You should always consult with a medical professional to get a diagnosis and consultant about treatments, but if they suggest an OTC cream as part of your treatment, there are some good ones to consider. You can find creams with various ingredients and in a variety of formats, including gels, roll-ons, and lotions. Some have a cooling effect, while others bring the heat, and there are scented and unscented options, so it all comes down to preference.
Schematic showing another inflammatory pathway that is activated by tissue injury. This is the NF-kB activation, in which once the protein is free as a result of tissue injury, it can enter the cell nucleus and activate the DNA to enhance the inflammatory response further by the production of additional cytokines, chemokines, and adhesion molecules (IKKB = IkB kinase)
Get enough restorative sleep. Getting enough sleep is critical to managing pain and promoting healing, so it's important to employ a variety of sleep aids to help you get a healthy amount of sleep. Regular exercise that physically exhausts the body helps promote deep sleep. Visualization, meditation, and other psychological techniques can also help you get to sleep and stay asleep.
The active ingredients in fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), enhance the conversion of COX to prostaglandin E3. A natural anti-inflammatory agent, prostaglandin E3 competitively inhibits the effects of the arachidonic acid conversion to prostaglandin E2, a highly inflammatory substance. Prostaglandin E3 also inhibits the synthesis of TNF-α and IL-1b, both of which are inflammatory cytokines. The EPA and DHA can inhibit the 5-LOX pathway, which converts arachidonic acid to inflammatory leukotrienes, by competitive inhibition as well. When EPA and DHA are incorporated into articular cartridge chondrocyte cell membranes, there is a dose-dependent decrease in the expression and activity of the proteoglycan-degrading aggrecanase enzymes.[12,23–25,27,50,85]

Sometimes referred to as vitamin P, citrus bioflavonoids enhance the absorption of vitamin C and act as important antioxidants. Flavonoids also inhibit collagenase and elastase, the enzymes responsible for the breakdown of connective tissue. Connective tissue breakdown is one of the factors that may cause arthritis. Flavonoids reinforce the natural structure of collagen, improve the integrity of connective tissue, protect against free radical damage and are a great natural remedy for inflammation and pain.
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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