People who use nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as topical diclofenac (Pennsaid, Voltaren) may have a higher risk of having a heart attack or a stroke than people who do not use these medications. These events may happen without warning and may cause death. This risk may be higher for people who use NSAIDs for a long time. Do not use an NSAID such as topical diclofenac if you have recently had a heart attack, unless directed to do so by your doctor.Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke; if you smoke; and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of your body, or slurred speech.
However, it probably does not work well for deeper tissues in most cases. For instance, there’s evidence that it doesn’t work at all for the muscle soreness that follows unfamiliar exercise intensity,7 probably because it can’t be absorbed far enough into thick muscle tissue — but oral NSAIDs do have a modest effect on that kind of pain89 (one of the only things that does).
Various randomized, placebo-controlled studies comparing white willow bark with nonsteroidal agents have shown an efficacy comparable to these agents and aspirin. Salicin from white willow bark is converted to salicylic acid by the liver and is considered to have fewer side effects than aspirin. However, it is costlier than aspirin, and should not be used in children (to avoid the risk of Reye’s syndrome), or in patients with peptic ulcer disease, poorly controlled diabetes, hepatic or renal disorders, or other conditions in which aspirin would be contraindicated. The usual dose of white willow bark is 240 mg/day.[18,19,33,41,64,69,99,100]
Finally, the active ingredients within a pain relief cream interact with local nerve endings to damp down inflammation, reduce pain and swelling and ease stiffness. All these different actions make topical, rub-in creams and gels highly effective for treating painful joints, sore muscles and sport injuries. Here, I’ve reviewed what I believe are the best pain relief creams, sore muscle creams and pain relief gels.
Studies have shown that pycnogenol is 50–100 times more potent than vitamin E in neutralizing free radicals and that it helps to recycle and prolong the activity of vitamins C and E. Studies have shown pycnogenol to be effective in reducing blood pressure and reducing the risk of venous thrombosis by its effect on vascular endothelium. The usual dosage is 100–200 mg daily. Few side effects from the use of pine bark extracts have been reported, the most frequent being mild gastrointestinal effects such as diarrhea and upset stomach. Pycnogenol should not be taken by patients who are being treated with immunosuppressants or by those receiving corticosteroid drugs because it can enhance immune system function and interact with drugs that suppress the immune system.[46–84]
Topical diclofenac gel (Voltarol) is highly effective for treating muscle and joint aches and pains. In fact, a direct comparison of topical non-steroidal anti-inflammatory diclofenac gel with an oral equivalent did not show any difference in their ability to reduce pain and stiffness. Data from 34 studies, involving over 7,600 people, suggests that the topical NSAID, diclofenac, is the most effective form of non-steroidal anti-inflammatory painkiller for applying to the skin to treat muscle and joint pain.
The US governmental agencies, through the FDA and others, routinely inspect the manufacture of vitamins or supplements made in this country, as they do for any other food product.[30,63,74] Contaminants, such as the recently discovered high lead content found in various Ayurvedic preparations that were made by an Indian manufacturer and imported into the US,[30,61,63,74,102] are generally thought to be uncommon, but can be a concern when purchasing imported supplements.
“I would rate Corganics Relief pain cream as EXCELLENT! I have a diagnosis of Stage 4 lung cancer with metastases to bones, spine, brain and liver. Every morning and night I use it on my lower back and pelvis, calves and shins. I rely on the relief I get from Relief pain cream to be comfortable all day. Thank you for giving me the peace of mind with such a quality product. I appreciate your excellence!” *
“For most people, it means their back hurts,” says Richard A. Deyo, MD, MPH,the Kaiser-Permanente Endowed Professor of Evidence-Based Medicine in the department of family medicine at Oregon Health & Science University in Portland. “But it’s often impossible to know the precise anatomical cause of back pain because the back has so many sources of pain.”
Find support and understanding.. Unlike a broken leg or other obvious sign of injury, chronic pain is usually unseen. It is a profoundly personal—and often lonely—experience. For many, it is difficult to find support and understanding from family and friends who may be well intentioned but don't really get what you're dealing with. If this is the case for you, we encourage you to find your own group of people who can be supportive and understanding. There may be a chronic pain support group at your local hospital or church. Or you may prefer to interact online. You may get started with a local or online forum seeking help, and then go on to find that you have a lot to contribute, and helping others is also a way to help yourself.
Schematic showing another inflammatory pathway that is activated by tissue injury. This is the NF-kB activation, in which once the protein is free as a result of tissue injury, it can enter the cell nucleus and activate the DNA to enhance the inflammatory response further by the production of additional cytokines, chemokines, and adhesion molecules (IKKB = IkB kinase)
Stay well hydrated. It is common knowledge that drinking enough water throughout the day is good for you, but did you know it can also help reduce pain? For people with back conditions, staying well hydrated helps the intervertebral discs stay healthy. Drinking enough water also helps reduce stiffness, it helps your blood carry healing nutrients and oxygen throughout the structures of you body, and helps flush toxins out of your muscles and other soft tissues. It will help prevent constipation (a side affect of many pain medications).
Cognitive Behavioral Therapy (CBT). In CBT, a psychotherapist helps you identify problematic behaviors (like becoming less active or doing fewer fun activities in response to pain), negative thoughts (about self, others and the future) and feelings (depression, guilt, anxiety). This can increase your awareness of how problematic patterns develop and help you understand the connection between thought patterns and feelings. You are then trained in pain coping skills, such as relaxation techniques, imagery, and goal setting, encouraging you to have an active role in managing and controlling pain. CBT can increase your ability to control pain while acknowledging that there may be occasionally flares beyond your control.
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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


Gentle stretches, walking, and periodically standing up at your desk can help stabilize your spine and prevent muscle imbalances. And despite how hard it is to imagine doing Downward-Facing Dog with a bad back, yoga can work in your favor, too. A 2013 review of studies found strong evidence it can help beat lower back pain. Any type works; one to consider is the restorative viniyoga style.
Ensure that the type of anti-inflammatory cream you buy for yourself, a friend, or family member is of the right quality and more efficient in helping you deal with your health predicaments. The best quality brands would be fast acting and gentle to your skin with every application. Most of all, the cream that you choose at any given point in time should not have any side effects otherwise you would be exposing yourself to the ordeal of tackling what would result from using the poor quality creams in hopes of dealing with a minor injury. The best cream would take the shortest period to help relieve you of any kind of pain or inflammation so that you would comfortably carry on with whatever you might be doing.
Diclofenac sodium 1% gel (Voltaren, also available as a generic). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day).  However, the total amount used on your body should not exceed 32 grams per day. A dosing card comes with the gel so you can measure the correct amount.
Aspirin is now believed to target both the NF-kB and COX pathways. These agents inhibit the NF-kB pathway in endothelial cells and block NF-kB activation to inhibit leukocyte recruitment.[114,115,116] NSAIDs have also been found to inhibit both the COX system and the NF-kB pathway. Immunosuppressant drugs also reduce nuclear expression of NF-kB.[39,70,75] Research now indicates that blocking the activation of NF-kB along with other inflammation mediators [Table 2] is the major mechanism for reducing inflammation by natural compounds.
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)

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org


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.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
A physical therapist will teach you stretches to manage your back pain, as well as exercises to correct any imbalances that might have brought on pain in the first place. Depending on the causes and severity of your back pain, your PT may also employ other treatment techniques, such as ultrasound, electrical stimulation, and active release therapy.
A lot of people who read this are going to want to try it on their low back pain, neck pain, and/or other kinds of muscle pain. Will it work? The only honest answer is, “Who knows?” I have no clinical experience with this yet, and certainly it’s unstudied. It might be worth trying, in moderation, with the full awareness that there’s every possibility that it could be a waste of time and money.
Laugh more often. One study showed that social laughter actually increases pain tolerance.5 Laughing along with others was shown to have the highest positive impact. Laughter has many positive effects, including increasing circulation and oxygen, and raising your body's level of endorphins (the body's natural pain killers). There is a whole movement called "laughter yoga"—which helps people enjoy the many benefits of laughter without having to need a reason to laugh—it just focuses on laughing for its own sake.
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.
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