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. 
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
I have pain in booth knees from arthritis. I have used this cream for over a year. All the other pain relievers I have used, don't come close to Topricin for quick and long lasting pain relief. I use it every night and sleep like a baby. I would recommend this product to anyone that needs fast and lasting relief from pain. To me this is a God sent.
The first is that inflammation-lowering NSAIDs destroy your gut lining. Check the bottle of ibuprofen or aspirin in your medicine cabinet. You’ll see it right on the label: “NSAIDs such as ibuprofen may cause ulcers, bleeding, or holes in the stomach and/or intestine.”[1] Long-term low-dose aspirin use is particularly likely to cause ulcers and tear holes in your intestine.[2]
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