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.
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
Over-the-counter (OTC) pain medications are fairly safe and somewhat effective in moderation and work in different ways, so do experiment cautiously. There are four kinds: acetaminophen/paracetamol (Tylenol, Panadol), plus three non-steroidal anti-inflammatories (NSAIDs): aspirin (Bayer, Bufferin), ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). Don’t take any of them chronically — risks go up over time, and they can even backfire and cause nasty rebound headaches. They are all probably equally effective for acute injuries (Hung), but benefits vary with people and issues (chronic pain, headache, arthritis, etc). Acetaminophen is good for both fever and pain, and is one of the safest of all drugs at recommended dosages, but it may not work well for musculoskeletal pain (at all?) and overdose can badly hurt livers. The NSAIDs all reduce inflammation as well as pain and fever, but at any dose they can cause heart attacks and strokes and they are “gut burners” (they irritate the GI tract, even taken with food). Aspirin may be best for joint and muscle pain, but it’s the most gut-burning of them all. Voltaren® Gel Review is an ointment NSAID, effective for superficial pain and safer (Derry). Athletes, puh-lease don’t take “Vitamin I” to prevent soreness — it doesn’t work!

My personal preference is regenerative injection therapy (RIT). This is a non-operative, therapeutic approach to pain reduction that involves multiple small injections into a joint to encourage the body to initiate healing methods. Through the process of concentrating and injecting specific substances, such as prolo, PRP, or stem cells at the site of injury, the process of regeneration and remodeling is facilitated and a robust healing response is achieved. 


Chondroitin sulphate is produced naturally in the body to promote the formation of healthy cartilage, tendons and ligaments, and it is also an important component of joint synovial fluid. As you get older, your joint cells secrete less and less chondroitin and this has been linked with reduced cartilage quality and the start of degenerative changes.

I’ve just emphasized that Voltaren is mainly appropriate for shallow inflammation, but there is some evidence that Voltaren might be able to “reach deeper.” This is hardly the stuff of medical certainty yet, but researchers Huang et al found that Voltaren treated pain coming from deep inside the spine, right in the centre.6 They concluded that it could be a “convenient and safe clinical intervention” for a few types of back pain. An anti-inflammatory gel will likely fail with many kinds of back pain, but there’s also virtually no down-side to trying. See my low back pain tutorial for extremely detailed information about medications for back pain.

Try taking one 250-milligram capsule of valerian four times a day. Some scientists claim that this herb’s active ingredient interacts with receptors in the brain to cause a sedating effect. Although sedatives are not generally recommended, valerian is much milder than any pharmaceutical product. (Valerian can also be made into a tea, but the smell is so strong-resembling overused gym socks-that capsules are vastly preferable.)


The most often neglected method to control inflammation that I see in my patients is rest. Not only does this mean resting from athletics, but often this means allowing an injured body part to rest from normal activities which may prolong inflammation. We live busy lives that may not allow for rest, but ignoring the signs of inflammation may prolong the problem. Therefore, look for ways to rest your injured body part to allow the inflammation to subside and the recovery process to unfold.
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Topical diclofenac for osteoarthritis comes as gel (Voltaren) to apply to the affected skin area four times a day to treat arthritis pain. Topical diclofenac for osteoarthritis also comes as a 1.5% liquid (Pennsaid) to apply to the knee four times a day. Topical diclofenac for osteoarthritis also comes as a 2% liquid (Pennsaid) to apply to the knee twice a day. Apply diclofenac gel (Voltaren) or liquid (Pennsaid) at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use topical diclofenac (Pennsaid, Voltaren) exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than prescribed by your doctor. Do not apply the gel or liquid to any area of your body that your doctor did not tell you to treat.

If you’re sensitive to aspirin, or if you’re taking any over-the-counter (OTC) anti-inflammatory drugs (like aspirin, ibuprofen, or naproxen), you should avoid willow bark. You should also avoid taking it if you’re taking warfarin (Coumadin) or other anticoagulant treatments, as salicin could increase the risk of bleeding. Talk to your doctor before taking willow bark if you’re taking other anti-inflammatory or pain medications.
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