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Anti-inflammatory Gels and Creams – Do They Work??

Anti-inflammatory Gels and Creams – Do They Work??

anti inflammatory cream gel physio painIf you’re in pain, anti-inflammatory tablets may be beneficial, however rising concerns over side effects are causing people to consider anti-inflammatory gels and creams as an alternative. Are they actually effective and if so, which one is best?

This blog follows on from last week’s article comparing heat packs vs deep heat creams.

Anti-inflammatory Options

When it comes to anti-inflammatory medication, there are various options ranging in effectiveness and side effects.

The most powerful anti-inflammatory effect can be gained by a corticosteroid injection (cortisone). This is like a water bomber dropping water on a fire. There are some risks such as infection, flare of pain, possible short term weakening of tissue and anxiety.

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The next most effective option is oral anti-inflammatory medications such as prednisolone (steroid – prescription only) and Non Steroidal Anti Inflammatories (NSAIDs), which are available over the counter (Nurofen, Voltaren, etc) or via prescription (Naprosyn, Celebrex, Mobic, etc). This is like using a garden hose to squirt water on a fire but it goes everywhere (systemic). Short-term side effects are rare but can affect the gastro-intestinal tract, kidneys, blood pressure, those with asthma, etc. It is advisable to consult a GP or pharmacist before commencing NSAIDs.

Finally, the topic of this blog involves the use of anti-inflammatory gels and creams, which include steroid based (not covered) and non steroid based such as voltaren and nurofen gel. These are like throwing a bucket of water at a targeted section of the fire. Less of the drug is absorbed into the blood stream when compared to oral medication, therefore the risk of harmful side effects is significantly lower.

Do Anti-inflammatory Gels and Creams Actually Work

The short answer is yes! A recent review of the literature (research evidence) by Cochrane revealed that topical NSAIDs provided good levels of pain relief in acute conditions such as sprains, strains and overuse injuries, probably similar to that provided by oral NSAIDs.

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But if it’s like using a bucket of water compared to a hose, how can we maximize the effectiveness? For a topical NSAID to be effective, it has to reach the inflamed tissue in sufficient concentration to produce a relevant anti-inflammatory effect.

Factors Influencing the Effectiveness of Anti-inflammatory Gels and Creams

  • Concentration – The concentration of anti-inflammatory medication in the gel/cream obviously has a strong bearing on how much is absorbed by the tissues. Voltaren has recently released their voltaren gel osteo 12 hourly product, which has twice the concentration of diclofenec (medication) compared to their standard product.
  • Formula – The formulation is crucial for skin penetration. Without getting into too much detail, gel is more effective than cream.
  • Blood Flow – If blood flow to the area is increased due to exercise, a heat pack, a hot shower, massage, etc there is a better chance of the medication being absorbed.
  • Wraps – Sports Doctors often recommend wrapping the affected area in glad wrap after applying the anti inflammatory gel to increase the time the gel has to penetrate the skin before being rubbed off or evaporating.
  • Massage – Don’t forget about the beneficial effects of massage including pain relief and increased blood flow. Some believe that the beneficial effects of anti-inflammatory creams can be attributed in full to the massage and not the actual cream/gel. However research has proven that anti-inflammatory gels and creams provide significantly more pain relief than placebo gels and creams when massaged into the affected area.

What Conditions do Anti Inflammatory Gels and Creams Help?

As discussed, the anti-inflammatory gel has to penetrate the skin before it can reach the affected tissues, so the problem area mustn’t lie too far away from the skin surface. Therefore anti-inflammatory gels are more likely to assist the following conditions:

  • plantar fasciitis
  • patellar tendinitis
  • Achilles tendinitis
  • ITB syndrome
  • shin splints
  • tennis and golfer’s elbow
  • ligament strains
  • bursitis
  • acute muscle strains

Although pain from the neck and back often comes from deep structures it doesn’t hurt to try anti-inflammatory gels.

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Summary

  • Anti-inflammatory gels are likely to provide pain relief for conditions that are close to the surface of the skin.
  • Voltaren Osteo 12 Hourly Gel is likely to be the most effective due to it’s high concentration of anti-inflammatory agent.
  • Massage the gel in if comfortable and consider wrapping the area in glad wrap over night.

Considerations

  • Don’t apply topical creams or gels to broken skin.
  • If you have eczema or other hand problems, wear a latex glove when applying gel.
  • Allergic reactions are uncommon, but on first use only apply a small amount to a clean, healthy area of skin and gently rub in until absorbed. Wait a while to test how you respond to the ingredients before using more. If skin redness, irritation or itching occurs, wash off and seek medical advice.
  • Wash your hands immediately after applying the treatment.
  • Don’t touch or rub your eyes while you have topical cream on your hands.
  • Follow the directions on the package.
  • Do not use any topical treatments if you are pregnant or breastfeeding, without seeking advice from a pharmacist or doctor.

6 Comments

  1. Tina Hempel on August 18, 2021 at 1:17 am

    I have really severe shoulder pain, I have had an cortisol injection that only lasted about 3 weeks I’m in severe pain most of the day . My question is what is the best anti-flammator cream for pain.
    .

    • Bonnie J Carter on September 8, 2021 at 6:09 am

      I had really bad shoulder pain a couple of years ago. Nothing worked. I decided to be proactive. Got a thing from my doctor that gave me 5 sessions with an exercise physiologist at the local gym. He developed a set of gentle exercises that focused on strengthening my shoulder/neck muscles. 6 months in, no pain. Give it a go. Nothing to lose. I’m a 62 year old woman who is generally allergic to gyms, by the way!🤣 Good luck!

      • Kara on September 14, 2021 at 10:22 pm

        I totally agree with Bonnie. I have witnessed (and personally experienced) so many severe pain issues/injuries including various shoulder problems (some of which the sufferers were advised that complicated and risky surgery was the only option) that have responded most favourably to a physical therapist who TRULY understands human physiology. The focus on healing, working together and aiding the body to function correctly seems to be the most significant factor, perhaps more important than the discipline the therapist is qualified in. A TRULY good therapist knows how to advise you what you can do to allow healing, what to do to first stabilise and then to strengthen the weaker areas, and what to avoid at any particular time that could inadvertently cause further damage. Wishing you good luck and speedy healing.

    • Jeff on September 27, 2021 at 9:55 am

      I had rotor cuff injury some 23 years ago,very painful and stiff with very limited arm movement.
      Went to see Sport doctor,after failed physiotherapy and dilated hydro therapies he suggested to have it operated.
      Since it close to the nerve system and I don’t really trusted doctors,mind you allopathic evidence base medicine is not much different than snake oil except it very expensive and covered by medicare,I didn’t go along.
      By chance someone suggested to see acupuncturist.
      The second the needle was inserted my pain is gone,the scary part was he is like crazy rotate my arm like a propeller to proof how good he is. LOL.
      Since then I never got problem with my shoulder anymore while my wife who had the same problem and had operation with one of the very top specialist in Melbourne still has pain now and then.

      But make sure that you don’t have a torn tendon.

      The same with my son who has pigeon toes,went to see Prof. Orthopedic for pediatric ,he suggested hips operation (what a crazy suggestion).
      Lucky I have a very good masseur,he just press certain point for few minutes and my son walk straight like been healed by Benny Hinn,LOL.
      It has been 20 years since,no more buying shoes because it worn one side only.

      If the acupuncturist put the needle on the shoulder probably he doesn’t know what he’s doing,it should be on the gall bladder meridian on the side of your calf.
      It is good that you ask him first how he going to threat you over the phone without wasting your money unnecessary but don’t mention anything about what I said to you.
      Or you may try the GP who do acupuncture on medicare,at least you are not paying from your own pocket.
      Good luck.

  2. Sue on August 29, 2021 at 8:41 pm

    I’ve had back pain now for 20 weeks been on naproxen but not helping when it flares up thinking of stopping tablets and using voltoral what’s peoples ideas

    • Ed on September 22, 2021 at 12:12 am

      Refer to a chiropractor, or similar. Suggest an x-ray to pinpoint the problem before they fix it. Little costly but you don’t want another 20 weeks of pain. Self management is always ideal for minor issues but when they become long term it’s best just to get professional help and nip it in the bud.
      Naproxen isn’t good as a long term solution, it puts a lot of pressure on other parts of the body eg kidney, intestines etc. So if you persist with it, be mindful of the side effects.
      Depending on the severity, there are physio exercises that may help – plenty of videos online eg https://www.csp.org.uk/conditions/back-pain/video-exercises-back-pain
      Fingers crossed for you.

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