Dr. Louise Achey
Last month, Richard got a prescription for the new Voltaren® gel for his left knee pain. At 89 years young, his activity level has dropped significantly for the past 6 months, ever since the COVID pandemic restricted access to gyms and exercise classes. The arthritis in his knee is now so bad that he can barely walk on it. Unfortunately, COVID restrictions will prevent him from having knee replacement surgery any time soon.
The Voltaren® gel really helped Richard, but if it hadn’t given him enough relief, there are several other non-prescription products he could use in addition to it. Methyl salicylate, camphor, menthol, eucalyptus, capsaicin and arnica are derived from natural sources and have been used for decades to treat aching muscles and stiff joints. Because you apply them to your skin instead of taking them as pills, they work locally instead of affecting your entire system and causing side effects.
Methyl salicylate, camphor, menthol, and eucalyptus work as counterirritants. Instead of calming or blocking nerves to relieve pain, counterirritants give you relief by triggering the sensory nerves located in your skin. This gives you a sensation of intense warmth or soothing coolness while it keeps your nerves too busy to recognize any painful sensations.
Capsaicin is derived from hot chili peppers and works by triggering the release of a nerve messenger called Substance P in the skin where you apply it. Substance P’s job is to transmit messages to your brain that there’s pain. Applying capsaicin to your knee flushes out all the Substance P in the tissue it touches, keeping your nerves from sending messages to your brain about your painful knee until your body can build it back up.
Lidocaine has been available as a patch for pain, but is now available without a prescription in a roll-on formulation. Aspercreme® Maximum Strength has 4% lidocaine, and can be used in between applications of Voltaren® gel or other topical roll-on products for additional relief of pain and stiffness from arthritis.
There are also several supplements and medicines that may help relieve arthritis pain. Tylenol® comes in short and long-acting formulations, and there are 2 anti-inflammatory non-prescription medicines available: ibuprofen (Motrin®) and naproxen (Aleve®).
There’s new evidence that you don’t have to choose between taking Tylenol® over an anti-inflammatory medicine. There’s evidence that combining Tylenol® with an anti-inflammatory agent like naproxen or ibuprofen is more effective than either by itself. They actually work better together in some people. If you can take ibuprofen or naproxen safely, you can also take Tylenol® at the same time.
Supplements that may give you some relief of arthritis include glucosamine sulfate, powdered gelatin, fish oil, and CBD from hemp oil.
Here Are 5 Tips for Relieving Joint Pain from Arthritis:
1.Increase your activity level.
The Centers for Disease Control and Prevention (CDC) found that nearly 26% of adults sat for more than 8 hours every day. And this was BEFORE the COVID pandemic and the stay-at-home directives that closed restaurants, gyms, health clubs and exercises classes. Sitting too much increases inflammation and encourages weight gain, both which can aggravate knee and hip pain. Getting up every hour to walk around and stretch, and walking 5-10 minutes several times a day can significantly improve joint pain and stiffness from osteoarthritis.
2.Use topical analgesics on joints first.
Topical pain relievers are best for joints like knees, hands, elbows, and wrists. There are many options available today in various formulations like patches, gels, and roll-on lotions. You can choose from the local anesthetic lidocaine, the anti-inflammatory Voltaren®, counterirritants like menthol, methyl salicylate, camphor, eucalyptus, and capsaicin. Some people use CBD oil or lotion from hemp with good results. Convenient roll-on formulas reduce mess and waste.
3.Use a combined approach.
It’s unusual to have one medicine or supplement give complete relief of arthritis pain and stiffness. Using a combination of topicals and pills can allow each to contribute additional relief of stiffness and discomfort with fewer side effects.
4. Use a symptom diary.
No medicine or supplement works for everyone. Tracking your response BEFORE and AFTER trying different medicines and supplements will help you keep what is working and discard what isn’t.
5.Try long acting options at bedtime.
Tylenol Arthritis® or Tylenol 8-Hour® work for at least 8-10 hours compared with 5-6 hours of the regular and extra-strength forms. Aleve (naproxen) lasts for 8-10 hours compared to 6-8 hours with Motrin (ibuprofen). Taking them at bedtime can help relieve morning pain and stiffness.
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website TheMedicationInsider.com for daily tips on how to take your medicine safely®2020 Louise Achey
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