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.
Menthol, Levomenthol, Eucalyptus, Camphor and Oil of Wintergreen are often added to topical joint treatments. These essential oils are absorbed into the skin and stimulate skin receptors to produce either a warm sensation or a cooling sensation as they numb the pain. They work by overwhelming nerve endings with these sensations so pain messages do not get passed on. This is known as a counter-irritant effect. Wintergreen is also a rich source of methyl salicylate, a natural anti-inflammatory painkiller related to aspirin. These essential oil creams and gels tend to have names such as Deep Heat or Deep Freeze to describe how they feel during use.
How it works: When back muscles hurt, the pain is usually caused by inflamed tissue. Cold reduces the swelling and discomfort, says Jason Highsmith, a neurosurgeon in Charleston, South Carolina. As soon as you feel pain, apply cold several times a day, 10 minutes at a time, for about three days. A bag of frozen peas works, or try a cold pack, like an Ace Reusable Cold Compress ($10 at drugstores).
For those amenable joints, though, Voltaren® Gel delivers a good dose of medication directly to the joint, while sparing the gastrointestinal tract from the harshness of NSAIDs — which are actually known as “gut burners,” and many people just can’t stomach ibuprofen. A gel almost completely eliminates the risks associated with digesting the stuff.4
It contains arnica, a wonderful pain reliever used by many massage therapists, vitamin B6 that makes red blood cells that produces neurotransmitters, homocysteine levels, and also makes the hormones serotonin and norepinephrine; it has pyridoxine; choline bitartrate cetyl myristoleate; MSM (methylsulfonlmethane) that helps with scars, stretch marks, and pain; and has glucosamine, and boswellia serrata.
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.
NSAIDs don’t just damage your gut lining. They affect your gut bacteria, too. A study of regular users found that different NSAIDs caused different changes in gut bacteria. Ibuprofen and arthritis drug celecoxib (Celebrex), for example, increased pathogenic Enterobacteriaceae, a family of bacteria that includes E. coli, Salmonella, and a number of lesser-known bacteria that contribute to eye, skin, respiratory, and urinary tract infections.