Arthritis pain relief: Creams and gels for aching joints

Learn about the various types of creams, gels and ointments available for pain relief. Find out whether these topical pain medications can ease your arthritis pain.

After an especially active weekend of hiking or work around the yard, your osteoarthritis might cause pain despite taking your usual pain medication. So you turn to other ways of soothing your aching joints. Reluctant to pop another pill, some people make a run to the drugstore to pick up an over-the-counter joint cream that promises to dull the pain.

But can these topical pain medications really offer arthritis pain relief? Here's a look at how topical pain medications work and whether they're a viable arthritis pain relief option.

What types of topical pain medications are available?

Topical painkillers come as gels, creams, lotions or patches that are applied directly to the skin over your aching joints. Three types of over-the-counter joint creams are sometimes used for arthritis pain relief, including:

Applications that make skin feel hot or cold. Doctors call these products counterirritants because they contain ingredients that irritate your skin. Ingredients such as menthol, oil of wintergreen or eucalyptus oil produce a sensation of hot or cold that distracts you from your arthritis pain, giving you temporary arthritis pain relief. Examples include Biofreeze, Flexall and Icy Hot.
Aspirin-like pain rubs. Some products, called topical analgesics, contain salicylates, the same ingredients that give aspirin its pain-relieving quality. In addition to offering arthritis pain relief, these products may reduce joint inflammation as they're absorbed into the skin. Examples include Bengay, Aspercreme, Mobisyl and Sportscreme. If you are allergic to aspirin or are taking blood thinners, check with your doctor before using topical medications that contain salicylates.
Creams made from chili pepper seeds. The seeds contain a compound called capsaicin (kap-say-IH-sin), which causes the burning sensation you associate with peppers. Creams made with capsaicin are most effective for arthritis pain in joints close to the skin surface, such as your fingers, knees and elbows. Capsaicin creams work by depleting your nerve cells of a chemical called substance P, which is important for sending pain messages. Capsaicin creams may need to be applied regularly for one or two weeks before arthritis pain relief may occur. Examples include Capzasin and Zostrix.

Some products contain a combination of these three types of arthritis pain relief methods.

Prescription pain gels and patches
A prescription gel containing the nonsteroidal anti-inflammatory drug (NSAID) diclofenac (Voltaren Gel) may provide some pain relief for people with osteoarthritis in their hands, wrists, elbows, feet, ankles or knees. Diclofenac gel is massaged into the skin around your affected joint four times a day. Side effects may include rash and redness where you apply the gel. NSAIDs, such as diclofenac gel, carry a risk of stomach bleeding and heart problems, including heart attack.

Diclofenac is also available as a patch. Diclofenac epolamine (Flector) patches are approved for treating pain caused by sprains and strains. Patches are applied to the skin and used twice daily. Patches aren't safe for people with chronic kidney diseases.

In some cases, doctors may prescribe lidocaine patches (Lidoderm) for joint pain. The patches are approved in the U.S. to treat a painful complication of shingles, but they may be used for other types of pain — what doctors call an "off-label use." Patches are placed on your skin over the painful joint for 12 hours at a time. The lidocaine numbs the area.

Do over-the-counter topical pain medications offer arthritis pain relief?

Over-the-counter topical pain medications may offer temporary relief from arthritis pain. Limited studies using these products showed reductions in pain. But studies have been small and poorly designed, making them less reliable.

These topical preparations aren't intended to take the place of your prescription arthritis medication and there's no evidence to suggest they can be helpful when used long term. However, you might find temporary relief from arthritis pain flares by using topical pain medications. Relying on these topical preparations more often may indicate that your arthritis is worsening or that medication prescribed by your doctor isn't working. Tell your doctor if your arthritis pain isn't being controlled.

Are these products safe for people with arthritis pain?

Over-the-counter creams and gels appear to be safe, though there are no data about long-term use for arthritis pain relief. Side effects may include burning or stinging where you apply the cream or gel. Some products may have a strong medicinal odor. Products containing salicylates may not be safe if you are allergic to aspirin or are taking blood thinners, so discuss this with your doctor first.

Carefully follow the directions on the product packaging. When using topical pain medications, be careful not to rub or touch your eyes until you've washed your hands thoroughly. Don't use these pain relievers on broken or irritated skin or in combination with a heating pad or bandage.

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