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Rub-on pain relievers offer kinder, gentler relief from arthritis pain, from the January 2013 Harvard Men's Health Watch

When joint pain cries out for relief but ibuprofen and other over-the-counter medicines upset the stomach, it may be worth trying a gentler alternative: anti-inflammatory pain relievers applied to the skin, not taken as a pill, reports the January 2013 issue of the Harvard Men's Health Watch.

Pain relievers applied to the skin are called topical analgesics. Prescription versions, which usually deliver nonsteroidal anti-inflammatory drugs (NSAIDs), come as creams, sprays, gels, or patches. The active ingredient soaks in through the skin to reach the pain. In contrast, oral pain relievers flood the whole body with the medication after being absorbed in the gut. The most widely available prescription topical NSAID in U.S. pharmacies is diclofenac gel.

"Topical pain relievers can be very helpful for the more superficial joints like the knees, ankles, feet, elbows, and hands," says Dr. Rosalyn Nguyen, a clinical instructor in physical medicine and rehabilitation at Harvard Medical School. "In those areas, the medication can penetrate closer to the joint."

The source of pain usually determines if a topical pain reliever is appropriate. For a localized problem with just one joint causing the pain, there's no need for medication to travel throughout the body. A topical analgesic isn't that helpful when pain emanates across an extended area, like the lower back.

Keep in mind that even with a topical analgesic, a small amount of the NSAID gets into the bloodstream. That may be enough to cause trouble for among people who have had ulcers or experienced gastrointestinal bleeding with an oral NSAID.

Not ready to commit to a prescription topical drug? It might be worth trying an over-the-counter product such as Icy Hot or Bengay, which temporarily mask pain with a sensation of coolness or heat. Other topical analgesics contain aspirin-like salicylates that have a mild anti-inflammatory effect. A third type contains capsaicin, the stuff that makes hot peppers so fiery. This substance overwhelms pain-sensing nerve circuits and masks the sensations from the underlying injury.

Read the full-length article: "Get rub-on relief for arthritis joint pain"

Also in this issue of the Harvard Men's Health Watch

  • Get rub-on relief for arthritis joint pain
  • On call: Is the new pneumonia vaccine better?
  • On call: Should I worry about finasteride side effect reports?
  • Pain relievers: Bad for your heart?
  • Prostate biopsy: What to expect
  • Mindful eating 101
  • Alzheimer's drug update
  • In the journals: January is not too late to benefit from a flu shot
  • In the journals: Regular exercise reduces the risk of mental decline
  • In the journals: Fish, not fish oil, prevents stroke
  • In the journals: How long does quitting smoking extend life?

More Harvard Health News »


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Harvard Health Publications publishes four monthly newsletters--Harvard Health Letter, Harvard Women's Health Watch, Harvard Men's Health Watch, and Harvard Heart Letter--as well as more than 50 special health reports and books drawing on the expertise of the 8,000 faculty physicians at Harvard Medical School and its world-famous affiliated hospitals.