painful factors in neck, back and muscle pain are deep inside the body — probably much deeper than Voltaren® Gel can “reach.” For instance, if your low back pain is coming from the facet joints — small joints deep in the spine, under a thick layer of muscle — chances are that a topical treatment simply doesn’t stand a chance of having an effect.
Release your inner endorphins. Endorphins are the natural pain relievers produced by your body. They work by binding to the opioid receptors in your brain to block the perception of pain, similar to opioid pain medications, such as oxycodone or morphine. Spurring increased production of these natural hormones can substantially help reduce your pain, as well as produce profound feelings of pleasure and satisfaction.1
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
Pycnogenol inhibits TNF-α–induced NF-kB activation as well as adhesion molecule expression in the endothelium. Grimm et al, recently reported that oral intake of pycnogenol inhibited NF-kB activation in lipopolysaccharide-stimulated monocytes as well, thus decreasing the inflammatory response. It also statistically significantly inhibited matrix metalloproteinase-9. This matrix-degrading enzyme is highly expressed at sites of inflammation, and contributes to the pathogenesis of various chronic inflammatory diseases.
Hi Patricia, Sorry to hear about your experience. The patient information leaflet for diclofenac gel inside each pack advises that users should avoid applying on large areas of skin, that an amount ranging in size from a 1 penny to a 2 pence piece will usually be sufficient, and not to use it if you are already taking NSAID tablets. High blood pressure is not listed as a possible side effect, as this was not detected in clinical trials. As you say, diclofenac tablets and other oral NSAIDs are now associated with an increased risk of cardiovascular disease which is why the gel is considered a better option. I have coverd this in a post about ibuprofen increasing blood pressure here. Research looking into the long-term tolerability of topical diclogenac gel in people with an elevated risk of NSAID-related side effects, such as existing high blood pressure, type 2 diabetes, stroke and heart disease, suggests that the gel appears to be safe to use to treat osteoarthritis, even in these high risk groups. Having said that, everyone is different, due to the genes they have inherited, and you may have experienced an unusual, idiosyncratic reaction to the small amounts absorbed via the skin. It’s good that you or your doctor were monitoring your blood pressure to detect this. I have a website dedicated to lowering a high blood pressure, which includes lots of complementary approaches, that you may find helpful. Are you able to share the name of the herbal cream which you have found works better? Best wishes, Sarah B
Physical therapists use PEMF to heal fractures and torn cartilage faster, and surgeons recommend it as a post-op way to minimize soft tissue inflammation. I use it to recover from workouts faster and keep inflammation low. PEMF machines send electromagnetic pulses through your tissue, gently stimulating anti-inflammatory and repair compounds.