Your first choice for relief from arthritis pain might be over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin or naproxen. These medicines are highly effective for most people. However, they come with some potential side effects that are worth considering.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
You may want to consider adding topical pain relievers such as creams, ointments, lotions, patches and rubs to your pain relief arsenal. These over-the-counter products can ease arthritis aches without the potential side effects of pills.
“Topical medicines, especially for hand and knee arthritis, are as effective in certain cases as oral medications,” says orthopedic specialist Jason Genin, DO. “A topical might be much better — and better tolerated.”
These pain-relieving medicines can have the greatest impact on arthritis in your hands, knees or elbows, Dr. Genin says. They are less effective with sources of pain that lie deep within your body like the hip joint, which is surrounded by a thick layer of muscle and fat.
Choosing a topical treatment
Topical arthritis pain relievers come in several forms, and are available over the counter and by prescription. They tend to be safer than pills, but they can still cause side effects — particularly skin irritation, Dr. Genin says.
Other symptoms like shortness of breath or low blood pressure indicate a possible allergy to the medicine. This is serious, and if this happens, you’ll need to stop using the medicine and contact your doctor.
The right topical treatment will depend on location and severity of your pain and your lifestyle. They tend to fall into three categories:
- Counter-irritants, such as Icy Hot, work well for pain triggered by activity. These medicines induce local inflammation, which produces a cooling sensation on the skin. This relieves inflammation and distracts the brain from sensing pain in underlying or adjacent tissues.
- Salicylates are anti-inflammatory substances that relieve pain. They are related to aspirin and may be a good choice if your arthritis tends to bother you at night.
- Custom-made compounds contain combinations of medicines, such as an anesthetic and an anti-seizure medicine, specifically made for individual patients to meet their unique medical needs. These custom drugs are made in compounding pharmacies, which make drugs prescribed by doctors for patients with needs that can’t be met by commercially available drugs. Your doctor will closely follow you for side effects with these drugs, because they are significantly stronger than most over-the-counter medicines.
“I like to use the topical compounds when a patient hasn’t tolerated oral medications, which are drugs that affect your entire body. With a topical compound, we can keep the side effect localized rather than body-wide, especially if they tried over-the-counter topical treatments and they didn’t work,” Dr. Genin says.
One tool among many
A pain-relieving cream, gel or patch likely won’t be your sole arthritis relief strategy. They work best in combination with other strategies, such as exercise, diet and oral pain relievers. Your doctor can advise you on the right combination for your needs.
“Hopefully, topical pain relievers are just one part of the arthritis treatment,” Dr. Genin says.