by Art Solbrig
Published November 07, 2020
Updated December 09, 2020
Now that winter is soon approaching, it seems to be a good time to mention some effective topical pain relievers as joint pain appears to be a bit more noticeable in winter and arthritis pain especially, so the list below may be timely and useful!
Many pain relievers currently available for oral/systemic use are relatively effective, but there are two problems with these oral pain relievers. One is that they can have some bad side effects. The other issue is that they are being delivered to areas of the body where they are not needed or wanted because of side effects that they are known to cause.
As an example of this, consider NSAIDs such as ibuprofen, naproxen, and aspirin, three very common pain relievers that are reasonably effective for moderate pain reduction but are known to cause damage to the gut, even with relatively short term use in some people.
It is the same issue with a more potent pain reliever such as morphine that can perturb the gut and cause constipation. It can also cause cramps, drowsiness, and sleepiness.
What I would like to do here is list topical pain-relieving options that can avoid some of the pitfalls associated with systemic pain relievers and will deliver sufficient pain relief to localized areas such as the wrist, neck, elbows, shoulders, back, hips, knees, spine, ankles or feet as needed without sending it to other areas of the body where it is not required. I will list these in order of likely level of pain-relieving strength.
1. This first one may come as a surprise to many Earth Clinic readers, as it is addicting, but this is a viable option for those who can use it for short term use only. This is only intended for use by people who are already taking the oral form, having been prescribed by their doctor, and are looking for a potentially better way of using it with less side effects. I am not suggesting that anyone take this if all that is needed is an NSAID such as ibuprofen or naproxen. I want to be very clear on that point!
One of the stronger pain relievers that can be made into a topical is morphine. Doctors don't usually prescribe morphine as a topical formulation, but they can. It will have to be made up by a compounding pharmacy that your doctor can write a script to. Why would you want to do this? Let's say that you are taking morphine via the oral route and are having the side effects of drowsiness and constipation. This delivers morphine in relatively large quantities throughout your body, but let's say your pain is confined to your spine or back. By being able to apply a topical cream formulation directly to your spine or back, it will very significantly reduce the amount of morphine that is delivered to other areas of the body and will likely reduce or eliminate the potential for constipation or drowsiness, allowing you to function much better, while still getting excellent pain relief! Another advantage is that you will very likely be able to reduce your total morphine intake while still getting good pain relief. Here is a link to a very brief article that describes how to make a topical morphine formulation yourself :
2. Topical Voltaren Gel 1% is what I would consider being next in terms of readily available otc NSAIDs, but it is relatively well absorbed, and this may be a problem in long-term use, especially if being applied to larger areas of the body or if applied frequently or both. A doctor told me that it might affect the kidneys over time, so if you have kidney issues, this may not be the best choice. This 1% strength used to be prescription-only but is now available otc.
Here is a link to the product:
3. Next on the list is a product that combines multiple effective pain-relieving ingredients with 8% menthol.
Although they refer to menthol as the active pain-relieving ingredient and the other ingredients are referred to as "inactive ingredients." One of the inactive ingredients is a well-known anti-inflammatory, and the active component used in this product is Boswellia serrata extract.
Other ingredients include MSM, Eucalyptus oil, glucosamine sulfate, and peppermint oil. The 8% menthol content gives pain relief but also acts as a transdermal penetrant enhancer. This is one of the best otc topical pain relievers available, and it is called Stopain Extra Strength and comes in an easy to apply roll-on. Here is a link to that product, which is also available at Walmart and Walgreens:
4. This next product, I would consider similar in pain-relieving efficacy to Voltaren Gel 1%. A bit on the pricey side at $43, but it is a large 16-ounce container, which makes it a pretty good deal compared to others that are 4 ounces or less.
The product is called China-Gel and has a good list of natural pain relievers in it such as Camphor 3% Menthol 5% Inactive Ingredients Aloe Barbadensis Leaf Extract, Angelica Archangelica Root Extract, Carbomer, Hamamelis virginiana ( Witch Hazel ) Extract, Imidazolinyl Urea, Lavandula Hybrida abrialis (Lavender) oil and Panax Ginseng Root Extract. Here is a link to the product.
5. This next product is a homeopathic topical formulation that I would rank as "almost equal" to Stopain. Since it is a super diluted homeopathic formulation, it has a slightly reduced potential for adverse reactions.
This topical is called "The Arnica Rub" by NatraBio and should be less reactive than regular forms of Arnica Montana. This product also contains seven other homeopathic remedies and is useful for speeding bruise recovery in addition to its considerable pain-relieving qualities. Here is a link to that product.
6. Penetrex is a popular pain reliever, but for me not quite as effective as the above-listed items. The main active component is arnica montana, but Penetrex has a significant number of known pain-relieving substances in it, such as MSM, glucosamine, Boswellia serrata, peppermint oil, camphor, and tea tree oil. Despite all of that, I consider Pentrex not as effective as the above at pain relief. Here is a link to the product. This one is one of the more expensive products at 4 ounces for $ 35.
7. Topical ibuprofen or topical naproxen are next on the list and are a way to avoid the gastrointestinal issues associated with both products' oral use. I have discussed these two topical preparations previously on this forum, so I will not detail how to make them here. I would rank their pain-relieving ability at or slightly below the level of the products mentioned above. Outside of the US, topical ibuprofen gel is available otc. I have not seen it here.
This is an example on Amazon UK :
8. This is another product with a high menthol content described as the active ingredient. It also lists one herb along with the menthol as ingredients. I would rate this product, Biofreeze, comparable to The Arnica Rub and Stopain Extra Strength roll on, but slightly less.
9. Next on the list is a product named Theraworks and is based on magnesium sulfate as the active ingredient for pain. It works at a level similar to magnesium chloride oil spray (MO), but it is much nicer on the skin than MO because it is a foam. This benefit comes at a price premium compared to MO, though. Magnesium-based topical products have another advantage over the topical pain relievers above in that they are also very effective against muscle cramps, relieving them in a minute or two. Good to have on the nightstand if you happen to be prone to leg and foot cramping at night. I do not consider magnesium topicals to have as much pain-relieving potential as the products above, but useful all the same.
Here is a link to the product Theraworks :
10. Magnesium chloride oil spray is similar to Theraworks in terms of pain relief and muscle cramp inhibition. Some people apply it before going to bed to areas where they frequently get cramps, while others only use it if they wake up with muscle cramps because it works so fast. Another benefit of MO or Theraworks is that if you apply it to your chest, back of the neck, and shoulder area, because of its muscle relaxing effects, it can help you get to sleep and possibly get better sleep. We carry a lot of tension and stress in these muscle groups even once we are horizontal in bed, and these two products can help those muscle groups relax, similar to deep breathing relaxation.
While the magnesium products are not the most potent pain relievers, I like them for their versatility and are worth having on hand even if you use one of the pain relievers above. I have previously posted on this forum how to make MO from magnesium chloride flakes much less expensively than the ready-made commercial products, but I will not go into that aspect here since it is already on the forum.
Here is a link to a typical product :
I did consider including homeopathic pain remedies other than NatraBio's The Arnica Rub, but most are for oral use, and the liquid ones are used for oral use, so I decided against it, one is enough, and it is a good one.
So that is my list of 10 pain-relieving supplements that, in my opinion, consider to be some of the better topically applied pain relievers and the order that I think they offer pain relief efficacy.
Obviously, the effectiveness can vary from person to person, so your personal opinion may be different than mine, or you may think that an unlisted product is better than some of the ones I listed. That is to be expected because we are all different and respond differently also. No problem, though, because if you have used a product that has worked exceptionally for you, list it along with your review in your reply, and everyone will be able to see what it is.
I have not tried every topical pain reliever out there, so if you have a different one that you think is worthy of consideration, then please post it so others can comment on it and receive the benefit of your experience!
I'm hoping that this page will eventually expose the best of the best topical pain relievers so that we can all benefit from the combined knowledge base of Earth Clinic's forum!
November 22, 2020 - Remedy Update
The borax lotion has proven repeatedly to be effective for arthritis of the hands, but borax is a fairly large molecule and does not easily penetrate and traverse the dermal layers, so I did not think it would be effective for anything except the hands and so that is how I wrote the original post, for essentially just arthritis of the hands.
Recently, an elderly friend who I had using oral borax effectively to treat arthritis throughout her body for years asked me if I had any alternatives that might be useful for arthritis and I told her that I thought her arthritis was well controlled with borax and she replied that her doctor had asked her to stop the borax because she had another health issue in her digestive tract that he was not able to figure out the cause of and so he told her that the borax might be the cause and asked her to stop taking it, so she stopped the borax and the arthritis started coming back about a month and a half to two months after she stopped the oral borax and it just continued to worsen to a point that was worse than ever before.
I told her about the borax lotion and made her up a bottle because she said both knees were hurting and both of her wrists were swollen and painful. I told her to try the lotion only on the worst knee and worst wrist so she would clearly know if the lotion was helping her or not because if it was working, the worst knee (left) and worst wrist(left) would start to be better than the untreated knee and wrist.
I talked to her at length today and she told me that the left knee was now better than the right knee and the left wrist was now better than the right wrist! This was the news that I have been waiting for and today she confirmed the improvement! To me this test tends to confirm the idea that little borax is going systemic as the right knee and right wrist would likely have improved also if the borax was being systemically absorbed. So her doctor will likely be happy about that and she probably will be happy about that too.
I wanted to share this with the EC community so they can share it with family and friends because I know there are many people out there who simply will not take borax orally and the borax lotion now offers these people who are adverse to taking oral borax a doable alternative!
Needless to say she is very happy and can now start applying the lotion to the other wrist and knee since she is past the testing phase. By the looks of things and her timeline to benefit, she is likely to have both knees and both wrists pain free by Christmas!
To be clear, this did not happen overnight for her as she has been applying the lotion twice daily for about three to four weeks now. Now I know that borax lotion can work elsewhere besides the hands and gives me another option to be able to offer to my friends who don't want to take oral borax.
I should also add that I did not use ibuprofen, naproxen or aspirin in the lotion I made her, just borax and lotion, because I did not want a pain reliever to affect the outcome in any way. So this is purely due to the borax lotion applied twice a day and results should be seen within a month or so except perhaps in severe cases which may take longer. I will try and update again in a month or so once she has been treating her other knee and wrist for a similar period of time as the the left knee and left wrist.