The main advantage of topical NSAIDs is the reduced exposure of the rest of the body to the product, which reduces the side effect profile. Given the toxicity of NSAIDs is related in part to the dose, it follows that topical treatments should have a better toxicity profile. Consequently, the cardiovascular risks of topical diclofenac, even in those with a high baseline risk of disease, should be negligible with the topical forms.

For arthritis relief, it is important to have proteolytic activity on the systemic level. Known as protease, this category of enzymes acts as a catalyst in the breakdown of proteins into peptides or amino acids. This helps control both systemic inflammation and inflammation resulting from soft tissue injuries, like those associated with both rheumatoid and osteoarthritis. Proteolytic enzymes also provide essential antioxidant and cardiovascular support. I will discuss two of the more potent ones here:
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.
The Inactive ingredients are aloe barbadensis leaf extract, arnica Montana flower extract, Actium lappa root (burdock) extract, boswellia carterii resin extract, calendula officinalis extract, carbomer, camellia sinensis (green tea) leaf extract, camphor, glycerin, ilex paraguariensis leaf extract, isopropyl alcohol, isopropyl myristate, melissa officinalis (lemon balm) leaf extract, silica, tocopheryl (vitamin E) acetate, triethanolamine, water, blue 1, and yellow 5. Ilex is a skin protectant for topical skin barrier gels and lotions designed to protect the skin from harmful irritants such as urine and feces. It usually contains good things such as corn starch, white petroleum jelly, and zinc oxide.
The processes used to prepare herb-derived compounds pose complications when it comes to determining the quantity and concentration of the products.[30,63,102] The preparation processes are not standardized, and therefore, the extraction process and the type of plant used may affect the true concentration of the product. In addition, there is a lack of uniformity within and between manufacturers. Although dietary supplements are not held to the same rigorous testing and standards as pharmaceutically derived medications in the US, there are many regulations that still control their manufacture because these are food products.
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.
studies and meta-analyses report a strong relationship between chronic pain and abnormalities in glucose metabolism. Insulin resistance and abnormal blood sugar pave the way for inflammatory pathways, resulting in chronic pain. Magnesium deficiency is another that comes to mind. Magnesium helps to block the brain’s receptors of glutamate, a neurotransmitter that may cause your neurons to become hypersensitive to pain. Intestinal integrity is one that many people don’t think to connect to their pain. However, high-quality food choices are crucial for managing pain due to the way they influence gut health. Substances in grains may increase intestinal permeability, allowing undigested food particles, bacteria, and other molecules to enter the bloodstream, which can influence inflammation and chronic pain.
“When I was pregnant two years ago with my daughter I had extreme pain in my right shoulder. It went on for months. They did cortisone shots, prescribed Loratab (Hydrocodone and Acetaminophen), and were ready to operate on a pregnant gal the pain was so severe. Eventually the cortisone shots worked and the pain went away. I am now pregnant again and at about 28 weeks the pain was back. This time the pain was worse. The joint hurt so bad I couldn't pull the covers over me in bed. I could only sleep on one side, and NOTHING worked. My chiropractor recommended Relief cream. I was skeptical that a cream could ease my pain when the medical community had nothing that worked. In a total act of desperation I had my husband rub it into the shoulder one night. I slept better than I had in weeks. He rubbed it in the next night and the pain was completely gone. Here I am now 34 weeks pregnant and the pain has been completely gone for 6 weeks. My husband has also used it on his back (after trying everything else under the sun) with similar results. Thank you for a truly amazing product. We have shared this info with our family and friends!” *
One concern about the use of products like Voltaren is that several conditions are less inflammatory in nature than they feel like. Patients usually assume that the “burning” pain of repetitive strain injuries like tendinitis is caused by inflammation, but in fact classic inflammation is largely absent, especially after initial flare-ups have died down (but pain is still carrying on). While it is possible, even likely, that tendinitis is still inflamed in some sense, it’s doubtful that they are inflamed in a way that NSAIDs are actually good for. The biochemistry of cranky tendons is rather complex and largely unknown. There’s probably some overlap between the biology of acute, classic inflammation and the subtler biology of chronic tendinitis, but no one really knows. So the value of Voltaren for tendinitis is unclear.
Physical activity. Exercise helps build strong, flexible muscles that will be less prone to injury. It can also help the healing process for an aching back, prevent problems in the future, and improve function. Work with your doctor to develop an exercise program, or seek a referral to another health professional who can. A good program typically includes the three major forms of exercise: aerobic activity, strength training, and flexibility exercises.
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.
Topical treatments: One potential concern with dietary supplements is that some may interfere with medications you’ve been prescribed to treat back pain or other health conditions. For this reason, Grossman suggests topical treatments: “Gels and creams can be very helpful and won't interfere with supplements or medications,” she explains. “They're generally inexpensive, too.”
Despite what a majority of people may have been made to believe concerning the issue of anti-inflammatory creams and the pain-relieving creams the truth is that the two types of creams differ immensely. Pain relief creams serve the important function of disrupting the transmission of pain signals from different parts of the body to the brain thus allowing you to feeling a sense of temporary pain relief. However, most cream pain relievers would not have elements that would help reduce inflammation or swelling. Nevertheless, the anti-inflammatory creams and the pain relief creams both can be used for arthritis flare-ups and dealing with minor sports injuries. Nevertheless, for those people who may have never used these types of medications before or those who may not be sure of the type to use it is important to consult with the doctor before using such a product. Most all, never use the anti-inflammatory creams on a child or expectant mother unless who check in with your doctor.
Curcumin is the bioactive compound in turmeric that gives the herb its healing properties. It’s one of the safest anti-inflammatories you can take, and is an effective natural pain reliever too — even for severe pain. In fact, curcumin matches or outperforms ibuprofen, acetaminophen, and other over-the-counter painkillers without any side effects.[12]
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