Topical anti-inflammatories work in the same way but, instead of having an effect on all of the body, they only work on the area to which you have applied them. When they are applied they are taken into (absorbed into) your skin. They then move deeper into areas of the body where there is inflammation (for example, your muscle). They relieve pain and reduce swelling affecting joints and muscles when rubbed into the skin over the affected area. Using a topical preparation means that the total amount of anti-inflammatory in your body is very low. This in turn means that you are much less likely to have a side-effect to this medicine.
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.

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
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 a true believer in Biofreeze ($15; performancehealth.com). My football coach introduced me to it years ago. It's a topical cooling pain reliever that works very similarly to ice but since it's a gel, I can apply it before teaching classes and training clients to keep function in my muscles and joints. In addition to relieving muscle pain or soreness, it can be used to help arthritis and other muscular and joint discomforts too. " —Mat Forzaglia, The Fhitting Room instructor
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.

PharmacyTimes.com [Internet]. Fudin J. Should Topical NSAIDs Have Strict Heart Risk Warnings?; 2018 March 10 [cited 18 Jun 12]. Although this article’s title implies concerns about topical NSAID safety, it ends up answering that concern with very reassuring data, and it turns into a piece suggesting that the FDA needs to make it clearer that only oral NSAIDs are of concern, while topical is an extremely safe alternative! “ … all topical vehicles of diclofenac delivery result in only a small fraction of the diclofenac that actually reaches the systemic circulation compared with the oral route.” BACK TO TEXT


It is a natural product which has been effectively used in the treatment of bone and muscle pain, in painful abnormalities resulting from spinal cord compression and as an analgesic medication following surgical interventions. It contains essential oils, alkaloid arnicine, glycosides, flavones, carotenes, mucilages and magnesia. Its main property is that it increases local blood flow due to its rubefacient effect, and its ability to relieve pain and improve muscle and nerve weakness. It is therefore very widely used for contusions, bumps, bruises, sprains, rheumatism, lower back pain, varicose veins, haemorrhoids and muscle pain.
Topical diclofenac for osteoarthritis comes as gel (Voltaren) to apply to the affected skin area four times a day to treat arthritis pain. Topical diclofenac for osteoarthritis also comes as a 1.5% liquid (Pennsaid) to apply to the knee four times a day. Topical diclofenac for osteoarthritis also comes as a 2% liquid (Pennsaid) to apply to the knee twice a day. Apply diclofenac gel (Voltaren) or liquid (Pennsaid) at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use topical diclofenac (Pennsaid, Voltaren) exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than prescribed by your doctor. Do not apply the gel or liquid to any area of your body that your doctor did not tell you to treat.
Finally, the active ingredients within a pain relief cream interact with local nerve endings to damp down inflammation, reduce pain and swelling and ease stiffness. All these different actions make topical, rub-in creams and gels highly effective for treating painful joints, sore muscles and sport injuries. Here, I’ve reviewed what I believe are the best pain relief creams, sore muscle creams and pain relief gels.
Hi Shelie, Sorry to hear about your fracture. Comfrey cream is traditionally used to boost healing and is known as ‘knitbone’. It contains allantoin – a substance which is also beneficial for Raynaud’s. As described in my post, a trial showed rapid reduction in pain, and more effectiveness than for diclofenac gel in reducing symptoms associated with ankle sprain. A cream will sink in better than an ointment if you are working as a seamstress. Best wishes, Sarah B
Deng ZH, Zeng C, Yang Y, et al. Topical diclofenac therapy for osteoarthritis: a meta-analysis of randomized controlled trials. Clin Rheumatol. 2016 May;35(5):1253–61. PubMed #26242469. “Topical diclofenac is effective in pain relief as a treatment of OA. It may also have a potential effect in function improvement, which needs further studies to be explored. Although, some adverse effects were observed in the application of topical diclofenac, none of them was serious.” BACK TO TEXT
The use of fish oil (in the form of cod liver oil), an omega-3 EFA, for the treatment of muscular, skeletal, and discogenic diseases, can be traced back to the late 18th century as detailed by Curtis et al.,[24,25] Unfortunately, because of the rapid onset of rancidity of this polyunsaturated oil when exposed to air, and hence its disconcerting odor, cod liver oil fell out of favor. With improved extraction techniques, such as using a protective nitrogen blanket and enhanced oxygen-free encapsulation methods, there is less chance of oxidation during the manufacturing process. The therapeutic benefits of fish oil can now be realized without the regurgitation and odor of previous products caused by peroxides and rancid tasting fish oil.[14]
One of the problems with pain relief creams is that application can become messy. It can be difficult to keep the cream contained to the area of skin that needs treating, and if you get the product on your hands, it’s easy to accidentally rub it into the eyes, which can be painful! To the rescue: Roll-on formulas, like Outback All-Natural Pain Relief, which allow for hands-free and targeted pain relief. The product contains just four ingredients: tea tree oil, vanilla, eucalyptus, and olive oil. The ingredients ease pain by reducing inflammation.
Turmeric root contains just 2% to 5% curcumin, so when reaching for a supplement, be sure you’re buying curcumin, not powered turmeric root. Curcumin is not easily absorbed by the digestive tract, so choose high-potency curcuminoids and combine with oil, since curcumin is fat-soluble. Black pepper extract (piperine), though not Bulletproof, has also been shown to increase curcumin’s bioavailability by 2000%.[13] However, some newer, high-tech curcuminoid formulas have been shown to offer the same potency levels without the use of piperine.[14]
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