Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with topical diclofenac 1% and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide.
Could you find pain relief through a method that focuses on soft tissue manipulation and your psyche? The answer is yes. Rolfing, also known as structural integration, involves soft tissue work and movement education to realign your body’s myofascial structure with gravity. (8) (Think of your body’s fascia as the “netting” that encases your muscles and organs.)

Prolotherapy treatments work by naturally promoting a minor inflammatory response near damaged connective tissue, promoting regeneration and the growth of new, healthier tissue in the process. These treatments have been used to effectively reduce or heal chronic musculoskeletal conditions of the back, such as herniated/bulging discs, arthritis, osteoarthritis or other chronic joint pains, and tendonitis that affects the lower body and causes compensations in the spine. (7) For the most benefits, it seems that prolotherapy works best when combined with other back pain treatments, such as spinal manipulation, exercise and in some cases medications when needed.
Alternate warm and cold. Try alternating soaks in warm and cold water, especially if you have swelling. Fill one sink with cold water (65 degrees Fahrenheit) and another with warm water (110 degrees Fahrenheit). Leave your hands or feet in the warm water for five to 10 minutes, and then switch to cold for one minute. Return to the warm for three to four minutes, and then switch to cold for another minute. Repeat this four or five times.
One reviewer describes the Penetrex cream as “magic in a jar,” saying that it helps her cope with back discomfort that doesn’t respond to other pain-treatment methods, whether massage or physical therapy. People say that the Penetrex cream has helped them while recovering from injury or surgery, but many also use it on a daily basis to alleviate arthritis pain as well as the normal but nagging aches that can spring up later in life.
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.
How old is your bed? You may be surprised to learn that the average life span of a mattress is less than 10 years. "There's no hard-and-fast rule," says Sean Mackey, chief of the division of pain medicine at Stanford University, "but if your mattress is sagging significantly or is more than 6 to 8 years old, I'd think about getting a new one. Something else to consider: a firm mattress may not do your back any favors, says Carmen R. Green, a physician at the University of Michigan Back & Pain Center. A number of studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with firm beds.

One concern about the use of products like Voltaren is that several conditions are less inflammatory in nature than they feel like. Patients usually assume that the “burning” pain of repetitive strain injuries like tendinitis is caused by inflammation, but in fact classic inflammation is largely absent, especially after initial flare-ups have died down (but pain is still carrying on). While it is possible, even likely, that tendinitis is still inflamed in some sense, it’s doubtful that they are inflamed in a way that NSAIDs are actually good for. The biochemistry of cranky tendons is rather complex and largely unknown. There’s probably some overlap between the biology of acute, classic inflammation and the subtler biology of chronic tendinitis, but no one really knows. So the value of Voltaren for tendinitis is unclear.


Diclofenac is an extremely popular drug — again, we’re talking oral here — and it is associated with serious cardiovascular risks: “There is increasing regulatory concern about diclofenac. … Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage.”14 This has been in the news quite a bit, and NPR had a hit in 2013 with this headline: “World's Most Popular Painkiller Raises Heart Attack Risk.”


Glucosamine is one of the most-studied supplements around the world for relief of arthritis symptoms and joint health. Sulfur is produced naturally in the body and is an essential component to joint health. Glucosamine sulfate is a type of glucosamine that is most useful in the support of joint mobility and pain relief because it absorbs well. Conversely, glucosamine chondroitin does not absorb in an amount significant enough to create enough of a change to make taking it worthwhile. Glucosamine sulfate works as well as NSAIDs for some people but without the negative effects to the gastrointestinal tract or liver.

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)
Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably take your blood pressure and order certain tests to check your body's response to topical diclofenac (Pennsaid, Voltaren). Be sure to tell your doctor how you are feeling so that the doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.

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.
Capsicum is an extract from the chilli or cayenne pepper which reduces pain by continuously stimulating nerve endings in the skin at a very low-level. This depletes nerve endings of neurotransmitter chemicals so they become less sensitive and pass on fewer pain messages to the brain. Those messages that are passed on tend to get screened out as they brain shuts off distracting, low-level irritation. Ingredients that do this are known as ‘counterirritants’. These effects also reduce sensation from underlying painful joints. See the best capsicum containing rubs at Amazon.co.uk or Amazon.com. Warning! These are HOT to use, but really relieve muscle and joint pain. Wash your hands thoroughly after use and do them rub your eyes by mistake during use.
"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
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.
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.

To avoid unwanted weight gain, consuming inflammatory ingredients or complications due to nutrient deficiencies, reduce or eliminate the following foods: added sugar, sweetened beverages or snacks, refined vegetable oils, refined grain products, too much alcohol and tobacco products (smoking impairs blood flow and adds to nutrient deprivation to spinal tissues).
"There are three that I swear by. I use Icy Hot Roll-On ($5; walmart.com) on my feet at the end of the day after I do my exercises to stretch my feet. It's also great for traveling because it doesn't get messy! I like Salonpas Spray ($8; walmart.com) because it can get hard-to-reach places on my back or shoulder blades. And since Tiger Balm ($5; walmart.com) is strong, I use that when my legs are sore and I sleep with it on. I wake up the next morning and feel great." —Nicole Winhoffer, founder NW Method
The Penetrex® inflammation formulations have received rave reviews on Amazon.com® since 2009. With the Penetrex® Pain Relief Cream you will need fewer applications, and it actually heals and repairs your problem without masking the pain. You can get around expensive prescription medications using this product. You will have no side effects and it is not addictive. The cream will increase and enhance your range of motion and flexibility when you have no pain to deal with.
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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.

After an injury, first rest, ice the area, use compression, and elevate the area. The acronym to help you remember is RICE. Rest the area. Ice the area 4 times a day for 10 to 15 minutes. If it looks better, compress the area with an Ace-type elastic bandage. To reduce swelling, ice helps, and so does elevating the area above your heart. When the swelling is down but you still have mild pain, apply a topical cream or gel according to the package directions. If it has worsened, consult your doctor.


In summer 2018 I had my first personal experience with dramatic relief from Voltaren Gel (topical diclofenac). It’s not the first time I have found it useful, but it was the first time it was amazing. I’d been having some unexplained knee pain intermittently for several weeks when it kicked up a notch or two and became constant and even started waking me up at night. When I finally remembered to try Voltaren Gel — I’m not sure what took me so long — things were bad enough that it was going to be obvious if it worked. And it was! After many days of constant discomfort ranging from 3-6 on a 10-scale, it just ended: half an hour after applying the stuff, I simply didn’t have that problem anymore. Hallelujah! It’s been weeks since then with no relapse. Although the pain was not terrible, this is actually one of the clearest examples of pain relief from any treatment that I’ve ever enjoyed.

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. 
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
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.
Capsaicin. Derived from hot chile peppers, topical capsaicin may be useful for some people in relieving pain. "Capsaicin works by depleting substance P, a compound that conveys the pain sensation from the peripheral to the central nervous system. It takes a couple of days for this to occur," says David Kiefer, MD, assistant clinical professor of medicine at the Arizona Center for Integrative Medicine.
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