Arthritis Foundation Logo
Español ES
Your Local Area
Sign In
Popular Search
arthritis gout home ja
Suggested Content
Article
Rx for Access
Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
Article
Do I Have Arthritis?
Think you may have arthritis? Learn about the four most common warning signs.
Article
Gout
Gout is an inflammatory type of arthritis that can come and go.
Arthritis Foundation Logo
  • About Arthritis
    Common Topics
    woman holding her wristWhat Is Arthritis?

    Arthritis is not one disease. Learn about the different types of arthritis, how they differ and why it’s important.

    microbesInflammation and the Immune System

    Body-wide inflammation is at the root of most chronic diseases — and you may have more control over it than you think.

    Patient talking with nurseNewly Diagnosed With Arthritis

    A new arthritis diagnosis can be overwhelming. These tips can help.

    • Understanding Arthritis
    • Arthritis Types
    • More About Arthritis
    • Where it Hurts
    • Related Conditions
  • Treatments
    Common Topics
    Managing Arthritis Care Costs

    Learn the basics about health care costs and financial tools available to you.

    About Biosimilars

    More of these biologic medications will soon be available. Learn what they are, whether you should consider them and what to ask your doctor.

    Webinar: Sleep Solutions for Pain

    Experts discuss solutions on how to quiet nighttime pain to get better sleep.

    • Treatment Plan
    • Drug Guide
    • Joint Surgery
    • Complementary Therapies
    • Insurance Management
  • Healthy Living
    Common Topics
    Woman with upset stomachMicrobiome, Gut Health & Arthritis

    Microbiome, microbes, microorganisms – these terms may be confusing, but the types of bacteria living in and on our bodies can impact arthritis. Learn what helps or harms the microbiome and the health of your gut and discover dietary changes that can make a difference. This episode was originally released on January 19, 2021.

    woman consoling anotherArthritis and Mental Health

    Learn about the connection between arthritis, depression and anxiety and how these conditions can make your arthritis worse.

    Woman ExercisingYour Exercise Solution (YES)

    Movement is the best medicine, even when your joints hurt. Your Exercise Solution (YES) is a resource to help you create a physical activity routine with modifications developed and approved by physical therapists.

    • Ease of Use Products
    • Managing Pain
    • Recipes & Nutrition
    • Physical Activity
    • Emotional Well-being
    • Daily Living
    • Family & Relationships
  • Juvenile Arthritis
    Common Topics
    JA Family Summit

    Learn about the National Juvenile Arthritis Conference, a place for families to connect, share and learn.

    JA Camps

    The Arthritis Foundation’s JA camp programs give kids with arthritis and related childhood rheumatic diseases the chance to make lasting memories.

    Juvenile Arthritis Volunteer

    • About Juvenile Arthritis
    • Treatment
    • Managing Pain
    • Medical Decisions
    • Nutrition
    • Emotional Well-being
  • Providers
    Common Topics
    Transforming Clinical Interactions

    The Live Yes! Arthritis community connects patients with others online and in-person for support and education, and encourages patients to play an active role in their health care.

    Partners 4 Patients with Arthritis

    The Arthritis Foundation recently launched an initiative to build stronger relationships and increase recognition of our most engaged practices. 

    Fellowships

    See how we're aiming to address the growing shortage of arthritis specialists, especially in under-served parts of the country.

    • Better Living Toolkits
    • Our Issue Briefs
  • Science
    Common Topics
    OACS Forum Series

    The Osteoarthritis Clinical Studies Forum Series features OA thought leaders from across the globe discussing the future of how the disease can be treated to improve patient outcomes.

    man bandaging boy's kneeConquering Childhood Arthritis

    The Arthritis Foundation is mobilizing patients and their families to engage in studies comparing the effectiveness of treatments for juvenile arthritis and funding research for more options.

    Focus

    • Awards
    • Funding Opportunities
    • OACS Forum Series
    • Osteoarthritis Focus
    • Participate in Clinical Trials
    • Partnerships
    • Publications
  • Get Involved
    Common Topics
    Capital hillAction Center

    Take action today - use the resources here to learn who your elected officials are, what opportunities we have to advocate from the comfort of your own home, federal and state legislation, and more!

    woman listening to podcastLive Yes! With Arthritis Podcast

    You may have arthritis, but it doesn't have you. The Arthritis Foundation’s one-of-a-kind podcast. Hosted by patients, for patients.

    Walk to cure arthritisWalk To Cure Arthritis

    Join the movement and make an impact by honoring those who rock your world at the Arthritis Foundation’s signature walk event, Walk to Cure Arthritis. Register as an individual or form a team and Rock the Walk in your community!

    • Advocacy
    • Ways to Give
    • Fundraising
    • Volunteer
    • Partnership
Donate
Back

Topical NSAIDs Offer Joint Pain Relief 

Topical anti-inflammatories may relieve pain with less risk of side effects. Are they right for you?

If you have arthritis in just a couple of your joints, you may not need to expose yourself to the risks of oral nonsteroidal anti-inflammatory drugs (NSAIDs) to get some relief. A topical NSAID, like other kinds of topicals, can be rubbed on the skin over sore joints to relieve pain, without the stomach upset or cardiovascular risks of oral medication.

What Are Topical NSAIDs?
First approved in the United States in 2007, topical formulations of diclofenac — the only topical NSAID product commonly available in the U.S. — are available as gels, liquids and patches. Until 2020 it was available only by prescription, but can now be purchased over the counter. Different strengths are available for different purposes. 

The American College of Rheumatology recommends topical a NSAID as a first treatment for osteoarthrtis (OA) pain, especially of the knees. And authors of a 2021 systematic review and meta analysis in The Physician and Sportsmedicine conclude, "It should be recommended to patients as a first-line conservative management for OA of the knee."

However, a 2016 Cochrane review looked at 39 studies with 10,631 participants and found that only about 10% more people get OA pain relief from topical diclofenac than from placebo. So they may not provide sufficient relief for everyone, but it's a good idea to try them before oral medications, and they are a good option for those who can't or don't want to take oral NSAIDs.

What Is Available?

  • Diclofenac sodium 1% gel (Voltaren Arthritis Pain, now available as an OTC). When used for osteoarthritis pain of the hands, elbows or wrists, apply 2 grams to each affected area four times a day (a total of 8 grams per day). When used on knees, ankles, or feet, apply 4 grams to each affected area four times a day (a total of 16 grams per day). However, the total amount used on your body should not exceed 32 grams per day. A dosing card comes with the gel so you can measure the correct amount.
  • Diclofenac epolamine 1.3% patch (Flector). Apply one patch to your most painful joint twice per day.
  • Diclofenac sodium 1.5% liquid (Pennsaid). When used for osteoarthritis knee pain, apply 40 drops per knee, 4 times a day. Dispense in 10-drop portions to prevent spilling.
  • Diclofenac sodium 2% liquid (Pennsaid). When used for osteoarthritis knee pain, apply 40 mg (2 pumps) on each painful knee, 2 times a day.
  • Specialized Options. Other NSAIDs, such as ibuprofen, ketoprofen, indomethacin and piroxicam can be made into topical solutions at a compounding pharmacy. This could raise the price and insurance may not reimburse you for the medicine.

Are Topical NSAIDs Right for You?
These gels, liquids or patches may work for you if:

  • You have arthritis in smaller joints. Topical NSAIDs penetrate the skin and help reduce pain locally. They work best on joints that are closer to the surface, such as the hands, knees, elbows and ankles.
  • You are older than 65. “A lot of elderly patients can’t take oral NSAIDs because they have stomach or heart risk factors, and they can’t take narcotic analgesics because they could become so drowsy they could fall and break a bone,” says Roy D. Altman, MD, professor of medicine in the division of rheumatology and immunology at the University of California, Los Angeles.
  • Your stomach is sensitive to NSAIDs. Using topical NSAIDs may help you avoid stomach upset. But if you have a history of ulcers or gastrointestinal bleeding, the medicine in the drug travels through your blood and can still put you at risk.
  • You have heart risk factors. The gel’s active ingredients still make it into your bloodstream and can still affect your cardiovascular system. But the amount absorbed is much less, reducing your heart risk compared with oral NSAIDs.

The topical NSAIDs may not be right for you if:

  • You also take oral NSAIDs. Topical diclofenac should not be used in combination with oral NSAIDs or aspirin because of the potential for adverse effects. The gel’s active ingredient still gets into your bloodstream, so you have to consider the total amount you’re getting from every route, Dr. Altman says.
  • You have sensitive skin. Some people may have skin reactions where the medicine is applied.
  • You have several affected joints. “Voltaren works fairly quickly — within a week — but the pill works quicker,” says Dr. Altman. And taking a pill would be a lot easier for someone who has multiple joints affected by arthritis, he says. You also have to make sure you don’t slather it on multiple joints and exceed the total recommended dosage.

Around the clock and all year long, we’ve got you covered with unique pain management tools and resources you won’t find anywhere else.

Medications
View All Articles
Topical Treatments for Arthritis Pain

Medication

Topical Treatments for Arthritis Pain
Learn about various topical treatments to relieve arthritis pain and if they are right for you.
Read More
Learn About Pain Meds for Osteoarthritis

Medication

Learn About Pain Meds for Osteoarthritis
Understand the pros and cons of different medicines for OA pain.
Read More
Making Sense of Your Insurance
Choose the right coverage, reduce costs and minimize claim denials with these helpful tips.
Get Started
Give & Get Your Best
Your gift does amazing things for the arthritis community. Help yourself and help others.
Donate

Stay in the Know. Live in the Yes.

Get involved with the arthritis community. Tell us a little about yourself and, based on your interests, you’ll receive emails packed with the latest information and resources to live your best life and connect with others.

 
Get Involved
  • Live Yes! Connect Groups
  • Live Yes! Online Forum
  • Local Office
  • Fundraising
  • Webinars
  • Volunteer
  • Store
About
  • About Us
  • Annual Report
  • Careers
  • Code Of Ethics
  • Financials
  • News and Stories
  • Privacy Notice
  • Terms of Use
  • Español
Join Us
  • Jingle Bell Run
  • JA Camps
  • Pathways Conference
  • Living Well Events
  • Walk to Cure Arthritis
  • Fundraise Your Way
  • JA Family Summit
Home Office
  • 1355 Peachtree St NE Suite 600
  • Atlanta, GA 30309
  • Helpline: 1-800-283-7800
  • Contact Us
 
75th anniversary logo
Ashburn, VA
64° Arthritis Index Beneficial
See More Details
Arthritis Foundation is a qualified 501(c)(3) EIN 58-1341679
I Want to Contribute
I Need Help
  • Donate

    Donate

    Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life.

  • Volunteer

    Volunteer

    Join us and become a Champion of Yes. There are many volunteer opportunities available.

  • Partner

    Partner

    Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.

Donate


Ways to Give

Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.

Make a Donation

Help millions of people live with less pain and fund groundbreaking research to discover a cure for this devastating disease. Please, make your urgently-needed donation to the Arthritis Foundation now!

Become a Member

Become an Arthritis Foundation member today for just $20 and you'll receive access to helpful tools..... and more. 

Make an Honor or Memorial Gift

Honor a loved one with a meaningful donation to the Arthritis Foundation. We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift.

Gift Planning

I want information on ways to remember the AF in my will, trust or other financial planning vehicles.
 

Other Ways to Give

  • Match Gift
  • Donate a Car
  • Donor-Advised Funds

Volunteer


Volunteer Opportunities

The Arthritis Foundation is focused on finding a cure and championing the fight against arthritis with life-changing information, advocacy, science and community. We can only achieve these goals with your help. Strong, outspoken and engaged volunteers will help us conquer arthritis. By getting involved, you become a leader in our organization and help make a difference in the lives of millions. Join us and become a Champion of Yes.

Become a Volunteer

More About Volunteering

  • Walk to Cure Arthritis
  • Jingle Bell Run
  • Fundraise Your Way
  • JA Camp
  • Start a Live Yes! Connect Group
  • Be an Online Community Moderator
  • Local Leadership Board

Partner


Meet Our Partners

As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Join us today and help lead the way as a Champion of Yes.

Trailblazer

Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. They contribute $2,000,000 to $2,749,000

Visionary

Our Visionary partners help us plan for a future that includes a cure for arthritis. These inspired and inventive champions have contributed $1,500,00 to $1,999,999.

Pioneer

Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. They contribute $1,000,000 to $1,499,999.

Pacesetter

Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. They contribute $500,000 to $999,000.

Signature

Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. They contribute $250,000 to $499,999.

Supporting

Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. They contribute $100,000 to $249,999.

More About Partnerships

  • Partner with Us
  • Ease Of Use Commendation
  • Let's Get a Grip On Arthritis
  • Promotions that Give Back