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]

"I don't use topical pain relievers often, but when I do I use a product called Biofreeze ($15; performancehealth.com). It's a menthol-based gel that soothes local aches and pains in much the same way that ice therapy works but with less skin irritation, and the ability to be mobile once it's applied. It's also the product physical therapists and massage therapists choose." — Yusuf Jeffers, Tone House coach
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.

Topical gels have been shown to reduce the need for oral analgesics which is a good thing for reducing side effects.One trial found that topical capsaicin reduce pain more than placebo in people with AS, although it can cause burning sensations. Another trial used a gel form of a drug called tenoxicam (an NSAID) that suggested it might be helpful. Do ask your specialist if you can try something like voltarol – or a stronger version on prescription – and follow their individual advice. They may prefer you to have some oral anti-inflammatory on board to reduce inflammation throughout the body, however.


Schematic showing that when a cell membrane is injured the arachidonic acid pathway is activated to initiate the local inflammatory response through the production of prostaglandins, thromboxanes, and leukotrienes. Their activation requires the enzymes COX and LOX. The NSAIDs can block COX action and thereby prevent the formation of the COX-derived inflammatory mediators. 5-HPETE = 5-hydroperoxyeicosatetraenoic acid; LTC4 = leukotriene C4; PGE2 = prostaglandin E2; PGF2 = prostaglandin F2; PGI2 = prostacyclin; TXA2 = thromboxane.
Pycnogenol inhibits TNF-α–induced NF-kB activation as well as adhesion molecule expression in the endothelium. Grimm et al, recently reported that oral intake of pycnogenol inhibited NF-kB activation in lipopolysaccharide-stimulated monocytes as well, thus decreasing the inflammatory response. It also statistically significantly inhibited matrix metalloproteinase-9.[46] This matrix-degrading enzyme is highly expressed at sites of inflammation, and contributes to the pathogenesis of various chronic inflammatory diseases.[96]
I recommend a woman takes 1,500 milligrams starting on the first day of her period and continuing until ovulation. If your’e on certain antidepressants, you have a bleeding or a seizure disorder, you’re on phenothiazine drugs for schizophrenia, or you’re being treated for high blood pressure, you should talk to your doctor before starting evening primrose oil.

The usual dosage of standardized turmeric powder is 400–600 mg taken three times per day.[13] Side effects are few, but with extended use, this agent can cause stomach upset, and in extreme cases gastric ulcers may occur at very high doses. Caution should be used if the patient is taking anticoagulant medications or high doses of nonsteroidal drugs. Studies have shown that curcumin may be used in combination with lower doses of nonsteroidal medications.[7–9,11,21,40,87,111,121]
We always want the best pain relief cream, topical gels, sprays, roll-ons, sticks, sprays, patches, and sometime powders that make more of a mess. You will need to decide on what product is best for you or if you should see your doctor for stronger medication. Most of us try to stay away from prescription drugs and NSAIDs (nonsteroidal anti-inflammatory drugs).
Prostaglandins act as short-lived localized hormones that can be released by any cell of the body during tissue, chemical, or traumatic injury, and can induce fever, inflammation, and pain, once they are present in the intercellular space. Thromboxanes, which are also hormone activators, can regulate blood vessel tone, platelet aggregation, and clot formation to increase the inflammatory response.[92,82] The inflammatory pathway is a complex biochemical pathway which, once stimulated by injury, leads to the production of these and other inflammatory mediators whose initial effect is pain and tissue destruction, followed by healing and recovery.[34,51] A major component of the inflammatory pathway is called the arachidonic acid pathway because arachidonic acid is immediately released from traumatized cellular membranes. Membrane-based arachidonic acid is transformed into prostaglandins and thromboxanes partly through the enzymatic action of cyclooxygenase (COX)[34,57]. There are two types of COX enzymes, COX-1 and COX-2. Both the enzymes act similarly, but selective inhibition (as accomplished by selective COX-2 inhibiting NSAIDs) can make a difference in terms of side effects.

Diclofenac topical gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining of the joints) in certain joints such as those of the knees, ankles, feet, elbows, wrists, and hands. Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain.
"Dr. Teal's Epsom Salt ($5; target.com) is a must-have for my sore muscles. Aside from the fact that baths are relaxing and stress relievers, adding Epsom salt helps your body absorb and replenish magnesium levels that are depleted when you're stressed. Weekly Epsom salt baths are huge for my overall well-being!" —Anna Victoria, creator of the Fit Body Guides (Next, check out the sweat-proof makeup trainers can't live without.)
As a doctor I’ve tried, recommended and prescribed many pain-relieving creams and gels to treat painful joints, backache, sore muscles, strained tendons and sprained ligaments. Medical guidelines even recommend that doctors prescribe topical creams and gels to treat mild to moderate joint pain. The best pain relief creams and gels are often just as effective as oral painkillers, but with much less risk of side effects. When I experience muscle or joint pain, I prefer to use a pain relief cream myself.
Capsaicin. The main ingredient of hot chili peppers, capsaicin is also one of the most effective ingredients for topical pain relief.It can be helpful for joint pain and for diabetic nerve pain. When first applied, capsaicin creams cause a warm tingling or burning sensation. This gets better over time. You may need to apply these creams for a few days up to a couple of weeks before you notice relief from pain.

Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated Jan 9th, 2019), Cerner Multum™ (updated Jan 14th, 2019), Wolters Kluwer™ (updated Jan 7th, 2019) and others. To view content sources and attributions, please refer to our editorial policy.
Also referred to as "hypnosis," hypnotherapy is a mind-body technique that involves entering a trance-like state of deep relaxation and concentration. When undergoing hypnotherapy, patients are thought to be more open to suggestion. As such, hypnotherapy is often used to effect change in behaviors thought to contribute to health problems (including chronic pain).
I’ve just emphasized that Voltaren is mainly appropriate for shallow inflammation, but there is some evidence that Voltaren might be able to “reach deeper.” This is hardly the stuff of medical certainty yet, but researchers Huang et al found that Voltaren treated pain coming from deep inside the spine, right in the centre.6 They concluded that it could be a “convenient and safe clinical intervention” for a few types of back pain. An anti-inflammatory gel will likely fail with many kinds of back pain, but there’s also virtually no down-side to trying. See my low back pain tutorial for extremely detailed information about medications for back pain.

Synovial fluid is a thick, slippery substance with a consistency similar to egg white. It acts like an oil and fills small cavities within the joint cartilage, providing oxygen and nutrients when the joint is resting. Synovial fluid also pushes the bones apart so they don’t rub together to cause pain. Glucosamine also provides building blocks for making new cartilage, and repairing damaged areas. Glucosamine is also known to damp down inflammation and act as a biological signal to stimulate tissue repair.
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

I purchased this because it was less expensive than Penetrex and I'd thought I'd try it out.. Unfortunately, compared to Penetrex, at least for me, I do not feel that it is worth the savings. I'm using it for Plantar Fasciitis and Osteoarthritis in my knees. Although it does provide some pain relief, the duration is limited to a couple hours, whereas Penetrex lasts for up to half a day. However, SynthaFlex does offer a little more relief, albeit very temporarily, for my Osteoarthritis than Penetrex does. It is not nearly as effective for my Plantar Fasciitis pain. Ultimately, if I have to apply it many times throughout the day, it is not cost effective in comparison.
When you suffer from recurring back pain, the last thing you want to do is become dependent on medication. Dr. Pat’s Ultra Freeze gel is a simple, non-intrusive solution to muscle aches and soreness that gets to work straight away, helping you get on with your daily life without pain. Designed to combat discomfort associated with arthritis and sciatica as well as muscle pain, the cooling gel comes in a larger than average container, meaning you can depend on it being there when you need it.

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.


Prostaglandins act as short-lived localized hormones that can be released by any cell of the body during tissue, chemical, or traumatic injury, and can induce fever, inflammation, and pain, once they are present in the intercellular space. Thromboxanes, which are also hormone activators, can regulate blood vessel tone, platelet aggregation, and clot formation to increase the inflammatory response.[92,82] The inflammatory pathway is a complex biochemical pathway which, once stimulated by injury, leads to the production of these and other inflammatory mediators whose initial effect is pain and tissue destruction, followed by healing and recovery.[34,51] A major component of the inflammatory pathway is called the arachidonic acid pathway because arachidonic acid is immediately released from traumatized cellular membranes. Membrane-based arachidonic acid is transformed into prostaglandins and thromboxanes partly through the enzymatic action of cyclooxygenase (COX)[34,57]. There are two types of COX enzymes, COX-1 and COX-2. Both the enzymes act similarly, but selective inhibition (as accomplished by selective COX-2 inhibiting NSAIDs) can make a difference in terms of side effects.

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


This cream acts as a natural pain reliever with every application on the body. With this particular cream, you are assured of getting relieved from the pain that you may experience on the joints and muscles, back pain, and arthritis pain. It would also assist you in effectively dealing with bruises by helping you deal with pain while reserving the gentle touch.
Beauty Breeze brings this exquisite muscle cream that emerges as a distinctive one for the factuality of getting crafted from peerless pain-soothing herbs and functional emollients extracted from Cajput, Clove, Mint and Cassia. Enriched by the nimbleness of Thai masseurs, this ‘Tiger Balm’ class cream for sore muscles is also lab-tested to be effective over severe type migraines. The reddish consistency muscle cream is accredited as an ‘Extra Strength’ one and is especially operative over abdominal cramps, spinal ache and joint inflammation. Vended in a unique edged carton-pattern container, the cream for sore muscles has a 30 gram density. It has a measure dynamics of 3 x 3 x 4.1 inches and a menthol aroma.
Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown efficacy in patients with osteoarthritis (OA) pain but are also associated with a dose-dependent risk of gastrointestinal, cardiovascular, hematologic, hepatic, and renal adverse events (AEs). Topical NSAIDs were developed to provide analgesia similar to their oral counterparts with less systemic exposure and fewer serious AEs. Topical NSAIDs have long been available in Europe for the management of OA, and guidelines of the European League Against Rheumatism and the Osteoarthritis Research Society International specify that topical NSAIDs are preferred over oral NSAIDs for patients with knee or hand OA of mild-to-moderate severity, few affected joints, and/or a history of sensitivity to oral NSAIDs.
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.

Physical therapists use PEMF to heal fractures and torn cartilage faster, and surgeons recommend it as a post-op way to minimize soft tissue inflammation.[20][21] I use it to recover from workouts faster and keep inflammation low. PEMF machines send electromagnetic pulses through your tissue, gently stimulating anti-inflammatory and repair compounds.

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