The use of non-steroidal anti-inflammatory drug (NSAID) medication is still the mainstay of most classically taught clinicians for joint and spine related inflammatory pain, despite their commonly known side effects [Table 1]. NSAID mechanisms are primarily through interaction with proinflammatory cytokines interleukin (IL)-1a, IL-1b, IL-6 and tumor necrosis factor (TNF-α). Increased concentrations of TNF-α are believed to cause the cardinal signs of inflammation to occur.[44]

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.


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.

Curcumin is a naturally occurring yellow pigment derived from turmeric (Curcuma longa), a flowering plant of the ginger family. It has traditionally been used as a coloring and flavoring spice in food products. Curcumin has long been used in both Ayurvedic and Chinese medicines as an anti-inflammatory agent, a treatment for digestive disorders, and to enhance wound healing. Several clinical trials have demonstrated curcumin’s antioxidant, anti-inflammatory, and antineoplastic effects. Results of a study by Zandi and Karin suggested that curcumin might be efficacious in the treatment of cystic fibrosis because of its anti-inflammatory effect.[121] Curcumin is known to inhibit inflammation by suppressing NF-kB, restricting various activators of NF-kB as well as stemming its expression.
This Biofreeze brand gel comes in a small tube of 4 oz, perfect for bringing to work in a small purse or bag. The small tube contains a gel substance that provides a cooling effect to fight aching pain. The popular gel is an excellent choice for those with joint or muscle pain and is the perfect addition to a physiotherapists toolbox. It can be used topically on areas of the body and is easy to apply. It's also inexpensive compared to some other gel formulations on the market. The product has been around for 25 years and is not tested on animals.
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.”
The pump bottle is convenient to use never needing to remove a lid for an analgesic (no aspirin) providing instant and direct pain relief to muscles and joints, such as arthritic pain. There are no NSAIDs (nonsteroidal anti-inflammatory drugs), Ibuprofen, aspirin, or other salicylates. The gel penetrates fast for those strains and sprains in muscle tissues and works just as well on hands, wrists, elbows, arm, ankles, feet, knees—your entire body. The gel will give you temporary relief from minor aches and pains of sore muscles and joints from arthritis, backache, strains and sprains.
These creams can be quite effective for temporary pain relief on the muscle and joints. The creams would also come in handy when handling inflammations that may be brought forth by minor injuries, sunburn, skin rash and other severe conditions. Although doctors would prescribe most of these creams for their patients, more often than not individuals go for the OTC medications to deal with simple medical conditions. When making your purchase for this particular product it is important that you make a comparison between active ingredients and the inactive ingredients used in the formulation of the cream. At the end of the day, ensure that you choose a product that would not have dire side effects on your health. The cream you choose should help you deal with your particular problem in the best way possible and if possible you should make sure that you consult with your doctor before using any of these creams.

Creams derived from natural products can also provide local relief for painful muscles in fibromyalgia. The best part is that topical treatments tend to be very well tolerated with few side effects. Arnica is an herb used since the 1500s to treat bruises, muscle pain, and inflammation. It is still used today as a natural treatment for muscle pain in many different topical remedies. One herbal homeopathic cream that I have found helpful is MyPainAway Fibro cream. It includes arnica to reduce muscle pain, echinacea to reduce inflammation, along with other herbs targeted to reduce nerve pain by improving microcirculation around pain-sensing nerves.
Our writers spent 5 hours researching the most popular arthritis creams on the market. Before making their final recommendations, they considered 30 different creams overall, screened options from 20 different brands and manufacturers, read over 50 user reviews (both positive and negative), and tested 1 of the creams themselves. All of this research adds up to recommendations you can trust.

This essentially necessitates you to pick one balm, which is competent to treat a trivial throbbing at the ankle as well as work over an aspect as grave as Shin Splint. One articulate conversation with a M.D can authentically aid you to this end. Moreover, always strive to elect one such muscle rub salve that is nurtured with organic essential oils and moisturizing agents and renders a cooling sensation within an utmost short pace.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: acetaminophen (Tylenol, in other products); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (Prinivil, Zestril, in Prinzide and Zestoretic), moexipril (Univasc, in Uniretic), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); certain antibiotics, beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); cyclosporine (Gengraf, Neoral, Sandimmune); diuretics ('water pills'); lithium (Lithobid); medications for seizures, and methotrexate (Otrexup, Rasuvo, Trexall). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

Turmeric can be consumed in a variety of forms, including as a spice added to foods or drinks and encapsulated for those who are not tolerant of the signature spicy taste. Two to three teaspoons of turmeric daily can help to provide therapeutic levels of relief and preventive benefits with little side effects. Note: Turmeric absorbs best when taken in combination with black pepper (approximately 1/4 teaspoon of black pepper for every 1 teaspoon of turmeric). (17)


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
I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
“When I was pregnant two years ago with my daughter I had extreme pain in my right shoulder. It went on for months. They did cortisone shots, prescribed Loratab (Hydrocodone and Acetaminophen), and were ready to operate on a pregnant gal the pain was so severe. Eventually the cortisone shots worked and the pain went away. I am now pregnant again and at about 28 weeks the pain was back. This time the pain was worse. The joint hurt so bad I couldn't pull the covers over me in bed. I could only sleep on one side, and NOTHING worked. My chiropractor recommended Relief cream. I was skeptical that a cream could ease my pain when the medical community had nothing that worked. In a total act of desperation I had my husband rub it into the shoulder one night. I slept better than I had in weeks. He rubbed it in the next night and the pain was completely gone. Here I am now 34 weeks pregnant and the pain has been completely gone for 6 weeks. My husband has also used it on his back (after trying everything else under the sun) with similar results. Thank you for a truly amazing product. We have shared this info with our family and friends!” *

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.
Nonsteroidal anti-inflammatory medications are one of the most commonly used types of medications for musculoskeletal conditions. NSAIDs can be effective for a wide variety of orthopedic conditions from arthritis, tendinitis, or other inflammatory conditions. Determining the best NSAID for your condition may depend on a number of different factors, and what works well for one individual may not be the best medication for another. There are possible side effects of different NSAID medications the patient should be aware of, and you should discuss with your physician if taking these medications for more than a short period of time.
Sleep disturbances are common among people with chronic back pain, and not getting enough quality sleep may actually worsen inflammation and pain. For a better night's sleep, invest in a good mattress and experiment with different sleeping positions. Adding an extra pillow under your body can help maintain the natural curve in your spine. If you’re a back sleeper, try putting the pillow under both knees; for stomach sleepers, try under your pelvis. If you sleep on your side, sleeping with a pillow between the knees may help.

After you apply diclofenac gel (Voltaren) or liquid (Pennsaid), you should not cover the treated area with any type of dressing or bandage and you should not apply heat to the area. You should not shower or bathe for at least 30 minutes after you apply the liquid (Pennsaid) and for at least 1 hour after you apply the gel (Voltaren). Do not cover the treated area with clothes or gloves for 10 minutes after you apply the gel (Voltaren), or until the liquid (Pennsaid) has dried if you are using the liquid.
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Even as you practice patience, a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil) or naproxen (Aleve) can help ease the pain you're pushing through. The research behind medicine guidelines for lower back pain finds that these may give slightly better relief than acetaminophen (Tylenol). Over long periods, NSAIDs can cause gastrointestinal problems, so don't take them for more than 10 days without consulting your doctor.
Many of the 10 million Americans suffering from widespread muscle pain due to fibromyalgia look for non-prescriptions options for pain relief. As a physician with fibromyalgia myself, I want to share with you the most effective natural options that I include in my own pain relief “toolbox,” which includes anti-inflammatory herbs, topical creams, and a unique form of massage that breaks up painful muscle knots.
I have nerve pain , spinal stenosis and no longer able to take oral medication that did help with symptoms but caused me to have allergic reactions .After stopping the oral medication I suffered with pain radiating from my lower back to my feet . At night I could not sleep. I am so glad that I found this miracle in a jar . I am sleeping very good at night without pain .It really do help with all my symptoms. I discussed the benefits of this with my doctor and have told family & friends .
Despite what a majority of people may have been made to believe concerning the issue of anti-inflammatory creams and the pain-relieving creams the truth is that the two types of creams differ immensely. Pain relief creams serve the important function of disrupting the transmission of pain signals from different parts of the body to the brain thus allowing you to feeling a sense of temporary pain relief. However, most cream pain relievers would not have elements that would help reduce inflammation or swelling. Nevertheless, the anti-inflammatory creams and the pain relief creams both can be used for arthritis flare-ups and dealing with minor sports injuries. Nevertheless, for those people who may have never used these types of medications before or those who may not be sure of the type to use it is important to consult with the doctor before using such a product. Most all, never use the anti-inflammatory creams on a child or expectant mother unless who check in with your doctor.
You may get pain relief from nonprescription medications such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin) or naproxen (Aleve). Or your doctor can prescribe a stronger medication if those don’t work. But you may have side effects or the medications might not provide complete relief for you. Here are other proven methods you can try to soothe arthritis pain in addition to pills and medical treatments.
Different creams and gels combine different pain-relieving ingredients for a greater, synergistic effect. The most effective natural ingredients are arnica, cannabidiol CBD oil, glucosamine, chondroitin, celadrin, comfrey root, capsicum, MSM and Green-lipped mussel extracts. The most effective pharmaceutical pain relief gel are those containing diclofenac, which is a stronger version of ibuprofen.

Foam roller exercises are a form of self-myofascial release that, while kind of mildly painful at times, actually gets out those nagging muscle knots while helping you fix muscle imbalances that lead to poor posture and related musculoskeletal pain. It’s also an emerging treatment to reduce your risk of developing delayed muscle onset soreness, a common exercise-related pain that keeps people out of the gym. (6)


Resveratrol is available commercially as a dietary supplement capsule, generally from the P. cuspidatum source. The trans-resveratrol is the active form, and although there is not an established dosing range, the typical dose is from 50 to 500 mg daily. Any significant side effect or safety issues with resveratrol have not been established, but due to an experimentally shown anti-platelet effect, caution should be exercised when taking other prescription or herbal anti-platelet or coagulation altering products.[29,54,59,68,72,107,109]
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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.
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.
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.
Wasabi is another spicy food with natural painkilling properties. Scientists are studying the isothiocyanates in wasabi as potential pain relievers. Researcher from University of California San Francisco made a recent discovery suggesting that isothiocyanates could block an inflammation receptor, making it a potentially important natural painkiller. (2)
Capsaicin cream, also called capsicum cream, is available in drug stores, health food stores, and online. A typical dosage is 0.025% capsaicin cream applied four times a day. The most common side effect is a stinging or burning sensation in the area. If possible, wear disposable gloves (available at drugstores) before applying the cream. Be careful not to touch the eye area or open skin. A tube or jar of capsaicin cream typically costs between $8 and $25.
“When I was pregnant two years ago with my daughter I had extreme pain in my right shoulder. It went on for months. They did cortisone shots, prescribed Loratab (Hydrocodone and Acetaminophen), and were ready to operate on a pregnant gal the pain was so severe. Eventually the cortisone shots worked and the pain went away. I am now pregnant again and at about 28 weeks the pain was back. This time the pain was worse. The joint hurt so bad I couldn't pull the covers over me in bed. I could only sleep on one side, and NOTHING worked. My chiropractor recommended Relief cream. I was skeptical that a cream could ease my pain when the medical community had nothing that worked. In a total act of desperation I had my husband rub it into the shoulder one night. I slept better than I had in weeks. He rubbed it in the next night and the pain was completely gone. Here I am now 34 weeks pregnant and the pain has been completely gone for 6 weeks. My husband has also used it on his back (after trying everything else under the sun) with similar results. Thank you for a truly amazing product. We have shared this info with our family and friends!” *
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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.
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