Learn your topical treatment options to manage painful arthritis.

When you’re experiencing pain in your joints and muscles, topical pain relievers are a good alternative for pain management. These medications are delivered through a variety of dosage forms, including patches, gels, lotions, creams, sprays, and ointments. Topical agents have been used for decades to help prevent and treat a wide variety of health conditions, including pain from arthritis, fibromyalgia and other chronic conditions.

Topical pain medications are absorbed through the skin and are best for relieving joint and muscle pain close to the skin's surface, including the hands, elbows, knees and feet. If you are reluctant to take pills, you may opt for an over-the-counter cream or patch or to have your doctor prescribe a stronger topical medication.

What are your options? And will they work to manage your pain?

Non-Steroidal Anti-Inflammatory Agents

Diclofenac is a topical non-steroidal anti-inflammatory medication available for topical pain management. Diclofenac is available in both patch and solution/gel formulas. The patch (Flector Patch) was first approved by the FDA in 1998 and can be used for the treatment of sprains and strains, but the solution/gel (Voltaren Gel) was designed for arthritis pain. Diclofenac works by reducing substances that cause inflammation and pain in the body. It is only available as a prescription and carries the same risk as other non-steroidal anti-inflammatory drugs (NSAIDs).

Topical Anesthetics

Topical anesthetics are local anesthetics that are used to numb the surface of a body part. They are available in creams, ointments, lotions and sprays. Transdermal patches that contain lidocaine can offer chronic pain relief but are only available with a prescription. The lidocaine transdermal patch (Lidoderm) works by stopping the nerves from sending pain signals to the brain. You should only use one patch a day. Using too many patches or wearing a patch for too long may result in overdose, in which too much lidocaine is absorbed into the blood. In case of an overdose, discontinue use and call 911.

Counterirritants

Counterirritants contain substances that create a hot or cold sensation in one location to temporarily lessen pain and inflammation. Counterirritants are generally non-prescription and available for topical use to manage muscle and arthritis pain. Counterirritants contain capsaicin, methyl salicylate, menthol, and/or camphor. Capasagel, Benjay, Icy Hot, Biofreeze, and Tiger Balm are all brand-name topical pain agents containing one or more of these ingredients, but there are other brands including generics. These products are intended for short-term use of mild pain. Use of heat with these products should be avoided.

Narcotic Analgesics

The FDA has only approved two narcotic analgesics for chronic pain. Fentanyl patches have been around since the 1990s and buprenorphine patches were approved in 2010. Both of these medications carry a high risk for abuse and misuse. The Fentanyl patch is usually prescribed to patients who are dependent on opioids (medications that reduce the intensity of pain signals to the brain) and require continuous opioid treatment. Buprenorphine patches are usually given to patients who require long-term chronic pain management.

Treatment Considerations

Topical medications are available in a variety of dosage formulas and more are being researched to improve pain management. Not everyone will experience good pain relief from using topical pain agents and many of these products do not guarantee arthritis pain relief.

Here is what you can do to get the greatest effect from using these medications:

• Follow usage instructions carefully.
• Wash your hands before applying them.
• Do not apply patches, creams, gels, sprays or lotions to damaged skin.
• Never use topical pain agents with heating pads or tight bandages.
• Do not use non-prescription topical pain agents for more than 7 days.
• Monitor yourself for signs of toxicity (tinnitus, nausea, vomiting). Products containing methyl salicylate can absorb into the bloodstream.
• If you are allergic to aspirin or take blood-thinning medicines, check with your doctor before taking topical pain agents containing methyl salicylate.

To learn more about arthritis treatments:

Stop Getting Unnecessary Medical Treatments
Alternative Treatments: Massage Therapy for Arthritis Pain
5 Main Treatments for Psoriatic Arthritis