Topical Treatment for RA Joint Pain

[Aporiac]

My RA has been fairly well-managed with fortnightly 40ml adalimumab injections and weekly 20mg methotrexate injections for a few months. Since starting these meds together I still get some stiffness in a few joints, but not the pain I used to suffer and so I now consider my symptoms to be manageable. Also, I no longer get the seriously debilitating flareups I used to regularly experience.

However, I still sometimes get acute pain in a couple of joints - this comes along periodically like flare-ups, but the pain is only present when I actually use the joint in question rather than being a constant aching pain. I could try to reduce the inflammation with, say, ibuprofen, and the pain with an analgesic (paracetamol or codine), but given that the pain tends to be in only a couple of joints (at the moment my right wrist and right knee) I wondered whether it might be worth trying a topical anti-inflammatory (like ibuprofen gel) rather than take another systemic treatment with all of the potential side-effects (especially on the stomach in my case).

I don't think I've ever seen a discussion of topical treatments for RA, which I understand because it's usually too serious and extensive to be susceptible to such easy cures. But what about as a supplementary treatment for a condition that is 90% controlled by DMARDs, etc., but is still niggly here and there? Does anyone have any experience? Are any gels/creams effective at all?

[Lolabridge]

Hi Aporiac.

I find Voltarol gel quite good for occasional joint pain like you describe. I’ve also got a Paingone pen which I use on my painful thumb/wrist joint. It’s a TENS type gadget. I got it from Tower Health.

But I usually use those as well as any painkillers not instead of!! Hope you find something that works for you.

[Neonkittie17 in reply to Lolabridge]

Same here, Lola .. Voltarol/Voltadol (I’ve got some of the German version but it’s the same thing and an easy to use gel cream!) if I’m going to be standing or walking more than usual. Also the sports type freeze sprays you can buy from most supermarket pharmacy shelves, on the back of my bad knee which helps me move without pain if it is more acute. Prefer the V gel. Spray enables me to get out without being mega ouch on worse days. Of course as the Voltarol gel product says, you must be mindful of any anti inflammatory tablets you take and how many, especially if you are using a topical gel. (You know that but others reading might not! 🥰)

[Aporiac in reply to Lolabridge]

Thanks, Lola (and Neon) - I'll talk to my GP about getting a Voltarol prescription. It's encouraging to hear that topical products can work, which gives us another weapon in the arsenal!

[Lolabridge in reply to Aporiac]

You can buy Voltarol gel over the counter, no prescription needed.

[Mmrr in reply to Lolabridge]

Same here, voltarol gel too. It works well on the smaller joints, not so good on the larger joints for me, but definitely worth trying.

[helixhelix]

I have a range of “other” solutions. Including perneton gel and anti-inflammatory patches. I don’ know if you can get them in the UK

Nsaids

[vonniesims in reply to helixhelix]

I get Ketoprofen Gel on prescription. It works well on me.

[Aporiac]

Thanks for this information! The two active compounds that people seem to find effective based on the responses here are diclofenac and ketoprofen (looks like it's supported in medical trial data as well). Interestingly, ibuprofen in combination with menthol (which is non-prescription) has good results for some people, but the action may not be as effective for RA as for the more typical soft tissue exercise-related damage. I'll have a chat with one of the rheumy nurses at my clinic and see what they think.

[tina73]

I use capsicum cream, it's a chilli based cream. I find it very effective.

[Fra22-57]

I get ibroprofen gel on prescription n use it when my back pain is real bad.Also used it on ankle and hand joints. pain relieves is only temporary but allows me to drift off to sleep

[13Lab]

Capsaicin cream from rheumatologist helps as he thinks pain is from the damage caused by RA..Ir is chilli based ( but supply difficulty until June in U.K.).

[Otto11]

I also have Capsacian cream. I was prescribed it for tendon pain in my wrist. It stings initially but does work well. I’ve never used it on a large joint. I would think Volterol gel better for that although not as strong. X

[Haz58]

My Rheumy consultant told me to put voltarol on my thumbs then put my spilnts on. I was on 20mg MTX epi pens at the time.

[greynot]

I have both RA and also osteoarthritis in a lot of specific joints. I use CBD cream/balm, and find it really good for those joints that stop me sleeping. On an as and when basis.

[Bails67]

I use Diclofenac cream and codeine( only painkiller I can have) only. Have codeine as last resort. Have you had X-ray. I was the same and X-rays have picked up OA you can get splints for your wrist and knees. Might be worth asking GP!

[Hidden]

note my diagnosis is Stills Disease which for me manifests as rheumatoid Disease with bilateral joint stiffness, pain and swelling. I was diagnosed in 1979 aged 17 and now 61.

I have found massage stick helps, the sports kind, as it’s a distraction and the increased blood flow seems to help the joint feel better. Salt heat pouches are great but expensive to buy and need boiling to reuse .

Prescription volterol is stronger and I use this a lot but have been warned it is an anti inflammation gel and may be absorbed and interact. Codeine is good but has the nasty side effect of constipation.

We’re all different and have different coping mechanisms, mine is one day without pain relief and one day with OR days with less and days with more. This helps to tolerate the relentless nature of RA pain.

I’m a big user of compression supports too.

[MerielPB]

I use Voltarol gel frequently on my hands and occasionally on other joints. It helps quite a bit.

[Water-nymph]

I find that Volterol and other topical treatments helps with my osteo-arthritis pain but not with my RA symptoms which I've had what seems like forever. I've has RA since my early 20's so 50 years+ now and I've tried most things since my RA was first diagnosed in 1970 (ish).

[Seatgeorge]

I use Voltaren for athiritus it contains diclofenic, so don't go too mad with it, but it certainly helps on my elbow and my hand, doesn't cause any problems with mtx or benepali.

[Nana246]

Hi there for some aches and pains I use magnesium oil, Kunzea cream or Zen herbal gel. They help a bit at times. I’m in Australia.