When your joints are stiffy and achy, your first instinct may be to pop a pain reliever, like ibuprofen or acetaminophen. For some, that’s the right move. But for others, arthritis cream might be a another way to ease the pain.   

Are Arthritis Creams Right for You?

If you have mild to moderate osteoarthritis (OA) in your hands or knees, perhaps yes. The same may be true for arthritis pain in your ankle or elbow. Topical pain relievers — like over-the-counter arthritis creams and gels — are rubbed on the skin, right on the spot where your joint hurts. Because the ingredients are absorbed through your skin, these creams tend to work best on more superficial joints, or ones close to the surface of your skin. 

Where arthritis creams don’t work as well: if the source of your osteoarthritis pain lies deep within your body — like the hip joint, which is surrounded by a thick layer of muscle and fat; on a larger area, like your lower back; or if arthritis affects multiple parts of your body. 

Can Arthritis Creams Treat Inflammatory Arthritis?

And if you have inflammatory arthritis like rheumatoid arthritis, arthritis creams are likely not for you. 

“Medications that mainly provide pain relief — like topical drugs — have a limited role in most patients with active RA,” says Justin Owensby, PharmD, PhD, a research pharmacist with the department of clinical immunology and rheumatology at the University of Alabama at Birmingham. 

Arthritis creams may be helpful in patients with end-stage RA (when the joint stops working but you still have pain and stiffness), he explains; and occasionally during disease flares in some patients, along with their other RA meds. 

Before adding any arthritis creams to your arthritis treatment arsenal, talk to your doctor to make sure they are appropriate and safe for you.  

How OTC Creams Relieve Arthritis Pain

The active symptom-easing ingredients in arthritis creams can include:  

Capsaicin

This is the stuff that makes chili peppers hot. It has the potential to alleviate pain by working on pain sensors in your body, says Dr. Owensby. Capsaicin is thought to stimulate the release of substance P, a chemical that sends pain signals to the brain. 

After a few uses, it depletes your nerve cells of that chemical, so fewer pain signals can be sent. One small study found that nearly 80 percent of patients experienced arthritis pain relief after using capsaicin cream for two weeks. The first few times you apply capsaicin cream, it may burn or sting; then the discomfort gradually lessens. You may need to wear latex gloves when applying the cream and avoid touching your eyes, nose, and mouth. Some brands include Capzasin and Zostrix.

Salicylates

These chemicals are similar to aspirin, so they have a mild anti-inflammatory effect. Creams that contain salicylates may provide some pain relief. Salicylates could be a good choice if your arthritis tends to bother you at night, according to the Cleveland Clinic. But if you are allergic to aspirin or are taking blood thinners, talk to your doctor to make sure these products are safe for you. Overusing these creams may also be toxic. Some brands include Aspercreme and Bengay.

Counterirritants

Substances like menthol, eucalyptus, and camphor oil are counterirritants — rub them into your skin over a painful joint and they create a temporary feeling of hot or cold. These sensations can interrupt pain signals to the brain. In other words, they distract the brain from sensing pain in the joint below.  Some brand names include Icy Hot and Biofreeze.

Always talk to your doctor before trying an OTC arthritis cream — they can alert you to any potential side effects and safety precautions. Don’t use topical pain relievers on broken or irritated skin or with a heating pad or bandage. And stop using the cream if your skin gets irritated. 

What About Prescription vs. OTC Arthritis Creams?

Prescription creams typically come in stronger concentrations than OTC versions and are made with NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs are usually taken by mouth to relieve arthritis pain, but they can cause stomach upset, bleeding, or ulcers, as well as heart, liver, or kidney problems. With topically applied NSAIDs, the risk of such side effects is lower, says Dr. Owensby. “That’s because topical NSAIDs work locally, on the application site, and don’t really get absorbed in your system like oral versions,” he explains. 

Cochrane reviews suggest some topical NSAIDs work as well as their oral counterparts for knee and hand OA.

If you have mild OA in a joint that’s close to the skin, especially in your knee or hand, your doctor may prescribe topical NSAIDs, says Dr. Owensby. They may also be used for older people or those who can’t tolerate oral NSAIDs. One topical NSAID currently available is called Voltaren, which contains the prescription NSAID diclofenac. Talk to your doctor to see if a topical NSAIDs is right for you, and how to use it safely.  

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