Almost every person with fibromyalgia describes their muscles as tight and full of painful muscle knots called trigger points. After I was diagnosed with fibromyalgia during medical school, I tried many different styles of massage, but got no benefit until I found a specialized technique called myofascial release pioneered by John Barnes, PT. This form of massage therapy involves using very slow but sustained gentle pressure to separate tiny adhesions in the muscle tissue and fascia, and this lessens muscle tension and gently breaks up knots in the connective tissue (to learn more about the vital importance of fascia in fibromyalgia, read my previous blog post). Two European studies found that myofascial release therapy was effective for reducing fibromyalgia pain, and that it gave long-lasting pain relief even at one month and six months after the last session. To find a John Barnes-trained therapist skilled in this technique go to www.mfrtherapists.com.
I’m often asked which is the strongest ibuprofen gel. If you’re looking for the best muscle pain relief, however, I recommend diclofenac gel rather than ibuprofen gel. Research shows that diclofenac gel (Voltarol) is stronger and more effective than even a strong ibuprofen gel. If you still prefer to use an ibuprofen gel, however, you can find them on Boots.com.

I have just read here that diclofenac gel is one of the best anti- inflam gels. What it does not say is that if you need to use it on more than one area of the body as I do, and only once a day before bedtime, that after the relatively short time of 6-8 weeks it can raise the B/P significantly in people like me for instance who have never had hypertension!
Low back pain and neck pain often involve a substantial amount of muscle pain,22 and muscle pain is not particularly inflammatory by nature. Muscle knots (trigger points) are more like poisoned muscle than injured muscle. Although there’s some anecdotal evidence that taking an anti-inflammatory medication reduces muscle pain, mostly it doesn’t seem to work very well. One of the classic signs of low back pain powered by muscle, for instance, is that ibuprofen doesn’t have much effect!
Nearly everyone suffers from some type of back pain at some point in their lives. But no matter when it appears or what may have caused it, back pain can be a real, well … pain to deal with. The good news? There are several simple things you can do to ease pain and keep your back in good condition. The following tips can help you get on the way toward feeling better.
I have just read here that diclofenac gel is one of the best anti- inflam gels. What it does not say is that if you need to use it on more than one area of the body as I do, and only once a day before bedtime, that after the relatively short time of 6-8 weeks it can raise the B/P significantly in people like me for instance who have never had hypertension!
For arthritic pain in the hands and knees, capsaicin is your best bet if you want to go the natural route. Otherwise topical NSAIDs work well, too. If you are taking any medications for your arthritis, be sure to talk to your healthcare provider before using any creams and gels and make sure there are no ingredients in them that could interact with your medication.

Yes, most of these creams can either be used on a daily basis or long-term basis. Nevertheless, at any given point in time, always ensure that you consult with your doctor to find out how often it would be advisable to use such forms of medication. The best quality ones are the ones that would be FDA approved and natural. Therefore, you should use these types of medication for as long as the health practitioners advise.


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
For arthritic pain in the hands and knees, capsaicin is your best bet if you want to go the natural route. Otherwise topical NSAIDs work well, too. If you are taking any medications for your arthritis, be sure to talk to your healthcare provider before using any creams and gels and make sure there are no ingredients in them that could interact with your medication.
Find support and understanding.. Unlike a broken leg or other obvious sign of injury, chronic pain is usually unseen. It is a profoundly personal—and often lonely—experience. For many, it is difficult to find support and understanding from family and friends who may be well intentioned but don't really get what you're dealing with. If this is the case for you, we encourage you to find your own group of people who can be supportive and understanding. There may be a chronic pain support group at your local hospital or church. Or you may prefer to interact online. You may get started with a local or online forum seeking help, and then go on to find that you have a lot to contribute, and helping others is also a way to help yourself.
"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.

Long term and/or large oral doses of NSAIDs can be extremely dangerous, even lethal. They “nuke” your entire system with much more active ingredient than you really need, all of it absorbed through the digestive tract and distributed through your entire circulatory system. These drugs can and do cause complications at any dose, and are linked to heart attacks and strokes and ulcerations of the GI tract. For example, Diclofenac …
There is nothing worse than having to wait for your pain medication to kick in when you’re in a bad way, only for it to wear off in a few short hours once it does start to work. What you need in these times is fast pain relief that acts fast and lasts for several hours. Thanks to the LUMINAS Pain Relief Patch, this is now possible, even without the use of harmful drugs.
"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
Back pain can interrupt your day or interfere with your plans. In fact, there’s an 84 percent chance that you will develop low back pain in your lifetime. But back pain isn’t always something you can ignore or wait for it to resolve on its own. Thankfully, there are several ways to treat back pain at home. These remedies include everything from herbs to massages. Keep reading to see how you can ease your back pain.
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.
One of the products I like mixes bromelain, curcumin, and quercetin. This powerful trio provides enhanced support for maintaining a healthy inflammatory response to reduce pain. Another favorite is a blend that contains essential nutrients the body needs to repair and recover, along with potent herbal pain alleviators, including black cohosh, white willow bark, valerian, and devil’s claw. Lastly, I suggest a high-potency proteolytic enzyme product combined with rutin. This supports the body’s natural processes for tissue and joint recovery. The enzymes work synergistically with rutin to naturally boost muscle and tissue repair.
Ensure that the type of anti-inflammatory cream you buy for yourself, a friend, or family member is of the right quality and more efficient in helping you deal with your health predicaments. The best quality brands would be fast acting and gentle to your skin with every application. Most of all, the cream that you choose at any given point in time should not have any side effects otherwise you would be exposing yourself to the ordeal of tackling what would result from using the poor quality creams in hopes of dealing with a minor injury. The best cream would take the shortest period to help relieve you of any kind of pain or inflammation so that you would comfortably carry on with whatever you might be doing.
Studies have shown that pycnogenol is 50–100 times more potent than vitamin E in neutralizing free radicals and that it helps to recycle and prolong the activity of vitamins C and E. Studies have shown pycnogenol to be effective in reducing blood pressure and reducing the risk of venous thrombosis by its effect on vascular endothelium. The usual dosage is 100–200 mg daily. Few side effects from the use of pine bark extracts have been reported, the most frequent being mild gastrointestinal effects such as diarrhea and upset stomach. Pycnogenol should not be taken by patients who are being treated with immunosuppressants or by those receiving corticosteroid drugs because it can enhance immune system function and interact with drugs that suppress the immune system.[46–84]
The InstaNatural™ pain relief gel is ohhh soo cooling for your sore aching back, chest, neck, elbows, arm muscles, knees, and arthritic conditions. Arthritis makes your bones ache and skin tender at that area. This will relax you and make you feel more comfortable. Arthritis stiffness is indeed very painful, especially in the fingers. This might provide relief to rheumatoid arthritis sufferers too, a more significant and painful condition. It performs well for tendonitis, carpal tunnel syndrome, sciatica, tennis elbow, golfer’s elbow, plantar fasciitis, fibromyalgia, and more aches and pains. The 2-ounce jar of gel will not stain your skin or clothes.

“Relief pain cream is my favorite vs. Icy Hot and Bengay, both of which I've never really liked due to their smell and their burning my skin. This stuff soothes & heals like no other! Relief has a pleasant and relaxing scent (including, but not limited to, lavender and menthol) and it doesn't hurt at all. I use it for muscle aches and headaches, allergies, colds (around temples, chest, neck, ears) AND on sunburns. Yep, this stuff is better than anything else I've tried on sunburns! I also use it occasionally for foot pain after being on my feet all day. I use essential oils, and I could probably blend my own version of this, but this blend is so perfect that I don't even want to try” *
Joints are complicated structures that “rely on bone, muscle, and ligaments all working together to provide a full range of motion,” says Holly Lucille, a Los Angeles-based naturopath. Understanding the source of your joint pain or inflammation is important, she adds, in order to pinpoint the most effective remedy. It could be an autoimmune disease such as rheumatoid arthritis, but in other cases, food sensitivities can be the culprit.

"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


From tissue spasms to neurological aches and from shooting aches to twist, this best muscle rub cream of Living Well Nutraceuticals is lab-accredited to heal all patterns of pain. Its exquisiteness is essentially fortified by the presence of Cetyl Myristoleate or CMO that enacts in depth over swelled up muscles, tendons and joints and eradicates the very inflammation—the root cause of all pains. The best muscle rub cream also owns Methylsulfonylmethane or MSM, which again reaches into the body cells and opens those up to prevent the aches affecting physique. The ointment is moreover nurtured with cruxes of Belladonna and Rhus Tox and caters enduring soothe. It comes in a 3oz density tube.
"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.)

Curcumin has also been suggested as a treatment for colitis, chronic neurodegenerative diseases, arthritis, and cancer. In addition, it regulates the activity of several enzymes and cytokines by inhibiting both COX-1 and COX-2. Most studies to date have been performed in animals, but given the centuries of use of curcumin, as well as its now demonstrated activity in the NF-kB, COX-1, and COX-2 inflammatory pathways, it may be considered a viable natural alternative to nonsteroidal agents for the treatment of inflammation.


"I don't use topical pain relievers often, but when I do I use a product called Biofreeze ($15; performancehealth.com). It's a menthol-based gel that soothes local aches and pains in much the same way that ice therapy works but with less skin irritation, and the ability to be mobile once it's applied. It's also the product physical therapists and massage therapists choose." — Yusuf Jeffers, Tone House coach
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.
Low and lower back pain can vary from dull pain that develops gradually to sudden, sharp or persistent pain felt below the waist. Unfortunately, almost everyone, at some point during life will experience low back pain that may travel downward into the buttocks and sometimes into one or both lower extremities. The most common cause is muscle strain often related to heavy physical labor, lifting or forceful movement, bending or twisting into awkward positions, or standing in one position too long.

Bark from the white willow tree is one of the oldest herbal remedies for pain and inflammation, dating back to ancient Egyptian, Roman, Greek, and Indian civilizations, as an analgesic and antipyretic agent. Because of the gastric side effects of aspirin, there has been a resurgence in the use of white willow bark for the treatment of inflammatory syndromes. The mechanism of action of white willow bark is similar to that of aspirin which is a nonselective inhibitor of COX-1 and COX-2, used to block inflammatory prostaglandins.[48]
Omega 3 fatty acid supplements are one of the most powerful ways to reduce oxidative stress and inflammation which are the underlying markers we see on labs with individuals who are suffering with chronic pain.   Omega 3’s help provide better cell membrane receptor activity and suppress genetic transcription factors associated with inflammation and pain.
Diclofenac sodium 1% gel (Voltaren, also available as a generic). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day).  However, the total amount used on your body should not exceed 32 grams per day. A dosing card comes with the gel so you can measure the correct amount.
About “tendinitis” versus “tendonitis”: Both spellings are considered acceptable these days, but the first is technically correct and more formal, while the second is an old misspelling that has only achieved respectability through popular use. The word is based on the Latin “tendo” which has a genitive singular form of tendinis, and a combining form that is therefore tendin. (Source: Stedmans Electronic Medical Dictionary.) BACK TO TEXT

I will admit I wasn't a believer. I have torn my knees all up and have had surgery. Surgery fixed the torn meniscus but the pain didn't stop. So I got on the pain pill routine. I hate taking the pills they make me feel fuzzy. A friend recommended Topricin to me. I got some and used it. Within days I noticed I needed less pills. It really does help the pain. I love it IT WORKS! I still have the pills in case it gets really bad but most of the time the pain can be managed by using the cream. I even keep a small tube in my purse just in case I need it. It also helps to show people what I am using. An added benefit is that it doesn't smell.


Stay strong. Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. "They help you maintain the proper posture and alignment of your spine," Reicherter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.
Authors of a 2016 review published in Seminars in Arthritis & Rheumatism conclude, “Topical NSAIDs have a moderate effect on pain relief, with efficacy similar to that of oral NSAIDs, with the advantage of a better risk:benefit ratio.” However, A 2016 Cochrane review looked at 39 studies with 10,631 participants and found that topical diclofenac, “can provide good levels of pain relief in osteoarthritis, but only for about 10% more people than get this result with topical placebo.”

Physical activity. Exercise helps build strong, flexible muscles that will be less prone to injury. It can also help the healing process for an aching back, prevent problems in the future, and improve function. Work with your doctor to develop an exercise program, or seek a referral to another health professional who can. A good program typically includes the three major forms of exercise: aerobic activity, strength training, and flexibility exercises.
Our writers spent 5 hours researching the most popular arthritis creams on the market. Before making their final recommendations, they considered 30 different creams overall, screened options from 20 different brands and manufacturers, read over 50 user reviews (both positive and negative), and tested 1 of the creams themselves. All of this research adds up to recommendations you can trust.
Any activity that gets your blood pumping for a sustained period will release pain-relieving endorphins into your system. The obvious problem is: How do you exercise if you're in too much pain to exercise? For many, the solution is to pick an exercise that is tolerable and start with help from a the right type of health professional, such as a physiatrist, chiropractor, or physical therapist.
Find support and understanding.. Unlike a broken leg or other obvious sign of injury, chronic pain is usually unseen. It is a profoundly personal—and often lonely—experience. For many, it is difficult to find support and understanding from family and friends who may be well intentioned but don't really get what you're dealing with. If this is the case for you, we encourage you to find your own group of people who can be supportive and understanding. There may be a chronic pain support group at your local hospital or church. Or you may prefer to interact online. You may get started with a local or online forum seeking help, and then go on to find that you have a lot to contribute, and helping others is also a way to help yourself.
MSM is a potent sulfur naturally found in plants, animals and humans that helps rebuild the connective tissue in your joints and is a powerful natural remedy for inflammation and pain. What’s more, MSM has the unique ability to improve cell permeability. This allows harmful toxins to flow out, while allowing health boosting nutrients to flow in to feed your joints, cartilage and connective tissue. It is used for hundreds of symptoms related to a myriad of health diseases and conditions, and is especially effective as a natural remedy for relieving inflammation for improved joint function, and pain associated with joint inflammation, osteoarthritis, rheumatoid arthritis, osteoporosis and tendonitis. One study published in the Journal of AntiAging Medicine found that MSM provides an 80 percent greater reduction in pain compared to the placebo.

Have your friend or partner give you a relaxing massage for your tired sore muscles at the end of the day and you do the same for them. Aging, as many know, is not too kind giving us cellulite, sagging skin, wrinkles, and other things we despise. Muscles are not as taunt and tight as they were when we were younger. And, the young people can keep their youthful appearance with this cream.
To avoid unwanted weight gain, consuming inflammatory ingredients or complications due to nutrient deficiencies, reduce or eliminate the following foods: added sugar, sweetened beverages or snacks, refined vegetable oils, refined grain products, too much alcohol and tobacco products (smoking impairs blood flow and adds to nutrient deprivation to spinal tissues).
Try taking one 250-milligram capsule of valerian four times a day. Some scientists claim that this herb’s active ingredient interacts with receptors in the brain to cause a sedating effect. Although sedatives are not generally recommended, valerian is much milder than any pharmaceutical product. (Valerian can also be made into a tea, but the smell is so strong-resembling overused gym socks-that capsules are vastly preferable.)
On September 30, 2004, Merck Research Laboratories announced the global withdrawal of rofecoxib (Vioxx), its primary selective COX-2–inhibiting NSAID.[52,90,122] Analysis of the results of the Adenomatous Polyps Prevention on Vioxx study (known as the APPROVe study) showed that there was double the risk of serious thromboembolic events, including myocardial infarction, which became apparent after 18 months of Vioxx treatment.[26] Selective COX-2 NSAID’s thrombotic mechanism of action is based on COX-1’s unopposed action to continued platelet synthesis of thromboxane. Thromboxane is a thrombogenic and atherogenic eicosanoid. Prostacyclin prevents formation of platelet clotting. By inhibiting COX-2 that blocks production of prostacyclin (PGI2) there is unopposed thromboxane which will increase the clotting risk. Thus, inhibiting prostacyclin led to the increased risk of thrombotic cardiovascular and cerebrovascular events.[5,26,73,123]
One concern about the use of products like Voltaren is that several conditions are less inflammatory in nature than they feel like. Patients usually assume that the “burning” pain of repetitive strain injuries like tendinitis is caused by inflammation, but in fact classic inflammation is largely absent, especially after initial flare-ups have died down (but pain is still carrying on). While it is possible, even likely, that tendinitis is still inflamed in some sense, it’s doubtful that they are inflamed in a way that NSAIDs are actually good for. The biochemistry of cranky tendons is rather complex and largely unknown. There’s probably some overlap between the biology of acute, classic inflammation and the subtler biology of chronic tendinitis, but no one really knows. So the value of Voltaren for tendinitis is unclear.
Zeng C, Wei J, Persson MS, et al. Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br J Sports Med. 2018 Feb. PubMed #29436380. “Topical NSAIDs were effective and safe for OA. Diclofenac patches may be the most effective topical NSAID for pain relief. No serious gastrointestinal and renal AEs were observed in trials or the general population.” BACK TO TEXT
A 2008 study published in the journal Spine found "strong evidence that acupuncture can be a useful supplement to other forms of conventional therapy" for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found "moderate evidence that acupuncture is more effective than no treatment" in relief of back pain.

I’m often asked which is the strongest ibuprofen gel. If you’re looking for the best muscle pain relief, however, I recommend diclofenac gel rather than ibuprofen gel. Research shows that diclofenac gel (Voltarol) is stronger and more effective than even a strong ibuprofen gel. If you still prefer to use an ibuprofen gel, however, you can find them on Boots.com.
Although it is normal to experience some pain and soreness when running or while engaging in similarly intense forms of physical activity, pain that persists long after you exercise is usually indicative of a greater problem. Be sure to consult with a medical professional before turning to any topical creams and gels; they can help you diagnose the source of your pain and may recommend alternate treatment options.
Various randomized, placebo-controlled studies comparing white willow bark with nonsteroidal agents have shown an efficacy comparable to these agents and aspirin. Salicin from white willow bark is converted to salicylic acid by the liver and is considered to have fewer side effects than aspirin. However, it is costlier than aspirin, and should not be used in children (to avoid the risk of Reye’s syndrome), or in patients with peptic ulcer disease, poorly controlled diabetes, hepatic or renal disorders, or other conditions in which aspirin would be contraindicated. The usual dose of white willow bark is 240 mg/day.[18,19,33,41,64,69,99,100]
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.
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