Arthritis Creams and Patches
If you suffer from mild or moderate arthritis joint pain, an arthritis cream or patch may help. Such creams and patches work to reduce pain in several different ways.
Some commonly used counterirritants contain menthol, eucalyptus oil, oil of wintergreen, camphor, eugenol from cloves, and/or turpentine oil. When rubbed on the skin, these arthritis creams or ointments create a feeling of cold or heat over the painful joint or muscle, which may help soothe painful arthritis joints. Popular brands include Therapeutic Mineral Ice, Icy Hot, and Tiger Balm.
Of topical pain medications, capsaicin, an ingredient found in cayenne peppers and available in over-the-counter creams and ointments (Capzasin-P, Dolorac, Zostrix), probably has been studied the most.
Capsaicin cream warms the skin when applied over the joint and temporarily blocks a chemical called substance P, which delivers pain messages to the brain. In one study, patients with osteoarthritis or rheumatoid arthritis applied topical capsaicin four times a day to painful knees. After four weeks, patients with osteoarthritis had a 33% reduction in knee osteoarthritis pain; those with rheumatoid arthritis had a 57% reduction in pain. Not all studies have shown capsaicin to be this effective. Use disposable gloves when applying capsaicin cream, and avoid getting it in your eyes, nose, and mouth.
Other arthritis creams are available that contain salicylates, compounds related to aspirin. Using topical salicylates may help you avoid most of the side effects of taking aspirin by mouth, but how well it works to relieve pain is unclear. Some brand names include Aspercreme, Bengay, Flexall, and Sportscreme.
NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen and naproxen, are commonly taken by mouth to relieve arthritis pain. Arthritis creams consisting of NSAIDs, commonly used in other countries, are starting to become available in the U.S. Although studies show topical NSAIDs give short-term relief only, some experts find the topical route may be safer than taking NSAIDs by mouth. Medications such as diclofenac, naproxen, ibuprofen, piroxicam, and other NSAIDs can be made into a treatment cream by an experienced compounding pharmacist, but you need a prescription from your doctor.
Lidocaine patches are another alternative pain remedy for arthritis joint pain. Lidocaine is a drug that blocks transmission of nerve messages. It acts as an anesthetic, an agent that reduces sensation or numbs pain. In findings presented at the American Pain Society's annual meeting, researchers reported that 143 patients with knee osteoarthritis pain either used the Lidoderm patch, which contains lidocaine, once daily for 12 weeks or took Celebrex, an NSAID, by mouth. At 12 weeks, 71% of both groups reported at least a 30% improvement in their knee pain, which is considered significant pain relief.
Side Effects of Arthritis Creams and Patches
Arthritis creams and patches are usually well tolerated. However, skin irritation is possible. Symptoms of skin irritation include redness or burning where you applied the cream or patch. If you notice any of these symptoms, talk to your doctor to see if you should stop using the product. Allergic reactions can also occur. If you have signs of a severe allergic reaction -- hives, difficulty breathing, closing of the throat, swelling of the lips, tongue, or face -- you should stop using the product and seek emergency care or call your doctor immediately.