Topical Treatments for Arthritis Pain

Salicylates contain the same pain-relieving substance in aspirin and have a mild anti-inflammatory effect. They are available as over-the-counter pain relief ointments, and used to treat minor injuries, aches and pains. Few studies have been conducted into the effectiveness of salicylates, and results are mixed. They are thought to be safe for most but talk to your doctor first. Those who have aspirin allergies or take blood thinners for heart disease may be at higher risk.  

For severe pain, topical NSAIDs likely won’t match the effects of oral meds, but those who have mild to moderate arthritis may find relief. They come in OTC and prescription gels and creams. A Cochrane review found that diclofenac or Voltaren, ibuprofen and ketoprofen gels are the most effective. Topical NSAIDs are less likely to cause GI issues or liver damage. Still, all NSAIDs may increase the risk of heart disease, so talk to your doctor.

Lidocaine is a topical anesthetic that relieves pain by creating a numbing sensation. It works by blocking pain signals at the nerve endings in the skin but doesn’t decrease inflammation. Studies about lidocaine for arthritis are limited. A small 2017 study found that lidocaine patches (5% concentration) effectively reduced pain in patients with total knee arthroscopy. Lidocaine is generally regarded as safe but rarely can cause serious side effects. Talk to your doctor before using lidocaine.

Topicals that use menthol or camphor are called counterirritants. They don’t affect pain signals or inflammation, but rather work by producing a cooling sensation to distract from the pain. These kinds of topicals have little side effects, but improvements in pain may disappear once the cooling sensation wears off.  

Capsaicin is what makes chili peppers spicy. Topicals with this active ingredient produce a mild tingling, burning sensation. It works by blocking pain signals to your nerves. Studies about its effectiveness are limited and mixed. It has the strongest recommendation for nerve pain and knee OA pain. Do not use on broken or irritated skin. If used on hands, wait at least 30 minutes before washing them. For other joints, wash your hands thoroughly after using.

There are few quality studies about topicals made with this ingredient, and it's unclear whether the CBD penetrates the skin to the joint. Some products also contain other active ingredients, like menthol. One study did find significant improvement in thumb joint pain, range of motion and strength with topical CBD, but results overall are mixed. Nonetheless, many people still report benefits to using CBD topicals. Learn more about CBD for arthritis pain here.

Topicals may contain multiple ingredients, so check the product list before applying. Side effects are uncommon and mild, including redness, itching or skin irritation, but it’s important to talk to your doctor about proper application and possible side effects. Only apply to intact skin and avoid using tight bandages or heating devices when using counterirritants. After applying, wash your hands and discuss any changes in skin, pain or irritation with your doctor lasting more than seven days.

On tough days with arthritis, you may seek extra relief in addition to meds. Topicals can be an effective way to get targeted relief for painful joints. They come in sprays, creams, gels and patches and can be made with various ingredients. Studies about their effectiveness is mixed, but limited evidence shows some may tame pain better than others. It may take some trial and error to find one that works for you. Here are some common options.