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Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. "Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes," she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice -- take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
Capsaicin. The main ingredient of hot chili peppers, capsaicin is also one of the most effective ingredients for topical pain relief.It can be helpful for joint pain and for diabetic nerve pain. When first applied, capsaicin creams cause a warm tingling or burning sensation. This gets better over time. You may need to apply these creams for a few days up to a couple of weeks before you notice relief from pain.
The active ingredient in cloves is eugenol, a natural pain reliever that’s also used in some OTC pain rubs. Rubbing a tiny amount of clove oil on your gums may temporarily ease toothache pain until you can get to a dentist. But too much undiluted clove oil may actually hurt your gums, so discuss this approach with your dentist before trying it at home.
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.”
The effect of NSAIDs on the GI tract is actually indirect: it’s not because the medicine comes into direct contact with the walls of the GI tract, but because the medication, once it is in the bloodstream, affects the behaviour of cells in the lining of the gut. So it’s actually just a matter of dosage. If you were to smear a diclofenac gel all over your body, you would absorb enough of it that it would be a “gut burner” too! BACK TO TEXT

Never use a topical product if you have open wounds, scratches, or broken skin to reduce risks. You don’t want to cover up these with Band-Aids. Never apply near your eyes or mucous membranes, including your private area. Be sure to follow the directions on the product. Using these products for too long can make you skin become sensitive and you might have an allergic reaction. If you use a patch and it starts to itch, burn, or your skin has a rash or is red, stop using it. You can use the product for a long time before your body becomes sensitive to one or more of the ingredients. If you have a reaction, see your healthcare provider at once. This can also happen with lotions, creams, sticks, roll-ons, and gels. Don’t keep adding more to your skin if the product doesn’t seem to work. More is not better.
As I write in this month’s Harvard Men’s Health Watch, these so-called topical analgesics work best for more superficial joints like the knees, ankles, feet, elbows, and hands. “In those areas, the medication can penetrate closer to the joint,” says Dr. Rosalyn Nguyen, a clinical instructor in physical medicine and rehabilitation at Harvard Medical School.
The active ingredient in cloves is eugenol, a natural pain reliever that’s also used in some OTC pain rubs. Rubbing a tiny amount of clove oil on your gums may temporarily ease toothache pain until you can get to a dentist. But too much undiluted clove oil may actually hurt your gums, so discuss this approach with your dentist before trying it at home.
"I love to make my own home remedy to soothe sore muscles by adding 1-2 cups of Minera Dead Sea Salt ($42; sfsalt.com) and 5-8 drops of lavender essential oils to my bath. This combination draws out toxins, calms the parasympathetic system and helps aching muscles, while easing swelling and improving blood circulation. Afterwards, I'll apply some coconut oil to soothe dry skin.' —Nikki Warren, co-founder Kaia FIT
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)
However, it probably does not work well for deeper tissues in most cases. For instance, there’s evidence that it doesn’t work at all for the muscle soreness that follows unfamiliar exercise intensity,7 probably because it can’t be absorbed far enough into thick muscle tissue — but oral NSAIDs do have a modest effect on that kind of pain89 (one of the only things that does).
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
As part of your exercise routine, you may want to consider doing yoga regularly for lower back pain relief. One study of over 960 people with low back pain found that those who completed a 12-week yoga program experienced greater improvements in back function and reduced pain compared to controls who did not participate. (4) There’s even evidence that mindfulness meditation, often practiced in some form with yoga, can also help people deal with chronic back pain more effectively. (5)
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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