tell your doctor if you have severe diarrhea or vomiting or think you may be dehydrated; if you drink or have a history of drinking large amounts of alcohol, and if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs; heart failure; or kidney or liver disease.
Since the time of Hippocrates white willow bark has been in use as a natural means of reducing inflammation and pain, specifically associated with osteoarthritis and rheumatoid arthritis, as well as headache, backache, gout and PMS. The bark of the willow tree contains the chemical salicin, which has a similar effect in the body as acetylsalicylic acid (aspirin). But it’s better than aspirin, because it has none of the gastrointestinal side effects, and it naturally contains flavonoids (anti-inflammatory compounds found in plants).

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."
Diclofenac topical gel (Voltaren) is used to relieve pain from osteoarthritis (arthritis caused by a breakdown of the lining of the joints) in certain joints such as those of the knees, ankles, feet, elbows, wrists, and hands. Diclofenac topical liquid (Pennsaid) is used to relieve osteoarthritis pain in the knees. Diclofenac is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain.
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It contains arnica, a wonderful pain reliever used by many massage therapists, vitamin B6 that makes red blood cells that produces neurotransmitters, homocysteine levels, and also makes the hormones serotonin and norepinephrine; it has pyridoxine; choline bitartrate cetyl myristoleate; MSM (methylsulfonlmethane) that helps with scars, stretch marks, and pain; and has glucosamine, and boswellia serrata.
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Sleep disturbances are common among people with chronic back pain, and not getting enough quality sleep may actually worsen inflammation and pain. For a better night's sleep, invest in a good mattress and experiment with different sleeping positions. Adding an extra pillow under your body can help maintain the natural curve in your spine. If you’re a back sleeper, try putting the pillow under both knees; for stomach sleepers, try under your pelvis. If you sleep on your side, sleeping with a pillow between the knees may help.
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.
"I love Elemental Herbs All Good Herbal Freeze with Arnica ($20; allgoodproducts.com) because the combination of menthol and arnica is incredibly cooling. Also, it's all-natural and super easy to just spray onto my sore areas. I also like Arnica Muscle and Joint Gel by Naturopathica ($28; naturopathica.com), which is a gel. You can rub it in and it really targets the sore muscles and joints." —Holly Rilinger, master Flywheel instructor, creator of LIFTED

The benefits of heat therapy are twofold: it increases the flow of healing oxygen and nutrients to the damaged area, and it suppresses pain signals. Some find that wearing a heat wrap, such as those from ThermaCare, is best because it releases a low level heat for several hours and can be worn under clothes so you can remain mobile. You can also combine the benefits of aromatherapy and a heat by adding an essential oil to the hot pack; you can experiment by making your own microwaveable heating pad at home and adding different essential oils to see what works best for you.
One of the most common reasons people develop low back pain is posture. Postural problems, including spinal abnormalities, along with muscular compensations or inactivity put added pressure on the back. Although people of all ages experience low back pain — including both athletes and those who are sedentary — middle-aged to older adults (especially when they’re overweight) are most likely to develop severe symptoms and therefore can benefit from lower back pain relief treatments like chiropractic care, soft tissue therapy and regular exercise.
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.
Biofeedback. You can learn to control your body’s responses to pain triggers. In biofeedback, through sensors connected to your body, a machine will show how thoughts and actions can affect your autonomic nervous system. This controls the heart, lungs, stomach and intestines, as well as the release of stress hormones. Learning how to control breathing and heart rate will allow you to control other physical reactions, such as pain.

Having a variety of solutions for pain relief is not only helpful, it’s strategic. Depending on which type of pain you’re experiencing, you want a personalized option. And having different solutions on hand helps you be prepared for whatever life throws at you. Try adding an external pain relief cream to the mix so you can relieve muscle and joint pain, then get back to doing what you love.
"Yoga Tune Up Therapy Balls ($15; yogatuneup.com). Hands down. They're like a surgeon's scalpel to your fascia. I use them on myself and with clients both pre-and post- workout to improve soft tissue and enhance mobility. They've really helped change my body for the better. Also, they're super easy to travel with." — Adam Rosante, fitness and nutrition coach and best-selling author of The 30 Second Body (BTW, we've got exclusive HIIT moves from his book here.)
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!
Soft tissue therapies help treat the underlying causes of back pain, such as poor posture, muscular compensations, and weakness through manipulative, hands-on adjustments. These natural therapies can help “turn on” muscles that have been “turned off” due to past injuries and therefore eliminate added stress on painful parts of the back or legs. I recommend finding a practitioner who offers one of the following:
Curcumin is a naturally occurring yellow pigment derived from turmeric (Curcuma longa), a flowering plant of the ginger family. It has traditionally been used as a coloring and flavoring spice in food products. Curcumin has long been used in both Ayurvedic and Chinese medicines as an anti-inflammatory agent, a treatment for digestive disorders, and to enhance wound healing. Several clinical trials have demonstrated curcumin’s antioxidant, anti-inflammatory, and antineoplastic effects. Results of a study by Zandi and Karin suggested that curcumin might be efficacious in the treatment of cystic fibrosis because of its anti-inflammatory effect.[121] Curcumin is known to inhibit inflammation by suppressing NF-kB, restricting various activators of NF-kB as well as stemming its expression.
Synovial fluid is a thick, slippery substance with a consistency similar to egg white. It acts like an oil and fills small cavities within the joint cartilage, providing oxygen and nutrients when the joint is resting. Synovial fluid also pushes the bones apart so they don’t rub together to cause pain. Glucosamine also provides building blocks for making new cartilage, and repairing damaged areas. Glucosamine is also known to damp down inflammation and act as a biological signal to stimulate tissue repair.
A combination of Boswellia and curcumin showed superior efficacy and tolerability compared with nonsteroidal diclofenac for treating active osteoarthritis. Boswellia typically is given as an extract standardized to contain 30-40% boswellic acids (300-500 mg two or three times/day). Boswellia has been well tolerated in most studies, although some people may experience stomach discomfort, including nausea, acid reflux, or diarrhea.[1–10,42,48,56,62,103,104]
The pump bottle is convenient to use never needing to remove a lid for an analgesic (no aspirin) providing instant and direct pain relief to muscles and joints, such as arthritic pain. There are no NSAIDs (nonsteroidal anti-inflammatory drugs), Ibuprofen, aspirin, or other salicylates. The gel penetrates fast for those strains and sprains in muscle tissues and works just as well on hands, wrists, elbows, arm, ankles, feet, knees—your entire body. The gel will give you temporary relief from minor aches and pains of sore muscles and joints from arthritis, backache, strains and sprains.
Author Bio: Ginevra Liptan, MD, developed fibromyalgia while in medical school. She is a graduate of Tufts University School of Medicine and board-certified in internal medicine. Dr. Liptan is the founder and medical director of The Frida Center for Fibromyalgia and the author of The FibroManual: A Complete Fibromyalgia Treatment Guide For You...And Your Doctor and The Fibro Food Formula: A Real-Life Approach to Fibromyalgia Relief.
One reviewer describes the Penetrex cream as “magic in a jar,” saying that it helps her cope with back discomfort that doesn’t respond to other pain-treatment methods, whether massage or physical therapy. People say that the Penetrex cream has helped them while recovering from injury or surgery, but many also use it on a daily basis to alleviate arthritis pain as well as the normal but nagging aches that can spring up later in life.

Topical gels have been shown to reduce the need for oral analgesics which is a good thing for reducing side effects.One trial found that topical capsaicin reduce pain more than placebo in people with AS, although it can cause burning sensations. Another trial used a gel form of a drug called tenoxicam (an NSAID) that suggested it might be helpful. Do ask your specialist if you can try something like voltarol – or a stronger version on prescription – and follow their individual advice. They may prefer you to have some oral anti-inflammatory on board to reduce inflammation throughout the body, however.

"Dr. Teal's Epsom Salt ($5; target.com) is a must-have for my sore muscles. Aside from the fact that baths are relaxing and stress relievers, adding Epsom salt helps your body absorb and replenish magnesium levels that are depleted when you're stressed. Weekly Epsom salt baths are huge for my overall well-being!" —Anna Victoria, creator of the Fit Body Guides (Next, check out the sweat-proof makeup trainers can't live without.)


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.”


The Biofreeze® pain relief gel is available in 16-, 32-, or 128-ounce bottles and is offered as the colorless or original green formula. The company has been making pain relief products for over 25 years. It is the #1 product that has been clinically used by professional healthcare hands-on providers, massage therapists, physical therapists, chiropractors, foot doctors (podiatrists), athletic coaches, instructors, and trainers. This is considered the best pain relief cream for muscle pain perfect for athletes. When professionals have over a hundred clients each week, the economical 128-ounce jug might be best for you for not running out. You always want it on hand for clients with sore aching body parts.
Arnica, also commonly known as mountain tobacco, is a plant that is defined as an ideal medicinal plant for “individuals who have suffered a significant fall or have injured themselves at work” in botanical texts dating as far back as the 17th century. It has many qualities from a topical perspective. First and foremost, it provides rapid relief from discomfort in the joints (including knees, elbows, shoulders and hands) and in individuals who suffer from arthrosis and live with chronic pain, and also for muscle cramps, blows, bumps, rheumatism, sprains, frostbite, etc. So what is the reason for this? As it happens, it causes an immediate calm in bruises from bumps and contusions thanks to localised reactivation of blood vessel circulation which reduces inflammation.
The good news regarding back pain is this: Most cases of lower back pain are believed to be due to “mechanical” problems of the musculoskeletal system rather than serious illness or chronic health problems. Abnormalities, weakness, and added stress placed on the bones, joints, ligaments and muscles can all contribute to back problems. It’s been found that the most common causes of low back pain (there are many!) include: (8)
Too much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head,” Davis says. “One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.”

Despite what a majority of people may have been made to believe concerning the issue of anti-inflammatory creams and the pain-relieving creams the truth is that the two types of creams differ immensely. Pain relief creams serve the important function of disrupting the transmission of pain signals from different parts of the body to the brain thus allowing you to feeling a sense of temporary pain relief. However, most cream pain relievers would not have elements that would help reduce inflammation or swelling. Nevertheless, the anti-inflammatory creams and the pain relief creams both can be used for arthritis flare-ups and dealing with minor sports injuries. Nevertheless, for those people who may have never used these types of medications before or those who may not be sure of the type to use it is important to consult with the doctor before using such a product. Most all, never use the anti-inflammatory creams on a child or expectant mother unless who check in with your doctor.

I am 63 with osteoarthritis of my knee. I have struggled with pain relief and steroid injection hasn’t helped now waiting for new knee but need to control pain. I have just been recommended emu oil. I went to holland and Barrett and found Blue ease gel that has emu oil, capsicum and MSN amongst its ingredients. It does help the pain but skin burns (may have put too much on) how much will I need for a knee and will the burning sensation go away I have tried capsicum cream on prescription and that advised that burning sensation improves in a couple of weeks. From reading your advise re capsicum am I right in thinking that the burning sensation distracts the brain from the joint pain thanks
Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010, January). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29–36. Retrieved from https://www.sciencedirect.com/science/article/pii/S0022399909000944

It contains arnica, a wonderful pain reliever used by many massage therapists, vitamin B6 that makes red blood cells that produces neurotransmitters, homocysteine levels, and also makes the hormones serotonin and norepinephrine; it has pyridoxine; choline bitartrate cetyl myristoleate; MSM (methylsulfonlmethane) that helps with scars, stretch marks, and pain; and has glucosamine, and boswellia serrata.

Menthol, Levomenthol, Eucalyptus, Camphor and Oil of Wintergreen are often added to topical joint treatments. These essential oils are absorbed into the skin and stimulate skin receptors to produce either a warm sensation or a cooling sensation as they numb the pain. They work by overwhelming nerve endings with these sensations so pain messages do not get passed on. This is known as a counter-irritant effect. Wintergreen is also a rich source of methyl salicylate, a natural anti-inflammatory painkiller related to aspirin. These essential oil creams and gels tend to have names such as Deep Heat or Deep Freeze to describe how they feel during use.
Having the best pain relief gel or cream in your household or any other place is a must. You can also keep this remedy in your office or in your purse as you don’t know when you have pain. Of course, suffering from a back pain is a one of the worst one. So you should always have a cream near you. Suppose due to work you get tired. You hit yourself somewhere and the entire day gets ruined. For this reason, you need to have a cream near to you as you can use it immediately and get relief from severe pain.
Hi doctor brewer , I am 69 years old I have had a hip replacement to my left leg. I have no pain from my hip now, but I have pain in my left knee. I have been prescribed Neproxine 500mg one twice a day. I was also told to use some gel from over the counter@ pharmacist, what would you recommend to use .Is Movelat safe to use many thanks Bob SPROSON.

Still an excellent product. It remains effective for pain relief for about 5 hours with each application for me. Make sure to rub in a good thick portion for several minutes to the entire area of pain. Each jar of Synthaflex lasts about 18 days for me with applications twice each day. It remains the best external joint and muscle pain relief rub that I have ever used.
"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.

Try an over-the-counter pain reliever. Anti-inflammatory drugs such as aspirin, ibuprofen (Advil, Motrin, Nuprin), and naproxen sodium (Aleve, Anaprox, Naprosyn) can help reduce back pain. Acetaminophen (Actamin, Panadol, Tylenol) is another over-the-counter option for pain management. Be sure to check with your doctor or pharmacist about any interactions over-the-counter pain relievers may have with other medications you are taking. People with a history of certain medical conditions (such as ulcers, kidney disease, and liver disease) should avoid some medicines.


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.

While most people are only looking to relieve the immediate symptoms of the pain, this will only provide temporary relief.  Addressing the underlying mental/emotional, chemical and physical stressors that are causing the chronic inflammation and pain is the ultimate goal.  This process takes time and deep introspection along with trusted holistic health care providers.
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