"I'm really big on heat, since it draws blood to the spot that is heated. I am a huge fan of ThermaCare Heatwraps ($8; drugstore.com) since you can just wrap or tape them on and go about your life (I really like and recommend using one at night if you have a knot, or an especially tight spot)." —Heidi Kristoffer, creator of CrossFlowX (Got PMS cramps? Kristoffer shares the best yoga poses to ease aches and bloating.)
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.

Anti-inflammatory painkillers are a group of medicines that are used to ease muscle pains, sprains, strains and arthritis. They can be taken by mouth (tablets, capsules or liquids), injected, or applied to the skin. When they are applied to the skin they are called topical anti-inflammatory painkillers. Sometimes they are called 'topical non-steroidal anti-inflammatory drugs' (NSAIDs), or just 'topical anti-inflammatories'.
Looking for a nonaddictive way to soothe aches? LifeSeasons’ award-winning Pain Bloc-R helps deliver the benefits of conventional approaches, including decreased aches and discomforts and increased relaxation, without the common pharmaceutical side effects. Pain Bloc-R combines natural ingredients and compounds, including Angelica dahurica, white willow bark, L-tetrahydropalmatine, and L-theanine, that work together to help support the body’s natural ability to relieve everyday aches.
Hi Pauline, sorry to hear about your knee. Yes, capsaicin/capsicum cause stimulation of nerves endings so their chemicals are depleted and they reduce the level of pain messages they send on. The brain also naturally dismisses persistent signals. Some people do find it irritating, however, but better than the traditional treatments that mimic this action -bee stings and nettles! Best wishes, Sarah B
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“I was first introduced to Relief by my Chiropractor after I pulled a muscle. Later my son, while playing hockey, received a very nasty hit during a game and was given Biofreeze as part of his recovery process. I can tell you Relief is 10x better—he was still in pain after using the Biofreeze, so I grabbed the Relief and he could not believe the difference. Now we are a Relief ONLY household. I am spreading the word to all the other hockey mom’s on the quality of your product and how well it works. Thank you for creating Relief and keep up the good work.” *
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.

If you’re someone who experiences muscle and joint pain from time to time (or on a regular basis), you’ve probably tried quite a few options for pain relief. And you’re probably already using external pain relievers—the kind you apply directly to your skin for fast relief from sore muscles and joints. But have you thought of adding an external pain relief cream to the mix?
A 2015 Cochrane review of 61 studies involving nearly 8,400 people found that topical NSAIDs relieved pain from strains, sprains, and overuse injuries, but with less side effects than oral NSAIDs. Similarly, a 2006 review of four randomized trials found that topical diclofenac reduced knee pain due to osteoarthritis and was generally well tolerated. 
studies and meta-analyses report a strong relationship between chronic pain and abnormalities in glucose metabolism. Insulin resistance and abnormal blood sugar pave the way for inflammatory pathways, resulting in chronic pain. Magnesium deficiency is another that comes to mind. Magnesium helps to block the brain’s receptors of glutamate, a neurotransmitter that may cause your neurons to become hypersensitive to pain. Intestinal integrity is one that many people don’t think to connect to their pain. However, high-quality food choices are crucial for managing pain due to the way they influence gut health. Substances in grains may increase intestinal permeability, allowing undigested food particles, bacteria, and other molecules to enter the bloodstream, which can influence inflammation and chronic pain.
Since the time of Hippocrates white willow bark has been in use as a natural means of reducing inflammation and pain, specifically associated with osteoarthritis and rheumatoid arthritis, as well as headache, backache, gout and PMS. The bark of the willow tree contains the chemical salicin, which has a similar effect in the body as acetylsalicylic acid (aspirin). But it’s better than aspirin, because it has none of the gastrointestinal side effects, and it naturally contains flavonoids (anti-inflammatory compounds found in plants).
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.
How it works: A misaligned spine can cause muscle tension (read: pain). Both physical therapy and chiropractic treatment improve spinal alignment. Physical therapists strategically stretch and strengthen the muscles that help hold the spine in place. Chiropractors manipulate the spine to relieve areas of tension on the muscles. Consult your primary-care doctor for a referral.
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.
Since the time of Hippocrates white willow bark has been in use as a natural means of reducing inflammation and pain, specifically associated with osteoarthritis and rheumatoid arthritis, as well as headache, backache, gout and PMS. The bark of the willow tree contains the chemical salicin, which has a similar effect in the body as acetylsalicylic acid (aspirin). But it’s better than aspirin, because it has none of the gastrointestinal side effects, and it naturally contains flavonoids (anti-inflammatory compounds found in plants).
Performance Health®, Bon Vital'®, Biofreeze®, BVspa™, TheraBand®, the Color Pyramid Design™ and Associated Colors™, TheraPearl®, Hygenic®, Pedigenix®, Prossage®, Active Ankle® and Cramer® trademarks are property of Performance Health and/or its subsidiaries and may be registered in the United States and other countries. Unauthorized use is strictly prohibited. ©2017 Performance Health. All rights reserved.

Chronic pain is a modern day epidemic that affects more than 1.5 billion people worldwide.  It costs nations billions of dollars in lost productivity and medical expenses every year. Debilitating pain effects more individuals than heart disease, cancer and diabetes combined.   Doctors throw drug after drug at these pain syndromes with very little long-term success.  Here are some of the best natural agents to reduce pain.
Warning: The gel is for external use only. It is flammable therefore keep it away from heat or open flames. Check with your healthcare provider before using it if you have sensitive skin are pregnant or breastfeeding. Do not put it near your eyes or mucous membranes or apply to wounds, sores, scratched or imperfect skin. Do not use this product with other creams, sprays, liniments, or ointments. Never put a bandage over the area. Stop using if your skin becomes red, has a rash, or feels irritated. Never use with a heating pad on top of the area and always wash your hands after using. Contact your doctor if problems continue after use. Consult your pediatrician if your child is under 2-years-old. Keep out of the reach of children.
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
For a blast of cool pain relief, Biofreeze has been a go-to for arthritis sufferers for decades. Made with 4 percent menthol, this gel promises immediate relief from pain that’s long-lasting. It has a light green color, so you can see where you’re applying it, but it also comes in a colorless version as well. Both versions are greaseless and have a scent that’s designed to disappear after application.
For short-term pain relief, over-the-counter pain relievers including acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) are sometimes suggested. The most common NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Potential side effects of NSAIDs include stomach and liver problems. Talk to your doctor if you don't find relief after taking the recommended dose.
The Boswellia species are trees located in India, Ethiopia, Somalia, and the Arabian Peninsula, and they produce a gum resin called olibanum, better known in the western world as frankincense. This resin possesses anti-inflammatory, anti-arthritic, and analgesic properties. Boswellia can inhibit the leukotriene biosynthesis in neutrophilic granulocytes by inhibiting 5-LOX, thus affecting various inflammatory diseases that are perpetuated by leukotrienes.[95] Clinically, the substance is used in the treatment of degenerative and inflammatory joint disorders. It reduces the total white blood cell count in joint fluid, and it also inhibits leukocyte elastase, which is released in rheumatoid arthritis. In one recent study, a statistically significant improvement in arthritis of the knee was shown after 8 weeks of treatment with 333 mg B. serrata extract taken three times a day. The treatment improved function, but radiographically there was no change in the affected joints.[62]
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)
In a 2011 research review published in the British Journal of Anaesthesia, investigators looked at the available research on the use of topically applied capsaicin in the treatment of several types of chronic pain. This included two clinical trials examining back pain, both of which found that capsaicin helped reduce low back pain without causing notable side effects.

Because natural supplements are made of organically existing substances, they affect the body in gentle ways—without side effects. The ingredients within natural remedies for inflammation, pain and anything for that matter often do not work as quickly as drugs do at relieving pain or inflammation. However, they do offer acute relief in the short term while working more powerfully over time to create a gradual and lasting change in condition. In other words, natural supplements need to build up in your system to get to a level where more significant change occurs, which is why you often will need to take them several times per day, over periods of weeks and months or even longer.
15. Bromelain – This natural pain-reducer comes from the enzymes present in pineapple stems. Research shows that it reduces levels of prostaglandins, which are hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions marked by musculoskeletal tension (like TMJ syndrome), in addition to those suffering trauma-related inflammation. The enzyme also promotes healing in muscles and connective tissues.
Just rub our best Arthritis Pain Relief Cream on and you'll feel aches and pains start to melt away. Your mind will relax as you're reinvigorated with waves of healing pleasure. There's no faster, easier, or better way to say "goodbye" to a life full of pain and "hello" to a brand-new world of pain-free living than with this powerful pain relief cream. 
The omega-3 fatty acids found in abundance in fish oil derived from cod, trout, herring, salmon and other coldwater fish are proven natural remedies to reduce inflammation. Research from Cardiff University in Great Britain found that cod liver oil not only relieves pain, but also stops and even reverses the damage caused by osteoarthritis and rheumatoid arthritis. Omega-3s help morning stiffness, regenerate joint tissue and have been shown to also aid in autoimmune disease like RA, lupus and psoriasis.
Aloe barbadensis (organic aloe) leaf juice, Limnanthes alba (meadow foam) seed oil, mentha arvensis (menthol), capsicum (capsicum annuum) oleoresin, cinnamomum camphora (white camphor) essential oil, ocimum basilicum (sweet basil) essential oil, piper nigrum (black pepper) essential oil, anthemis nobilis (Roman chamomile) flower essential oil, chamomilla recutita (German chamomile) flower essential oil, cinnamomum zeylanicum (cinnamon) leaf essential oil, cymbopogon winterianus (citronella) essential oil, eucalyptus globulus (eucalyptus) leaf essential oil, helichrysum italicum (helichrysum) essential oil, zingiber officinale (ginger) root essential oil, citrus paradisi (pink grapefruit) essential oil, juniper communis (juniper) berry essential oil, cymbopogon flexuous (lemongrass) essential oil, mentha piperita (peppermint) essential oil, pinus sylvestris (pine) needle essential oil, ravensara aromatica (ravensara) essential oil, Rosmarinus officinalis (rosemary) leaf essential oil, mentha spicata (spearmint) essential oil, origanum vulgare (wild oregano) essential oil, glycerin, hamamelis virginiana (witch hazel), water, alcohol, phenoxyethanol, carbomertriethanolamine (TEA), and tetrasodium (EDTA)
Curcumin has also been suggested as a treatment for colitis, chronic neurodegenerative diseases, arthritis, and cancer. In addition, it regulates the activity of several enzymes and cytokines by inhibiting both COX-1 and COX-2. Most studies to date have been performed in animals, but given the centuries of use of curcumin, as well as its now demonstrated activity in the NF-kB, COX-1, and COX-2 inflammatory pathways, it may be considered a viable natural alternative to nonsteroidal agents for the treatment of inflammation.
“I cannot even tell you how AMAZING this stuff is. I never do reviews, but this product most certainly deserves one. I have dealt with MANY injuries, I was in a bad car wreck, and I have had more surgeries than I could count on both hands. My main area of pain is my upper back and neck. I have bulging disks, cervical stenosis, degenerative disk disease that causes horrible spasms, swelling, tension, and PAIN. I also have cancer and several other issues that put my pain level over the top every day. I have seen neurosurgeons, all of whom say they will eventually need to operate. I have done absolutely every possible treatment other than a spinal fusion, have had probably 10 injections, and they even went and tried to burn the nerve endings throughout my entire cervical spine, yet nothing worked. I can't even begin to tell you the medications the doctors have tried, each of which help some, but you get to a point where you don't want to constantly take medications forever. One day I was at my spine doctor's office and they had a bottle of Relief pain cream on the counter. While I was waiting there I asked the staff some questions about Relief and thought "yea, yea, but can I try it?" So, I put some on, and thought, "HOLY COW! What is this! Whatever this is, it's amazing!" Then and there I literally bought the rest of the supply they had on-hand because I couldn't believe how much it helped relieve my pains and aches. That night, I couldn't sleep because I was in so much pain, and none of my medications were helping. I felt like I was dying. So again, I put on some Relief cream and it helped soooo much. Since that day I never, ever, go anywhere without Relief! I will use this pain cream forever and continue to tell everyone I know about it because it truly works! I'm so glad I randomly tried this stuff at the doctor's office because I finally found something that gives true RELIEF!!” *
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.

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.

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
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.
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]
Injections. If other measures don't relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
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.
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.
Hi iv just had my cast removed following my broken wrist where both bones were broken, im 58 and would like advice on which creams/gels i could safely use to help reduce the swelling in my fingers and hand and help reduce the muscle and tendon stiffness, im already doing exercises but the swelling stops me from being able to do much, im a self employed seamstress so maximising the use of my hand is essential, i cant use ice packs as i have Raynards syndrome, any advice would be very much appreciated, kindest regards
The first generic (cheaper) equivalent of Voltaren® Gel entered the marketplace in 2016, produced by Amneal Pharmaceutical. It should be widely available now. Both products are still prescription-only in the US, but fortunately they are over-the-counter almost everywhere else (there’s a rack of tubes of Voltaren by the till at my neighbhourhood drugstore).
Many arthritis creams have a telling medicinal smell, but you won’t get that from this Blue Emu cream. Like other arthritis creams on the market, it contains glucosamine and MSM. What stands out about this one, however, is that it contains emu oil (thus the name), which promises to penetrate deeply into the skin and provide soothing relief to joints and muscles. Thousands of customers say it delivers on those promises too.

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.
Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.
Diclofenac is also available as a 3% gel (Solaraze; generic) that is applied to the skin to treat actinic keratosis (flat, scaly growths on the skin caused by too much sun exposure). This monograph only gives information about diclofenac gel (Voltaren) and liquid (Pennsaid) for osteoarthritis. If you are using diclofenac gel (Solaraze, generic) for actinic keratosis, read the monograph entitled diclofenac topical (actinic keratosis).

These proinflammatory cytokines result in chemoattractant for neutrophils and help them to stick to the endothelial cells for migration. They also stimulate white cell phagocytosis and the production of inflammatory lipid prostaglandin E2 (PGE2). NSAIDs’ ability to interfere with the production of prostaglandin during the inflammatory cascade is the major mechanism cited for the anti-inflammatory success of these medications [Figure 1].[112]
Preliminary research suggests that hypnotherapy may be of some use in the treatment of low back pain. For instance, a pilot study published in the International Journal of Clinical and Experimental Hypnosis found that a four-session hypnosis program (combined with a psychological education program) significantly reduced pain intensity and led to improvements in mood among patients with chronic low back pain.
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.
Still an excellent product. It remains effective for pain relief for about 5 hours with each application for me. Make sure to rub in a good thick portion for several minutes to the entire area of pain. Each jar of Synthaflex lasts about 18 days for me with applications twice each day. It remains the best external joint and muscle pain relief rub that I have ever used.

Topical treatments: One potential concern with dietary supplements is that some may interfere with medications you’ve been prescribed to treat back pain or other health conditions. For this reason, Grossman suggests topical treatments: “Gels and creams can be very helpful and won't interfere with supplements or medications,” she explains. “They're generally inexpensive, too.”
The human body’s natural response to injury results in inflammation-induced pain, swelling, and erythema. In order to reduce pain, anti-inflammatory agents such as NSAIDs act on the multiple inflammatory pathways, which, although often very effective, can have undesirable side effects such as gastric ulceration and, infrequently, myocardial infarction and stroke.

Various studies have also shown that NSAIDs can delay muscle regeneration and may reduce ligament, tendon, and cartilage healing.[4,13,77] Specifically, NSAIDs are believed to wipe out the entire inflammatory mediated proliferative phase of healing associated with WBC actions (days 0–4). A study of the effects of NSAIDs on acute hamstring injuries was done in humans by Reynolds et al.,[93] and these investigators concluded that patients who used NSAIDs did not experience a greater reduction of pain and soft-tissue swelling when compared with the placebo group. Interestingly enough, the authors noted that the NSAIDs’ group had worse pain associated with severe injuries compared with the placebo group.
Many individuals perceive surgery as the best modality for their health issues and sometimes it is.  However, research has indicated that nerve damage unavoidably produced during a surgical operation will cause chronic pain in 15 – 50% of patients (3).  Other individuals are severely damaged by treatments such as chemotherapy and radiation that cause states of increased inflammation and pain.
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