Pain is a leading cause of insomnia—difficulty with falling asleep and/or staying asleep. Approximately two-thirds of people with chronic back pain suffer from some type of sleep disorder. Paradoxically, inadequate sleep can make your back pain worse. This vicious cycle makes it ineffective to treat just the pain. If you have sleep problems, you need to get the sleep problems addressed too.
To minimize your risks for a skin reaction, Cowling recommends doing a skin test before starting any topical pain reliever and washing your hands immediately after applying. Also don’t use topicals on any areas of the body where you have an open wound or broken skin, even a scratch. If you develop severe itching, redness, swelling or any other signs of a worsening skin reaction, contact your doctor. 
Voltaren® Gel (topical diclofenac) is a particularly safe and useful medicine. It’s an anti-inflammatory cream, so it can be applied only where you need it, instead of soaking your entire system with a medication, avoiding or dramatically reducing common side effects like indigestion, as well as some serious safety concerns associated with oral diclofenac. In the US, this drug is FDA-approved to treat osteoarthritis in “joints amenable to topical treatment, such as the knees and those of the hands,” but it probably also works for some other painful problems, such as some repetitive strain injuries and back pain. The evidence shows that it “provides clinically meaningful analgesia.” So this product actually works and gets a pass from skeptics and critics — a rare thing in the world of pain treatments!

Diclofenac is an extremely popular drug — again, we’re talking oral here — and it is associated with serious cardiovascular risks: “There is increasing regulatory concern about diclofenac. … Diclofenac has no advantage in terms of gastrointestinal safety and it has a clear cardiovascular disadvantage.”14 This has been in the news quite a bit, and NPR had a hit in 2013 with this headline: “World's Most Popular Painkiller Raises Heart Attack Risk.”
Apply to the affected area and massage into the skin gently. Always wash your hands after you have finished rubbing the cream, gel or spray into the skin. This is to make sure that you avoid rubbing this medicine into sensitive areas of the body such as the eyes. Do not apply to skin that is broken, or near the eyes, nose, mouth, genital or bottom (anal) areas. Do not use plasters or bandages (dressings) on top of these medicines. Generally these medicines are applied to the skin 2-4 times a day. However, for specific advice for your medicine, see the leaflet that comes inside the packet.
"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.)
Research shows that applying celadrin cetylated fatty acid cream with menthol to knees can reduce arthritis pain and improve the range of movement. Applying celadrin cream also makes it easier to climb up and down stairs. Celadrin cream cetylated fatty acids is also effective as a muscle pain relief cream to treat pain associated with trigger points in the neck.
Since herbal therapies for pain management have yet to be thoroughly studied, be careful when embarking on this treatment path. Regardless of the herb you try, remember that they're not benign. Research into their safety and efficacy is still limited, and the government doesn't regulate herbal products for quality. The best course is to talk to a health-care professional before testing out a herbal remedy.
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.
I am in my mid 50’s and was recently diagnosed with arthritis in both my knees. My left knee was the absolute worse. Seems squats and lunges are the worst for arthritic knees and my worst pain followed these exercises. Since then I have gotten a personal trainer so that I won’t hurt myself trying to workout. Anyway, I am a 5k runner and I want to continue. But let me tell you guys about the topical regimen that I am using that I employed just short of going to get a cortisone injection. Magnesium Oil, MSM lotion and organic silica gel. I got all of these products from an on-line source of organic foods, products and such. I absolutely love their products and these 3 products have made my knee feel like I never was diagnosed with arthritis, and I’ve been following this morning and night application of the 3 products for a little over two weeks now. Let me tell you, I couldn’t sleep at night because of the pain. Now it’s the difference between night and day. I hope this helps someone
Laugh more often. One study showed that social laughter actually increases pain tolerance.5 Laughing along with others was shown to have the highest positive impact. Laughter has many positive effects, including increasing circulation and oxygen, and raising your body's level of endorphins (the body's natural pain killers). There is a whole movement called "laughter yoga"—which helps people enjoy the many benefits of laughter without having to need a reason to laugh—it just focuses on laughing for its own sake.
Foam roller exercises are a form of self-myofascial release that, while kind of mildly painful at times, actually gets out those nagging muscle knots while helping you fix muscle imbalances that lead to poor posture and related musculoskeletal pain. It’s also an emerging treatment to reduce your risk of developing delayed muscle onset soreness, a common exercise-related pain that keeps people out of the gym. (6)
Feverfew. Feverfew has been used for centuries to treat headaches, stomachaches, and toothaches. Nowadays it's also used for migraines and rheumatoid arthritis. More studies are required to confirm whether feverfew is actually effective, but the herb may be worth trying since it hasn't been associated with serious side effects. Mild side effects include canker sores and irritation of the tongue and lips. Pregnant women should avoid this remedy.
Reduce the inflammation that's contributing to your pain. It may seem obvious but it bears repeating; inflammation is a contributor to most forms of chronic pain, and reducing the inflammation will help reduce your pain. A simple way to address inflammation is to regularly apply a cold pack or ice to the local area of pain. Ice also helps by acting as a local anesthetic and by slowing nerve impulses, which in turn can interrupts the pain signals generated in the affected area.
Products that create a feeling of heat on the skin can also help relieve discomfort by distracting you from pain signals. The Sombra Warm Therapy Natural Pain Relieving Gel provides controlled warming to ease conditions like arthritis, bursitis, fibromyalgia, or even a simple backache. The gel quickly absorbs into the skin and won’t stain clothing. It’s also free of artificial colors, fragrances or alcohol.
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]
A type of enzyme extracted from pineapple stems, bromelain reduces levels of prostaglandins, which are hormones that induce inflammation. Bromelain may benefit people with arthritis and conditions associated with musculoskeletal tension (such as TMJ syndrome), as well as those suffering trauma-related inflammation. What's more, the enzyme may promote healing in muscles and connective tissues.
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