NSAID medications have potential side effects, even though many of these medications can be obtained over-the-counter. Some of the side effects are minor, other certainly worrisome. Some people may be more prone to side effects given other medical conditions. For that reason, NSAID medication should be used with caution. If there is ever a question of whether or not it is safe for you to take these medications, and you should discuss this with your doctor. Anyone taking NSAID medications for more than a few days should have a discussion with her physician about the potential for side effects.

Various studies have also shown that NSAIDs can delay muscle regeneration and may reduce ligament, tendon, and cartilage healing.[4,13,77] Specifically, NSAIDs are believed to wipe out the entire inflammatory mediated proliferative phase of healing associated with WBC actions (days 0–4). A study of the effects of NSAIDs on acute hamstring injuries was done in humans by Reynolds et al.,[93] and these investigators concluded that patients who used NSAIDs did not experience a greater reduction of pain and soft-tissue swelling when compared with the placebo group. Interestingly enough, the authors noted that the NSAIDs’ group had worse pain associated with severe injuries compared with the placebo group.
There is a large amount of natural products on the market with anti-inflammatory properties which contain arnica, such as sports massage creams combining arnica and other natural plant extracts (devil’s claw, calendula, St John’s wort and peppermint oil, among others, as well as PHYSIORELAX FORTE PLUS cream) for symptomatic relief of joint and muscle pain. However, we must be well informed about the quality and origin of the extracts used in any creams, gels and ointments purchased at pharmacies, herbal shops and specialised phytotherapy shops, so that we use the best quality product possible.

In one study of 28 women with osteoarthritis pain, half of the women listened to a 10 to 15 minute recorded script twice daily that guided them through muscle relaxation techniques. Women in the guided imagery group showed statistically significant improvements in their pain levels and mobility within 12 weeks, versus women in the control group who did not see any improvements.4
The NF-kB molecule is a transcription factor that controls the transcription of DNA for the perpetuation of the inflammatory immune response. It acts as a switch to turn inflammation on and off in the body. NF-kB has the ability to detect noxious stimuli, such as infectious agents, free radicals, and other cellular injuries, and then directs DNA to produce inflammatory cytokines. The NF-kB proteins are localized in the cytoplasm of the cell and are associated with a family of inhibitory proteins known as inhibitor of kB (IkB).[43,119] The TNF-α, and especially IL-1b, can also directly stimulate enzymes known as matrix metalloproteinases, which break down extracellular collagen matrix, a hallmark of inflammatory joint disease.[32,76,77] The IkB proteins are normally bound to NF-kB and block their nuclear localization signal. A variety of provoking stimuli can degrade the IkB and result in the nuclear translocation of NF-kB to be free to activate DNA synthesis of inflammatory cytokines [Figure 2].
Many athletes and arthritis patients swear capsaicin creams reduce their pain and they love the deep warming sensation they provide. This heat may be associated with relaxation, which reduces their pain response. Researchers have concluded that capsaicin creams may reduce nerve and osteoarthritis pain in some patients (when compared to placebo), but they aren't very effective in reducing muscle pain.  Best results are achieved in joints that are close to the skin, like those in the hands or knee.

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


Schematic showing that when a cell membrane is injured the arachidonic acid pathway is activated to initiate the local inflammatory response through the production of prostaglandins, thromboxanes, and leukotrienes. Their activation requires the enzymes COX and LOX. The NSAIDs can block COX action and thereby prevent the formation of the COX-derived inflammatory mediators. 5-HPETE = 5-hydroperoxyeicosatetraenoic acid; LTC4 = leukotriene C4; PGE2 = prostaglandin E2; PGF2 = prostaglandin F2; PGI2 = prostacyclin; TXA2 = thromboxane.
“I recently started using Relief in my practice after being introduced to the product by a friend. My patients tell me they prefer Relief to the other analgesic gel because Relief works better, lasts longer, and there is no stickiness or unpleasant scent after using the cream. In addition to the patient response, I use Relief in my office because Corganics provides a high quality product with great customer service. Relief has been a great addition to my practice.” *
The packaging for this Outback cream doesn’t look like that of your typical arthritis cream, and thousands of customers say it doesn’t work like one either. They say, in fact, that Outback works better than them. It was developed by Dave Ireland, aka the Wildlife Man, who couldn’t find relief from his arthritis pain, so he developed this and put his picture on it.
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.

The most often neglected method to control inflammation that I see in my patients is rest. Not only does this mean resting from athletics, but often this means allowing an injured body part to rest from normal activities which may prolong inflammation. We live busy lives that may not allow for rest, but ignoring the signs of inflammation may prolong the problem. Therefore, look for ways to rest your injured body part to allow the inflammation to subside and the recovery process to unfold.
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.
How it works: A misaligned spine can cause muscle tension (read: pain). Both physical therapy and chiropractic treatment improve spinal alignment. Physical therapists strategically stretch and strengthen the muscles that help hold the spine in place. Chiropractors manipulate the spine to relieve areas of tension on the muscles. Consult your primary-care doctor for a referral.
"I am a huge fan of Normatec recovery bags (starting at $1600; normatecrecovery.com) You put them on like sleeves and fill up with air while massaging the muscle. It is a game changer when it comes to helping with sore muscles. Not only does it help with soreness but helps flush lactic acids and improves circulation." —Chase Weber, celebrity personal trainer (Try his three-part total-body workout for strength, power, and stability.)
Cold and heat therapies. It's best to use cold compresses or an ice pack, not heat, immediately following a back injury, since this can alleviate pain by numbing the area and prevent or reduce swelling. About 48 hours after the onset of back pain, though, applying heating pads or a hot-water bottle to your back may be helpful. The warmth soothes and relaxes aching muscles and increases blood flow, which helps the healing process. Keep in mind that heat therapy is only helpful for the first week.
Patient information articles published in both the Journal of North American Spine Society and the Journal of the American Medical Association found evidence that spinal manipulations were safe, effective, drugless forms of professional treatment for both acute (short-term or sudden) and chronic low back problems in adults. (2, 3) Egoscue, another type of postural therapy protocol that focuses on fixing musculoskeletal misalignments, may also be able to help reduce and prevent back pain.
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I have had an Osteo Arthritic left knee for 12 years since a car accident. I have had surgery on it twice. I have Cortisone Injections in it every 90 days. I am 62.. I also have been diagnosed with Rheumatoid Arthritis and SLE Systemic Lupus which means that I have long periods of fatigue and my autoimmune system does not function properly. My left knee will need replacement in 2 to 3 years. Long story short......I needed a good external rubbing cream for my knee joint to manage world class pain. So far ......Synthaflex Joint Cream has been the best product that I have purchased and used. I rubbed it in with a paper towel because it has the old fashioned peppermint heat feel....so you do not want it on your hands. Keep it away from your face and your eyes because it will burn. It is a white cream. It takes effect instantly and lasts with my usage for about 5 hours. I use it twice per day. It has worked so well since I received it last week that I am getting ready to order two more jars tonight. I will post updates over the coming months but as of week one I strongly recommend this product. I have far less pain walking and no pain sitting or resting so far.
Cetyl myristoleate (CMO) is a fatty acid, an ethylated esterified fatty acid derived from bovine tallow oil. Though it is similar to fish oil, it is made specifically to help joints through its action as a cellular lubricant. Clinical studies show CMO to be an effective natural anti inflammatory compound that promotes healthy joint function. It increases joint flexibility and range of motion by lubricating the joint at a cellular level. It works to decrease inflammation specifically in the joints and lubricate their movement. In other words, it increases the fluids that cushion the space between the joint bones. CMO is reported to effect change at the cellular level, within the cell membranes themselves. It assists in the reduction and prevention of breakdown in joint cartilage. This can be especially helpful for those suffering degenerative osteoarthritis. The Journal of Rheumatology reported on a double-blind study of patients with chronic knee osteoarthritis where the CMO group saw significant improvement while the placebo group saw none. In fact, the scientists were so impressed with the results they concluded CMO “may be an alternative to the use of non-steroidal anti-inflammatory drugs for treatment of osteoarthritis.”

"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.)
This US-made pain relieving gel comes in a 16-ounce jar, meaning it doesn’t run out fast and is there when you need it. It provides an immediate cooling sensation as soon as it is applied, but it’s what happens next that makes it stand out. The cooling relief intensifies over the next 10 minutes while the ingredients are working together, until it reaches the maximum level of ultra freeze pain relief. This sensation is maintained for the next 30 minutes or more.
Comfrey root has a long history of traditional use to heal wounds and fractures when applied as a poultice, and was commonly known as ‘knit bone’. Modern research shows that comfrey contains two main active ingredients: allantoin which promotes tissue regeneration, and rosmarinic acid which damps down inflammation and reduces pain. Comfrey root cream is a popular and effective treatment for joint pain, sprains and strains.
Amanda has a Masters of Science in Nutrition from Syracuse University which equipped her with courses applied to licensure as a dietitian. She also worked as a Program Director for the Wellness and Fitness Department for the YMCA. She is well versed in physical fitness, with a certificate from the National Academy of Sports Medicine in physical fitness training. She has taught numerous fitness classes, including college courses in the Athletic Department, as an adjunct instructor, at the SUNY University at Buffalo. She currently resides with her husband in the NYC area, and loves to put her knowledge of anatomy and physiology to use by being active. Both her and her husband are self-declared "foodies."

For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trials, the report's authors found "encouraging evidence" suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.

According to recommendations of the Arthritis Foundation, when treating conditions related to arthritis it is best to use “fish oil capsules with at least 30 percent EPA/ DHA, the active ingredients. For lupus and psoriasis, 2 grams EPA/DHA three times a day. For Raynaud’s phenomenon, 1 grams four times a day. For rheumatoid arthritis, up to 2.6 grams fish oil (1.6 grams EPA) twice a day.”
Hallie Levine is an award-winning magazine and freelance writer who contributes to Consumer Reports on health and fitness topics. Her work has been published in Health, Prevention, Reader's Digest, and Parents, among others. She's a mom to three kids and a fat but feisty black Labrador Retriever named Ivry. In her (nonexistent) spare time, she likes to read, swim, and run marathons.

Aspirin is now believed to target both the NF-kB and COX pathways. These agents inhibit the NF-kB pathway in endothelial cells and block NF-kB activation to inhibit leukocyte recruitment.[114,115,116] NSAIDs have also been found to inhibit both the COX system and the NF-kB pathway. Immunosuppressant drugs also reduce nuclear expression of NF-kB.[39,70,75] Research now indicates that blocking the activation of NF-kB along with other inflammation mediators [Table 2] is the major mechanism for reducing inflammation by natural compounds.
Transcutaneous electrical nerve stimulator (TENS) machines are small, battery-powered devices that transmit low-voltage electrical currents through electrodes that are attached to your skin. Considered very safe, TENS machines, according to one theory, work by scrambling the message of pain to the brain — literally blocking it. Another theory suggests that the electrical impulses cause a release of endorphins that override the sensation of pain. Many back pain patients have had success with TENS machines, though their effectiveness has not been clearly proven in controlled studies. Ask your doctor or physical therapist if this therapy might be right for you.

10. Cherries – Due to the presence of compounds called anthocyanins—the same phytonutrients that give cherries their rich ruby hue – you can count on cherries to tamp down pain. Muraleedharan Nair, PhD, says, “They block inflammation and they inhibit pain enzymes, just like aspirin, naproxen, and other nonsteroidal anti-inflammatories.” Cherries are said to have the highest anti-inflammatory content of any food, making them great for remedying issues such as arthritis.


Uncaria tomentosa and Uncaria guianensis are Peruvian herbs derived from woody vines with small claw-like thorns (hence the vernacular name, cat’s claw) at the base of the leaf, which allow the plant to climb to heights of up to 100 ft. Traditionally, the bark of cat’s claw is used to treat arthritis, bursitis, and intestinal disorders. The active ingredients appear to be polyphenols (flavonoids, proanthocyanidins, and tannins), alkaloids, and sterols. Various studies indicate that this Peruvian herb induces a generalized reduction in proinflammatory mediators.
As a doctor I’ve tried, recommended and prescribed many pain-relieving creams and gels to treat painful joints, backache, sore muscles, strained tendons and sprained ligaments. Medical guidelines even recommend that doctors prescribe topical creams and gels to treat mild to moderate joint pain. The best pain relief creams and gels are often just as effective as oral painkillers, but with much less risk of side effects. When I experience muscle or joint pain, I prefer to use a pain relief cream myself.
Enjoy essential oils. Essential oils have long been valued for their analgesic effects in many cultures. There are many ways to benefit from essential oils—some people inhale them (aromatherapy), others include several drops in their massage oil and enjoy as part of a therapeutic massage. Several oils in particular are thought to have an analgesic effect, including peppermint oil, rosemary, and lavender.
The omega-3 fatty acids found in abundance in fish oil derived from cod, trout, herring, salmon and other coldwater fish are proven natural remedies to reduce inflammation. Research from Cardiff University in Great Britain found that cod liver oil not only relieves pain, but also stops and even reverses the damage caused by osteoarthritis and rheumatoid arthritis. Omega-3s help morning stiffness, regenerate joint tissue and have been shown to also aid in autoimmune disease like RA, lupus and psoriasis.
The original Aspirin, white willow bark contains salicin which, in the stomach, converts to salicylic acid—the primary component of Aspirin. Synthetically, it can irritate the stomach, but naturally through white willow bark, it is effective in relieving pain, inflammation and fever. The recommended dose is 1 to 2 dropperfuls of white willow bark tincture daily.
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