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. 
Many pharmaceutical pain medications, while effective and useful at times, can be downright dangerous, but there is another solution to your pain problem. “Almost always, if we find pharmaceuticals doing the trick, we’ll find a plant doing the same trick—and doing it more safely,” remarks botanist James A. Duke, PhD, author of The Green Pharmacy Guide to Healing Foods.
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.
Voltaren® Gel (topical diclofenac) is a particularly safe and useful medicine. It’s an anti-inflammatory cream, so it can be applied only where you need it, instead of soaking your entire system with a medication, avoiding or dramatically reducing common side effects like indigestion, as well as some serious safety concerns associated with oral diclofenac. In the US, this drug is FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands,” but it probably also works for some other painful problems, such as some repetitive strain injuries and back pain. The evidence shows that it “provides clinically meaningful analgesia.” So this product actually works and gets a pass from skeptics and critics — a rare thing in the world of pain treatments!
The first generic (cheaper) equivalent of Voltaren® Gel entered the marketplace in 2016, produced by Amneal Pharmaceutical. It should be widely available now. Both products are still prescription-only in the US, but fortunately they are over-the-counter almost everywhere else (there’s a rack of tubes of Voltaren by the till at my neighbhourhood drugstore).

Thank you for providing a list with creams that aren’t simply analgesic! Most lists are just full of creams that provide analgesic properties by blocking pain receptors. It doesn’t really help your body repair from damage or strain. I use a cell-regenerative, anti-inflammatory cream with analgesics and its completely natural. It has the MSM and Arnica. I apply it before I work out and after to help nurture and heal my muscles & joints as well provide pain relief. This way I recover faster and get into the gym quicker knowing my body is supported and I am not just exasperating a problem.


Ongoing pain can wreak havoc on your life, affecting your cherished relationships, finances, and your ability to get stuff done at work and at home. It can also interrupt your sleep and affect your mood. Because many other problems commonly occur along with chronic lower back pain, anything you can do for yourself that is a natural anti-depressant will help.
"I am a true believer in Biofreeze ($15; performancehealth.com). My football coach introduced me to it years ago. It's a topical cooling pain reliever that works very similarly to ice but since it's a gel, I can apply it before teaching classes and training clients to keep function in my muscles and joints. In addition to relieving muscle pain or soreness, it can be used to help arthritis and other muscular and joint discomforts too. " —Mat Forzaglia, The Fhitting Room instructor

“I was first introduced to Relief by my Chiropractor after I pulled a muscle. Later my son, while playing hockey, received a very nasty hit during a game and was given Biofreeze as part of his recovery process. I can tell you Relief is 10x better—he was still in pain after using the Biofreeze, so I grabbed the Relief and he could not believe the difference. Now we are a Relief ONLY household. I am spreading the word to all the other hockey mom’s on the quality of your product and how well it works. Thank you for creating Relief and keep up the good work.” *


11. Aquamin – Derived from red seaweed, aquamin is a powerful pain reducer, too. In a study published in Nutrition Journal, of 70 volunteers, Aquamin users reduced arthritis pain by 20% in a month and had less stiffness than patients taking a placebo. Helping to diminish inflammation and helps to build bone, aquamin is rich in both calcium and magnesium, too.
Acetylsalicylic acid works by irreversibly disabling the COX enzymes to block the cascade [Figure 1]. NSAIDs have evolved from blocking both COX-1 and COX-2 to selectively only blocking COX-2 in order to inhibit the inflammatory response and reduce the production of inflammatory prostaglandins and thromboxanes. The major push to develop the selective COX-2 inhibitors has been the recognition of significant complications associated with the nonselective COX-1 and COX-2 NSAIDs. Nonselective NSAIDs’ major side effects include significant gastrointestinal upset, gastritis, ulceration, hemorrhage, and even death. By locking COX-1, which also normally acts to protect the gastrointestinal mucosa, nonselective NSAIDs and aspirin can cause significant gastric tissue damage.[34,51,78,91,3,101,115]
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.
Looking for a nonaddictive way to soothe aches? LifeSeasons’ award-winning Pain Bloc-R helps deliver the benefits of conventional approaches, including decreased aches and discomforts and increased relaxation, without the common pharmaceutical side effects. Pain Bloc-R combines natural ingredients and compounds, including Angelica dahurica, white willow bark, L-tetrahydropalmatine, and L-theanine, that work together to help support the body’s natural ability to relieve everyday aches.

I use my Rogue Fitness Supernova ($40; roguefitness.com) for self-myofascial release (SMR). By applying pressure directly to sore muscles with my supernova, I am able to roll out knots (or adhesions) on the muscle. This allows the body to bring blood flow to troubled areas by transporting nutrients and oxygen to the muscles for faster repair." — Troy Brooks, YG Studios and founder TB Elite Fitness
The powerful anti-inflammatory ginger is more effective than drugs like ibuprofen for pain relief, according to a 2013 study published in the journal Arthritis. The study revealed that drugs like Tylenol or Advil do block the formation of inflammatory compounds. Ginger, however, “blocks the formation of the inflammatory compounds–prostaglandins and leukotrienes–and also has antioxidant effects that break down existing inflammation and acidity in the fluid within the joints,” reported care2.com.
Hi Paul, This is not a condition I’m very familiar with. I’ve done a bit of research for you and found that most people will regain up to 70-90% of their original strength and functional levels within two years. The same reference suggests that ‘Specific pain medications used to treat PTS include opiates and non-steroidal anti-inflammatory drugs (NSAIDs), which are usually used in combination. … After the acute phase, different medications such as gabapentin, carbamazepine, and amitryptiline may be used specifically to treat nerve pain.’ It’s possible that diclofenac gel will help the pain – this is the most effective topical NSAID available without prescription. Your doctor can prescribe other versions. Nerve pain is difficult to treat topically, although capsaicin cream (chilli extract) is prescribed to treat other forms of nerve pain eg related to shingles. Physio will help the nerves to recover – a medical herbalist may be able to suggest herbal creams that might promote nerve regrowth. Hope that helps.
Note: The cream is hot to your skin and should be used with caution. The heat comes from capsicum (capsicum annuum) oleoresin a hot pepper. Try a small amount the first time at your inside wrist and wait a half hour to see how it feels. Do not bathe or shower after putting it on because that will only make you feel hotter. Let your body cool down first. Never put the cream near your eyes or mucous membranes such at the lower nose. Do not use on your private area. Wash your hands after you have rubbed the cream into your skin.
Traditional wisdom says that NSAID pain relievers only damage your gut lining if you take them every day for a long time, but recent research disagrees. High-level athletes with stress-related intestinal damage tried taking ibuprofen to improve muscle soreness and recovery. Ibuprofen ended up damaging their gut lining even further after just a couple weeks; it increased inflammation and made their original pain issues worse.[3] In fact, a single dose of aspirin can significantly increase your intestinal permeability.[4]
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