A study involving 120 people with acute upper or lower back pain showed that rubbing in comfrey cream, three times a day for 4 to 6 days, reduced pain intensity by 95%, compared with just 38% reduction for inactive ‘placebo’ cream. Comfrey works quickly, providing good pain relief within an hour of application. In fact, researchers have found that comfrey cream is more effective than a prescribed, non-steroidal anti-inflammatory treatment (diclofenac gel) for treating ankle sprains.
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'.
While these are not the only risks NSAID medications, they are somewhat more common, and some of the more worrisome, side effects. It is always safest to have a discussion with your physician if you have any concerns about the risk of taking these medications. It is important to understand that even in healthy people without underlying medical conditions, there is always the risk associated with any medication. The benefits of taking an anti-inflammatory medication need to be balanced with the possible risks of taking the medication.

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.
Many readers assume that “skeptics” will always favour mainstream and pharmaceutical treatments like Voltaren, but nothing could be further from the truth. Indeed, some skeptics are leading the charge against bad pharmaceutical industry science and practices (and a great example is Ben Goldacre’s new book, Bad Pharma: How drug companies mislead doctors and harm patients). Pharmacist Scott Gavura of Science-Based Pharmacy was certainly skeptical about topical NSAIDs like Voltaren when he first tackled the topic early in 2011.13 “When I recently noticed a topical NSAID appear for sale as an over-the-counter treatment for muscle aches and pains … I was confident it would make a good case study in bad science.”
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.
The good news is that myofascial release is also something we can do for ourselves! A recent study showed that a regular program of self-myofascial release lowered pain intensity and lessened stiffness. To start, you can simply lie on the floor and place a small, soft ball (around the size and density of a large orange) under any tight and painful muscle areas. Then allow your body to sink onto and around the ball for a few minutes to provide the right amount of sustained pressure to allow the fascia to release. Learn how to self-myofascial release with this Myofascial Self Care Video Course that was developed by a pair of myofascial release therapists, and is is a great way to do MFR treatment at home.
Whether or not research can prove that massage therapy helps, many people report that it relaxes them and eases chronic pain. In a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in the treatment of back pain. The study authors concluded that massage "might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education." The authors called for further studies that might help determine whether massage is a cost-effective treatment for low back pain.
The NSAIDs are also known to have adverse effects on kidney function.[31] Dehydration or preexisting chronic renal failure or disease, resulting in stimulation of the renin–angiotensin system, may predispose certain populations to acute renal failure through inhibition of prostaglandin synthesis, which can occur when taking NSAIDs.[31] The National Kidney Foundation asserts that approximately 10% of kidney failures per year are directly correlated to substantial overuse of NSAIDs.
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.

Five updates have been logged for this article since publication (2009). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more Like good footnotes, update logging sets PainScience.com apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages.


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)
One way to increase the effectiveness of Biofreeze is to add it to a massage! And what do professional massage therapists use in their practice regularly? Creams and oils to help their hands glide across the skin and focus on relieving pain. External pain relief creams can be used as a part of your at-home massage to not only enhance your comfort, but to soak in and relieve any residual pain.
Digging a metal tool into a painful spot, such as the bottom of your foot if you’re dealing with plantar fasciitis, sounds like some sort of medieval torture practice. The Graston technique is an instrument-aided manual therapy that serves as a noninvasive way to deal with soft tissue ailments like achilles tendonitis, carpal tunnel syndrome, fibromyalgia, shin splints, back and shoulder pain, and other ailments. It’s even been proven to help relieve pain associated with chronic conditions like trigger finger and post-surgery pain in a way that can reduce the amount of painkillers administered.
If you’re sensitive to aspirin, or if you’re taking any over-the-counter (OTC) anti-inflammatory drugs (like aspirin, ibuprofen, or naproxen), you should avoid willow bark. You should also avoid taking it if you’re taking warfarin (Coumadin) or other anticoagulant treatments, as salicin could increase the risk of bleeding. Talk to your doctor before taking willow bark if you’re taking other anti-inflammatory or pain medications.
×