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.
How pain relief creams and gels work
You probably learned as a child that ‘rubbing it better’ quickly reduces the pain of knocks and sprains. The physical action of massaging in a cream or gel helps to warm the area and increase blood flow. This allows the active ingredients to sink into the skin more readily, where they can get to work to relieve your pain, soothe discomfort and hastening healing.The active ingredients interact with nerve endings to damp down inflammation and reduce pain perception.
Rubbing also stimulates nerve endings and sends signals to the brain which overwhelm those from pain receptors so nerve messages relating to discomfort are less likely to get through. This same concept makes topical, rub-in creams and gels highly effective for treating painful joints and sport injuries, and I’ve reviewed what I believe are the best products below.
Which is the best pain relief cream for muscles and joints?
Different creams and gels combine different pain-relieving ingredients for a greater, synergistic effect. The most effective natural ingredients are glucosamine, chondroitin, celadrin, comfrey root, capsicum, MSM and Green-lipped mussel extracts.
Glucosamine gel and glucosamine cream for pain
Glucosamine in creams and pain relief gels provides building blocks for the production of synovial fluid, which oils mobile joints, and cartilage which cushions bones. Glucosamine cream or gel also damps down inflammation and stimulates tissue repair. The glucosamine found in these topical treatments is in the form of n-acetyl glucosamine, which is small enough to sink into skin and penetrate underlying tissues to reduce pain.
Topical glucosamine cream and gel can significantly reduce the pain of knee osteoarthritis within 4 weeks. One study involving a glucosamine cream found that 100% of those with arthritis of the shoulder gained benefit. Of those with arthritis of the ankle, wrist or elbow, glucosamine cream reduced pain in 75% of people, and it worked in 58% of those with knee osteoarthritis.
Chondroitin cream for pain
Chondroitin has a complementary action to glucosamine and the two are often combined in joint and muscle pain relief creams. A study involving 63 people with osteoarthritis found that applying a knee pain cream containing both glucosamine and chondroitin produced greater pain reduction than a placebo cream. After 4 weeks, the active glucosamine and chondroitin cream was 20% more effective, and after 8 weeks, it was 80% more effective than the placebo cream.
If you’re looking for the best pain relief cream for back pain, then Penetrex is the one with the highest number of 5* reviews in the US, which you can read here. In the UK, the most popular pain relief cream is Flexable, while the most popular gel is Voltarol Back and Muscle Pain Relief gel (see diclofenac review further down).
Celadrin cream for pain
Celadrin is a blend of waxy, cetylated fatty acids (CFAs) that are laid down in cell membranes to improve their flexibility and resilience. It also has an anti-inflammatory, pain-killing action.
Cetylated fatty acids are unusual in that they only occur in two places in nature – in sperm whale oil and in a strain of mice renowned for their immunity against arthritis. The celadrin in inflammation cream for muscle and joint pain is derived from monounsaturated fats found in olive oil, however.
Research shows that applying celadrin cetylated fatty acid cream with menthol to knees can reduce arthritis pain and improve the range of movement. Applying celadrin cream also makes it easier to climb up and down stairs. Celadrin cream cetylated fatty acids is also effective as a muscle pain relief cream to treat pain associated with trigger points in the neck.
Celadrin cream works really well when you rub it all the way around a painful joint, such as the knee, rather than just on the front or back of the joint. A good way to prove to yourself that it is working is to apply it to one joint (eg left knee) and not the other (eg right knee) three times a day for 10 days and you will notice a difference.
MSM cream for pain
MSM (methyl-sulfonyl-methane) is a naturally rich source of sulphur which is a vital constituent of connective tissues and structural proteins. It is essential for the repair of muscles, joints and ligaments and has a powerful antioxidant and anti-inflammatory action. MSM is an effective sore muscle cream and is often combined with glucosamine and chondroitin.
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.
A study involving 120 people with acute upper or lower back pain showed that rubbing in comfrey cream, three times a day for 4 to 6 days, reduced pain intensity by 95%, compared with just 38% reduction for inactive ‘placebo’ cream. Comfrey works quickly, providing good pain relief within an hour of application. In fact, researchers have found that comfrey cream is more effective than a prescribed, non-steroidal anti-inflammatory treatment (diclofenac gel) for treating ankle sprains.
Capsicum is an extract from the chilli or cayenne pepper which reduces pain by continuously stimulating nerve endings in the skin at a very low-level. This depletes nerve endings of neurotransmitter chemicals so they become less sensitive and pass on fewer pain messages to the brain. Those messages that are passed on tend to get screened out as they brain shuts off distracting, low-level irritation. Ingredients that do this are known as ‘counterirritants’. These effects also reduce sensation from underlying painful joints.
Green-lipped mussel gel
Green-lipped mussel extracts were first investigated as a pain-relieving ingredient when it was noticed that Maori living in coastal regions suffered less arthritis symptoms than those living inland. Those who regularly consumed these delicious, green-lipped mussels tended to remain free of joint problems.
Freeze-dried extracts of raw New Zealand green-lipped mussels are now known to contain unique omega-3 fatty acids which damp down inflammation in a similar way to non-steroidal anti-inflammatory drugs (NSAIDs) to reduce joint pain and swelling.
Essential oils for pain
Menthol, Levomenthol, Eucalyptus, Camphor and Oil of Wintergreen are often added to topical joint treatments. These are absorbed into the skin to produce a cooling or warming sensation and also act as counter-irritants. Wintergreen is also a rich source of methyl salicylate, a natural anti-inflammatory painkiller related to aspirin.
Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in pain gels
NSAID gels were originally only available on prescription and, as a GP, I prescribed a lot of these before they were available for self purchase. They are now widely available and much better for your health than taking the same non-steroidal anti-inflammatory pain killers by mouth. These pain relieving gels do not cause the same level of side effects such as indigestion and heartburn.
I’m often asked which is the strongest ibuprofen gel. If you’re looking for the best muscle pain relief, however, I recommend diclofenac gel which is more effective than ibuprofen. If you still prefer to use an ibuprofen gel, however, you can find them on Boots.com.
Topical NSAIDs are highly effective for treating muscle and joint aches and pains and, in fact, direct comparison of topical NSAID with an oral NSAID did not show any difference in their ability to reduce pain and stiffness.
Data from 34 studies, involving over 7,600 people, suggests that the topical NSAID, diclofenac, is the most effective form of non-steroidal anti-inflammatory painkiller for applying to the skin to treat muscle and joint pain.
Diclofenac is found in Voltarol Pain-eze Emulgel and voltarol Thermal Patch.
Tips for using a muscle pain cream or pain relief gel
Using a rub-in cream or gel treatment can reduce the need for oral pain medication, such as paracetamol or ibuprofen tablets.
Don’t apply topical creams or gels to broken skin or they may sting like fury.
If you have hand eczema, cuts or other hand problems, wear a latex glove when applying your joint cream or gel or ask a close friend or relative to apply it for you.
For best results, apply a topical joint cream or gel after a warm bath or shower, or after exercise when you are still glowing, as this helps the treatment sink in more quickly.
Allergic reactions are uncommon, but on first use only apply a small amount to a clean, healthy area of skin and gently rub in until absorbed. Wait a while to test how you respond to the ingredients before using more. If skin redness, irritation or itching occurs, wash off and seek medical advice.
Wash your hands immediately after applying the treatment.
Don’t touch or rub your eyes while you have topical cream on your hands.
Wearing a neoprene joint wrap after applying the treatment will keep the area warm and may boost its effectiveness (NB check product leaflet first in case the manufacturer does not advise this).
Follow the directions on the package as some products may need to be used at regular intervals, while others may be used as and when necessary.
Do not use any topical treatments if you are pregnant or breastfeeding, without seeking advice from a pharmacist or doctor.
Review: Best glucosamine gel for pain
|Glucosamine Joint Complex Gel has a non-sticky formulation that includes Aloe vera, plus Devil’s Claw and MSM for an additional anti-inflammatory action.
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|Extra Strength Glucosamine Gold Gel has added Indian Frankincense and Horse Chestnut to promote healing.
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Natures Plus Advanced Therapeutics Triple Strength cream is non-greasy and penetrates quickly to relieve pain. It contains glucosamine, chondroitin and MSM plus celadrin and black cherry for additional anti-inflammatory actions.
A version without Celadrin and black cherry is also available in the US. Check price on Amazon.com.
Review: Best celadrin cream for pain
|Celedrin Accelerator Balm contains anti-inflammatory cetylated fatty acids plus menthol in a sweet almond oil base that is lovely to use.
It sinks in quickly to relieve muscle and joint aches and pains. Some have found it helpful for relieving gout, too.
In the US, a similar product, Dr Shepard’s Pain Therapy Relief Cream also includes MSM.
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Review: Best comfrey ointment for pain
Comfrey Ointment remains a popular treatment for a variety of muscle, joint and back aches and pains, because it works. Many original brands, developed by traditional medical herbalists are still going strong.
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Dr Christopher’s Comfrey Ointment is another popular product that contains organic comfrey leaf extracts in a beeswax and extra virgin olive oil base (refrigerate after opening).
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Review: Best New Zealand green-lipped mussel gel for pain
|Pernaton is the only gel that contains 100% Perna green-lipped mussel extracts sourced using a patented, freeze-drying process without heat, chemicals or solvents (which would inactivate the active ingredients). The non-greasy gel is quickly absorbed and includes additional menthol, pine needle and other essential oils for a rapid cooling, analgesic action. Pernaton Gel improves circulation and relaxes stiff, aching muscles and joints.
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Review: Best non-steroidal anti-inflammatory gel for pain
|In both the UK and the US you can obtain NSAID gels from a pharmacy. Research shows that diclofenac is one of the most effective topical NSAIDs for relieving musle and joint pain and inflammation.
In the UK Voltarol Pain-eze Emulgel which contains diclofenac is available on-line.
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Have you used any rub-in painkilling creams, ointments or gels and found them helpful? If so, what symptoms did they relieve? How long did they take to work for you?
If you have any questions or comments, please use the form below and I’ll get back to you.
Click here to read my review of LQ Liquid Health Joint Care.
Click here to read my review of the best non-prescription oral pain killers.
Click here to read my post on the 9 Best Supplements For Knee Pain.
Click here to read about methods of pain relief for tennis elbow.
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