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.

Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010, January). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29–36. Retrieved from https://www.sciencedirect.com/science/article/pii/S0022399909000944
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!

Cannabidiol, or CBD, is extracted from non-marijuana strains of industrial hemp plants. CBD oil is one of the most popular supplements for pain when taken orally, and CBD creams, salves and ointments are equally effective for pain relief when applied directly to painful muscles and joints. CBD is absorbed through the skin to interact with cannabinoid receptors (CB2) and suppress inflammation, relieve local pain and reduce itching, irritation and soreness. You can use a CBD salve or ointment at the same time as taking CBD oil capsules which reduce pain perception within the brain, aid relaxation and sleep as well as reducing discomfort and fatigue. Click here to find out more about oral cannabidiol CBD oil supplements for pain.
The use of both over-the-counter and prescription nonsteroidal medications is frequently recommended in a typical neurosurgical practice. But persistent long-term use safety concerns must be considered when prescribing these medications for chronic and degenerative pain conditions. This article is a literature review of the biochemical pathways of inflammatory pain, the potentially serious side effects of nonsteroidal drugs and commonly used and clinically studied natural alternative anti-inflammatory supplements. Although nonsteroidal medications can be effective, herbs and dietary supplements may offer a safer, and often an effective, alternative treatment for pain relief, especially for long-term use.

Back pain is one of the most common reasons why people visit a health care provider. The good news is that the pain often goes away on its own, and people usually recover in a week or two. Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only won’t help but it may, in fact, actually delay your recovery. Here’s why:
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.
NSAIDs such as topical diclofenac (Pennsaid, Voltaren) may cause swelling, ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who use NSAIDs for a long time, are older in age, have poor health, smoke, or drink alcohol while using topical diclofenac. Tell your doctor if you have any of these risk factors and if you have or have ever had ulcersor bleeding in your stomach or intestines, or other bleeding disorders. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); aspirin; other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva), and sertraline (Zoloft); or serotonin norepinephrine reuptake inhibitors (SNRIs) such as desvenlafaxine (Khedezla, Pristiq), duloxetine (Cymbalta), and venlafaxine (Effexor XR). If you experience any of the following symptoms, stop using topical diclofenac and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool,or black and tarry stools.
Pycnogenol, like white willow bark, is a nutraceutical material that has been used since ancient times. Pycnogenol is derived from the bark of the maritime pine tree (Pinus maritima) and has been used for more than 2000 years. It has been considered helpful for wound healing, treating scurvy, healing of ulcers, and reducing vascular inflammation. It contains a potent blend of active polyphenols, which includes catechin, taxifolin, procyanidins, and phenolic acids. It is one of the most potent antioxidant compounds currently known.[17,118]
Glutathione is a natural protein found within every cell in the body and consists of the amino acids Glutamic acid, L-cysteine, L-glycine. It is produced by the liver and is also found in fruit, vegetables and meats like mutton, lamb and beef. It is the most powerful antioxidant in the body and helps protect cells from free radical damage and oxidative stress, thereby improving cellular health and strengthening the immune system. As such, in addition to a host of other diseases, L-glutathione is useful in the natural treatment of rheumatoid arthritis.
Gels are less messy than creams because they tend to be less greasy. Water-based gels are also hydrating for the skin. Creams may be more difficult to get off your hands when you’re done applying but are good for massaging affected areas. However, some people feel that creams provide additional hydration and that the increased time it takes to rub most creams in actually allows it to penetrate deeper into the sore muscles and tissues. It really comes down to personal preference.
Have your friend or partner give you a relaxing massage for your tired sore muscles at the end of the day and you do the same for them. Aging, as many know, is not too kind giving us cellulite, sagging skin, wrinkles, and other things we despise. Muscles are not as taunt and tight as they were when we were younger. And, the young people can keep their youthful appearance with this cream.
Bromelian is a mix of proteolytic enzymes (those found in pineapples), which have been used for centuries to help indigestion and reduce inflammation. Studies indicate this product helps reduce pain associated with arthritis, especially when used in combination with some other natural pain-relieving agents making it a great natural remedy for inflammation and pain.
I am allergic to anti-inflammatory pills since they affect my stomach. I don't like the bad side effects they give either. So I look to topical anti-inflammatory cream to help when I have back, hip and/or shoulders sprains and strains. I have tried endless products: Penetrex, Aspercreme, Australian dream, Celadrin and so on. Out of these, Muscle Care works best for pain management. However, I do have some skin reactions to it so I have to give it a rest. When that happens, I use Topricin which works quite well. However, to me, SynthaFlex works as well, if not better. On top of that, it gives a strong cool menthol effect which Topricin doesn't. So when I overwork some muscles, I like to use SynthaFlex and/or Topricin. When my skin reactions calm down, I go back to using Muscle Care from time to time. I also use a roller to stretch which also helps. I hope this review gives others a better sense of what might work for them.
Ginger can be eaten raw or pickled, grated or brewed into tea, added as a spice to dishes, or encapsulated. Ginger tea or capsules seem to be the most efficient way to regularly consume it. You can drink up to four cups of tea daily, and capsules should follow daily recommendations or what practitioners suggest. Similar to turmeric, those on blood thinners should consult their doctors before adding daily ginger to their diet.
Improve your posture. Good posture can prevent future arthritis pain. Years of compensating for a sore knee can result in pain in a hip or ankle. Jutting the abdomen forward can cause lower back pain, as can slouching in a desk chair. Consult a physical therapist. A physical therapist can observe how you sit, stand and walk and teach you how to adjust your posture so you can move with less pain.
Perhaps you bent the wrong way while lifting something heavy. Or you're dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they've had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.
Many readers assume that “skeptics” will always favour mainstream and pharmaceutical treatments like Voltaren, but nothing could be further from the truth. Indeed, some skeptics are leading the charge against bad pharmaceutical industry science and practices (and a great example is Ben Goldacre’s new book, Bad Pharma: How drug companies mislead doctors and harm patients). Pharmacist Scott Gavura of Science-Based Pharmacy was certainly skeptical about topical NSAIDs like Voltaren when he first tackled the topic early in 2011.13 “When I recently noticed a topical NSAID appear for sale as an over-the-counter treatment for muscle aches and pains … I was confident it would make a good case study in bad science.”
Bromelian is a mix of proteolytic enzymes (those found in pineapples), which have been used for centuries to help indigestion and reduce inflammation. Studies indicate this product helps reduce pain associated with arthritis, especially when used in combination with some other natural pain-relieving agents making it a great natural remedy for inflammation and pain.

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.
Side effects from topical medications include redness, itching, and other skin irritation. They are generally mild—and uncommon. The cause of skin irritation is often the material used to make the cream or gel, not the NSAID, says Dr. Joanne Borg-Stein, medical director of the Harvard-affiliated Spaulding-Wellesley Rehabilitation Center in Massachusetts. When that happens, it’s possible for a pharmacist to create a preparation with ingredients that are less irritating to your skin.
With more than 23,000 reviews on Amazon, customers give Penetrex sky-high marks for effective pain relief. If it doesn’t work for you, it comes with a 100 percent, no-questions-asked, money-back guarantee. Formulated to fight inflammation, it contains a mix of ingredients including arnica, choline, glucosamine, Vitamin B6, and MSM. It’s not odor-free, but rather has a light scent that disappears quickly after you apply it. You can use it alone or in conjunction with heating pads, massagers, ice, and other therapies.

"My go-to muscle soothing product is Topricin Pain Relief Cream ($17; topicrin.com) as it is a combination of 11 homeopathic ingredients proven to be safe for your skin. I typically apply it to my lower back (where I've had trauma) before I go running and again before bed. I'm a believer!" —Kira Stokes, creator of The Stoked Method (Try her 30-day plank challenge to score tighter abs, faster.)
You never want to put a heating pad on top of the topical product after it’s on your skin. It can cause skin irritation and possible burns. If you apply a lotion or gel having methyl salicylate, do not start exercising. Your body can absorb too much of it from your increased blood circulation and that’s not good. Do not put on areas such as broken skin, rashes, dermatitis, eczema, or irritated area. Pregnant and breastfeed women should not use topical pain relievers without consulting their doctor. Babies should not use these products, nor young children.

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.

Those who have tried using this Neosporin product say that cuts and scrapes heal within three days when this ointment is applied and that pain subsides quickly. To properly use the ointment, be sure to first clean the affected area with mild soap or saline water. Apply the Neosporin and then use a bandage to properly protect the area while it heals.
In the case of topical creams, many individuals may suffer from allergies that they weren't even aware of until they encounter a negative reaction. These reactions can range in severity from mild skin irritation to more severe issues such as inflammation and increased pain. Remember to check all the ingredients for any topical medication you buy in order to avoid potential allergens and irritants.
Capsicum annum is a small spreading shrub which was originally cultivated in the tropical regions of the Americas but is now grown throughout the world, including the US. The small red fruit commonly used to accentuate chili owes its stinging pungency to the chemical, capsaicin. This was isolated by chemists more than a century ago and constitutes approximately 12% of the chili pepper. This fruit has been used for various medicinal purposes by the native peoples of the American tropics for hundreds of years.

Natural remedies, on the other hand, are made from the stuff of nature. This includes leaves, twigs, berries, bark, roots, vines, vitamins and minerals. They are natural substances that can’t be regulated by the FDA because they are technically foodstuffs. If you understood herbology you could, as many traditional cultures do, adjust your diet to include the herbals in your meals. However, for painful and chronic conditions, like arthritis, this would mean at every meal. Taking these ingredients as supplements to your diet is the way to go.
Within the cartilage around your joints is a chemical known as chondroitin. Chondroitin is naturally produced by the body. As you age, your natural supply starts to plummet. And a loss of chondroitin from cartilage is linked to a major cause of joint pain. Moreover, through wear and tear the joint cartilage breaks down, resulting in the condition of Osteoarthritis. We can’t regenerate cartilage on our own, but we can take a supplement called chondroitin sulfate which, studies show, can help slow down this degenerative process and help naturally reduce arthritic pain. Chondroitin sulfate is made from the cartilage of cows and other animals, and is often used in combination with other products including glucosamine and manganese.
Spreading a medication on your skin is not the same thing as swallowing it. Because Voltaren Gel is applied to the skin, dramatically less medication reaches the bloodstream — only a tiny fraction of what you would get from oral usage.1516 It is safe to assume that cardiovascular risks of moderate topical use are negligible compared to oral diclofenac, because so much less medication is actually getting into general circulation, and that is what the evidence now shows.17 Multiple studies have concluded that topical NSAIDs are both effective and safe.181920

Staying in bed for any prolonged period can make you stiff and increase pain. When you don’t move and bend, you lose muscle strength and flexibility. With bed rest, you lose about 1 percent of your muscle strength each day. And you can lose 20 to 30 percent in a week. It becomes more difficult to return to any activity. As you become weaker and stiffer your recovery takes longer.
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.
Joints are complicated structures that “rely on bone, muscle, and ligaments all working together to provide a full range of motion,” says Holly Lucille, a Los Angeles-based naturopath. Understanding the source of your joint pain or inflammation is important, she adds, in order to pinpoint the most effective remedy. It could be an autoimmune disease such as rheumatoid arthritis, but in other cases, food sensitivities can be the culprit.

Hi Patricia, Sorry to hear about your experience. The patient information leaflet for diclofenac gel inside each pack advises that users should avoid applying on large areas of skin, that an amount ranging in size from a 1 penny to a 2 pence piece will usually be sufficient, and not to use it if you are already taking NSAID tablets. High blood pressure is not listed as a possible side effect, as this was not detected in clinical trials. As you say, diclofenac tablets and other oral NSAIDs are now associated with an increased risk of cardiovascular disease which is why the gel is considered a better option. I have coverd this in a post about ibuprofen increasing blood pressure here. Research looking into the long-term tolerability of topical diclogenac gel in people with an elevated risk of NSAID-related side effects, such as existing high blood pressure, type 2 diabetes, stroke and heart disease, suggests that the gel appears to be safe to use to treat osteoarthritis, even in these high risk groups. Having said that, everyone is different, due to the genes they have inherited, and you may have experienced an unusual, idiosyncratic reaction to the small amounts absorbed via the skin. It’s good that you or your doctor were monitoring your blood pressure to detect this. I have a website dedicated to lowering a high blood pressure, which includes lots of complementary approaches, that you may find helpful. Are you able to share the name of the herbal cream which you have found works better? Best wishes, Sarah B
Whether the pain that someone experiences is activity related, leftover from an old injury, or due to a chronic inflammatory condition, bone broth in the diet can help to reduce chronic pain and flares. This is due to the presence of collagen in bone broth, which can help to alleviate joint problems and repair pain that originates from the digestive tract. (23)
Warming tissues eases arthritis pain by increasing blood flow to affected areas, which decreases inflammation, relaxes tight muscles, and eliminates waste products, like lactic acid, that cause stiffness and soreness. Cold decreases blood flow to reduce swelling, slows the transmission of pain signals through nerves, and inhibits inflammatory chemicals. Cold therapy is best for pain and swelling after exercise, during a flare, or in the first 48 to 72 hours after an injury. Here are some ways to soothe joint pain with heat and cold at home:

“I am a musician and have been one for almost 40 years. With practice and performance comes pain, which sometimes becomes chronic. I manage it with body work and adjustments but I can’t always be around practitioners, especially when I am traveling. These pain relieving patches fill the void extremely well providing relief, very quickly without chemicals or drugs. Kudos to Luminas for developing them. Highly recommended!” – Rafe S.
This herb has been shown to prevent the activation of the transcriptional factor NF-kB and it directly inhibits TNF-α production by up to 65-85%. It inhibits the expression of inducible genes associated with inflammation, specifically negating the expression of inducible nitric oxide synthase, and hence attenuates nitrous oxide production. Side effects may include nausea, although it has shown an impressive protective effect on indomethacin-induced enteritis in laboratory studies.
3. Menthol, Eucalyptus and Mint Oils. Pain relieving creams containing either one or a combination of menthol, camphor, eucalyptus, spearmint, wintergreen or peppermint are thought to work by "confusing" nerve signals into feeling heat and cold sensations instead of pain.  Popular brands include Mentholatum Deep Heating Rub® and Icy Hot® (which may contain methyl salicylate too).  While many pain sufferers say these products work, its' relief is temporary at best.  These pain relief creams have to be reapplied frequently and tend to have strong fragrances.
Did you know that the sensation of pain actually originates in your brain? Fortunately, we can actively alter the way our brain evaluates painful stimuli, helping to increase our pain tolerance and decrease painful symptoms.[12,13] Several techniques that aim to take more control over our minds and that relax the body can work wonders for pain control. Here are a few good examples:
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