Topical diclofenac for osteoarthritis comes as gel (Voltaren) to apply to the affected skin area four times a day to treat arthritis pain. Topical diclofenac for osteoarthritis also comes as a 1.5% liquid (Pennsaid) to apply to the knee four times a day. Topical diclofenac for osteoarthritis also comes as a 2% liquid (Pennsaid) to apply to the knee twice a day. Apply diclofenac gel (Voltaren) or liquid (Pennsaid) at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use topical diclofenac (Pennsaid, Voltaren) exactly as directed. Do not use more or less of it or use it more often or for a longer period of time than prescribed by your doctor. Do not apply the gel or liquid to any area of your body that your doctor did not tell you to treat.
The use of non-steroidal anti-inflammatory drug (NSAID) medication is still the mainstay of most classically taught clinicians for joint and spine related inflammatory pain, despite their commonly known side effects [Table 1]. NSAID mechanisms are primarily through interaction with proinflammatory cytokines interleukin (IL)-1a, IL-1b, IL-6 and tumor necrosis factor (TNF-α). Increased concentrations of TNF-α are believed to cause the cardinal signs of inflammation to occur.[44]
Thank you for providing a list with creams that aren’t simply analgesic! Most lists are just full of creams that provide analgesic properties by blocking pain receptors. It doesn’t really help your body repair from damage or strain. I use a cell-regenerative, anti-inflammatory cream with analgesics and its completely natural. It has the MSM and Arnica. I apply it before I work out and after to help nurture and heal my muscles & joints as well provide pain relief. This way I recover faster and get into the gym quicker knowing my body is supported and I am not just exasperating a problem.
“I had sciatic pain so bad that I went to a doctor for a 'series of three shots' (or so he said) for the pain, yet ten shots later the pain was still there. When a friend of mine gave me a tube of Relief pain cream that had a little left in it so I could give it a try I was so amazed at how effective it was in relieving my pain that I immediately called and ordered two tubes, and I will be asking my doctor to stock it—because I absolutely love this stuff!" *

Wasabi is another spicy food with natural painkilling properties. Scientists are studying the isothiocyanates in wasabi as potential pain relievers. Researcher from University of California San Francisco made a recent discovery suggesting that isothiocyanates could block an inflammation receptor, making it a potentially important natural painkiller. (2)


ASU is a vegetable extract made from the oil of avocados and soybeans that is said to slow the progression of osteoarthritis. It slows down the production of inflammatory chemicals in the body and thus the breakdown of cartilage in the joints. It has also been found to spur new cartilage cell growth. It is available in capsule form at a recommended 300 mg daily.
Can inversion therapy help with back pain? Inversion therapy, where a person is held upside down for several minutes, is an alternative therapy for back pain. They may use gravity boots or an inversion table or chair to reduce the pressure on their spine. Evidence for the effectiveness of this technique is mixed. Learn more about the benefits and risks here. Read now
While these are not the only risks NSAID medications, they are somewhat more common, and some of the more worrisome, side effects. It is always safest to have a discussion with your physician if you have any concerns about the risk of taking these medications. It is important to understand that even in healthy people without underlying medical conditions, there is always the risk associated with any medication. The benefits of taking an anti-inflammatory medication need to be balanced with the possible risks of taking the medication.
Today, the most common conventional treatments for lower back pain relief are medications, including NSAIDS like aspirin and Tylenol, along with more potent prescription painkillers, such analgesics. These drugs can potentially cause adverse side effects in some patients and commonly don’t solve the underlying causes of lower back pain (such as poor posture, obesity or exercise-related strains). Some medications for back pains have even been tied to complications, such as liver damage or intestinal bleeding, when taken for long periods of time or in high doses.

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.


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.

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.
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.
Traditional wisdom says that NSAID pain relievers only damage your gut lining if you take them every day for a long time, but recent research disagrees. High-level athletes with stress-related intestinal damage tried taking ibuprofen to improve muscle soreness and recovery. Ibuprofen ended up damaging their gut lining even further after just a couple weeks; it increased inflammation and made their original pain issues worse.[3] In fact, a single dose of aspirin can significantly increase your intestinal permeability.[4]
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