Now that winter is soon approaching, it seems to be a good time to mention some effective topical pain relievers as joint pain seems to be a bit more noticeable in winter and arthritis pain especially so the list below may be timely and effective!
There are many pain relievers currently available for oral / systemic use that are fairly effective, but two problems with these oral pain relievers is that one they can have some bad side effects and another 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 stronger pain reliever such as morphine that can also 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 a 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 needed. I will list these in order of likely level of pain relieving strength.
1. 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 very good 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 :
practicalpainmanagement.com...
2. Topical Voltaren Gel 1% is what I would consider to be next in terms of readily available otc NSAIDS, but it is fairly 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. I was told by a doctor that over time it may have an effect on the kidneys 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 :
vitacost.com/voltaren-arthr...
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 antiinflammatory and the active component used in this product is boswellia serrata extract. Other ingredients include MSM, Eucalyptus oil, glucosamine sulphate 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:
vitacost.com/stopain-roll-o...
4. This next product is a homeopathic topical formulation that I would rank as "almost equal" to Stopain and 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 7 other homeopathic remedies and is useful for speeding bruise recovery in addition to its multiple pain relieving qualities. Here is a link to that product.
vitacost.com/natrabio-the-a...
5. This product, I would consider slightly less 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 actually 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 :
amazon.com/China-Gel-Topica...
6. Topical ibuprofen or topical naproxen are next on the list and are a way to avoid the gastrointestinal issues associated with the oral use of both products. I have discussed these two topical preparations previously on this forum so I will not go into detail on how to make them here. I would rank their pain relieving ability at or slightly below the level of the above mentioned products. Outside of the US, topical ibuprofen gel is available otc. I have not seen it here. This is an example on Amazon UK :
amazon.co.uk/ibuleve-Speed-...
7. 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 Penetrex 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.
walmart.com/ip/Penetrex-Joi...
8. This is another product that has a high menthol content that is described as the active ingredient. It also lists one herb along with the menthol as ingredients. I would rate this product, Biofreeze, as less effective than the others, but the higher than most, menthol content may make it more appropriate for certain issues.
vitacost.com/biofreeze-cold...
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 because it is a foam, it is much nicer on the skin than MO. 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 :
walmart.com/ip/Theraworx-Re...
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 apply 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 to relax, similarly 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 am not going to go into that aspect here since it is already on the forum. Here is a link to a typical product :
vitacost.com/now-foods-solu...
I did consider including homeopathic pain remedies other than the NatraBio The Arnica Rub, but most are for oral use and the liquid ones are really 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 I 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, then just 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 thread will eventually expose the best of the best topical pain relievers so that we can all benefit from the combined knowledge base of this forum!
I am adding the following homeopathic topical pain reliever as an alternative to the one listed above because that manufacturer has discontinued their 4 ounce tubes and are now offering a smaller tube, but still charging about the same as they used to charge for the 4 ounce tube. Here is a link to the new homeopathic topical pain relieving gel, Arnicare from Boiron :
pureformulas.com/arnicare-g...
I have not had a chance to try it myself, but it is highly rated in reviews.
Art
. Not long ago, I ordered Natra-Bio Arnica and Arnica pellets. They are both excellent pain relievers. 
Magnesium benefits in PD as Oral and Topical Application 
