In October 2007, diclofenac sodium 1% gel (Voltaren Gel) became the first topical NSAID for OA therapy approved in the United States following a long history of use internationally. Topical diclofenac sodium 1% gel delivers effective diclofenac concentrations in the affected joint with limited systemic exposure. Clinical trial data suggest that diclofenac sodium 1% gel provides clinically meaningful analgesia in OA patients with a low incidence of systemic AEs.

While there are mixed answers on how many servings of leafy greens one should eat each day for preventive effects, an overall eight to ten servings of vegetables and fruits daily is recommended for the best results. Of those, perhaps two to three servings of vegetables should be leafy greens. Leafy greens are rich in quercetin, a type of flavonoid that is responsible for broad anti-inflammatory benefits, as well as vitamin C, vitamin K, and essential minerals like magnesium. (15)
People with sensitive skin, infants, children, pregnant women, and seniors might be at a higher use using these products. People with kidney problems or kidney failure in the past shouldn’t try an Ibuprofen cream. If you take aspirin, prescribed blood thinners such as Coumadin (warfarin) or have bleeding of the gastrointestinal tract, consult your healthcare provider before using these topical pain products. Do not use salicylates that cause blood to be thinner.
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

Lower back pain can be mild to very severe depending on its underlying causes, how long it’s been left untreated and the state of someone’s overall health. The University of Maryland Medical Center states that several important risk factors for lower back problems include family history of back pain, smoking or using tobacco, being overweight or obese, being female, being anxious or depressed, and either doing too much physical work or living a sedentary lifestyle.
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

if you are having surgery, including dental surgery, tell the doctor or dentist that you are using diclofenac gel (Voltaren) or liquid (Pennsaid).plan to avoid unnecessary or prolonged exposure to real or artificial sunlight (tanning beds or lamps, ultraviolet light) and to wear protective clothing to cover areas treated with diclofenac gel (Voltaren) or liquid (Pennsaid). Diclofenac may make your skin sensitive to sunlight.


Cetyl myristoleate (CMO) is a fatty acid, an ethylated esterified fatty acid derived from bovine tallow oil. Though it is similar to fish oil, it is made specifically to help joints through its action as a cellular lubricant. Clinical studies show CMO to be an effective natural anti inflammatory compound that promotes healthy joint function. It increases joint flexibility and range of motion by lubricating the joint at a cellular level. It works to decrease inflammation specifically in the joints and lubricate their movement. In other words, it increases the fluids that cushion the space between the joint bones. CMO is reported to effect change at the cellular level, within the cell membranes themselves. It assists in the reduction and prevention of breakdown in joint cartilage. This can be especially helpful for those suffering degenerative osteoarthritis. The Journal of Rheumatology reported on a double-blind study of patients with chronic knee osteoarthritis where the CMO group saw significant improvement while the placebo group saw none. In fact, the scientists were so impressed with the results they concluded CMO “may be an alternative to the use of non-steroidal anti-inflammatory drugs for treatment of osteoarthritis.”

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.


Zeng C, Wei J, Persson MS, et al. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br J Sports Med. 2018 Feb. PubMed #29436380. “Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population.” BACK TO TEXT
Whether or not research can prove that massage therapy helps, many people report that it relaxes them and eases chronic pain. In a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in the treatment of back pain. The study authors concluded that massage "might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education." The authors called for further studies that might help determine whether massage is a cost-effective treatment for low back pain.
Jessica Hegg is the content manager and at ViveHealth.com. With vast product knowledge and understanding of individual needs, she aims to share valuable information on making smart buying choices, overcoming obstacles and overall improving the quality of life for others. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle.
The soothing sensation of a rollerball can add additional relief for some arthritis sufferers, and this version from Stopain is popular. The active ingredient is menthol, which provides a cooling effect. It also contains MSM and glucosamine as well as eucalyptus and peppermint oils in a non-greasy formula that won’t stain clothing. You can apply it up to four times a day, and customers say it works to alleviate pain quickly.
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.
The good news is that myofascial release is also something we can do for ourselves! A recent study showed that a regular program of self-myofascial release lowered pain intensity and lessened stiffness. To start, you can simply lie on the floor and place a small, soft ball (around the size and density of a large orange) under any tight and painful muscle areas. Then allow your body to sink onto and around the ball for a few minutes to provide the right amount of sustained pressure to allow the fascia to release. Learn how to self-myofascial release with this Myofascial Self Care Video Course that was developed by a pair of myofascial release therapists, and is is a great way to do MFR treatment at home.

Almost every person with fibromyalgia describes their muscles as tight and full of painful muscle knots called trigger points. After I was diagnosed with fibromyalgia during medical school, I tried many different styles of massage, but got no benefit until I found a specialized technique called myofascial release pioneered by John Barnes, PT. This form of massage therapy involves using very slow but sustained gentle pressure to separate tiny adhesions in the muscle tissue and fascia, and this lessens muscle tension and gently breaks up knots in the connective tissue (to learn more about the vital importance of fascia in fibromyalgia, read my previous blog post). Two European studies found that myofascial release therapy was effective for reducing fibromyalgia pain, and that it gave long-lasting pain relief even at one month and six months after the last session. To find a John Barnes-trained therapist skilled in this technique go to www.mfrtherapists.com.
Since herbal therapies for pain management have yet to be thoroughly studied, be careful when embarking on this treatment path. Regardless of the herb you try, remember that they're not benign. Research into their safety and efficacy is still limited, and the government doesn't regulate herbal products for quality. The best course is to talk to a health-care professional before testing out a herbal remedy.
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