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Inflammation is behind a lot of chronic disease, including arthritis. That is why nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are so popular among people with joint pain. However, even though these drugs relieve pain and calm inflammation, they may cause serious side effects such as kidney damage, cardiovascular complications and digestive distress. Sometimes doctors prescribe a topical NSAID such as Pennsaid or Voltaren gel in an effort to get more benefit and less risk. The medicine is also available without a prescription. Are there advantages of Voltaren gel?
Shopping Internationally for Voltaren Gel:
Q. I first bought Voltaren gel from a pharmacy at the airport in Rome over 10 years ago. It helped my joints so much that I started buying it every time we traveled abroad.
The label on the box I bought in New Zealand says VOLTAREN Osteo Gel 12 Hourly 23.2 mg/g diclofenac diethylammonium. Apply once every 12 hours.
The Voltaren now available OTC in the US is to be applied every 6 hours. Is what I bought overseas stronger? What is the difference?
A. The FDA first approved a prescription form of Voltaren Gel (diclofenac sodium) in 2007. It was a 1% topical NSAID formulation. The same strength was approved for OTC use in 2020.
This product contains 10 mg diclofenac per gram of gel. Some people get good relief from topical diclofenac without side effects, while others get less benefit. Side effects may include digestive upset, skin reactions and cardiovascular complications. Because of the differences in formulation, it’s hard to say whether gel from New Zealand is stronger than the US version.
Enjoying the Advantages of Voltaren Gel:
Q. Both my husband and I have been using a small amount of Voltaren gel for years. This has enabled me to avoid knee replacements and my husband, back surgery.
When I first asked my orthopedic doctor about using the gel, he checked its effect on the kidneys and decided that it was ok to use.
In fact, at first, Voltaren gel wasn’t available in the US. We purchased it in Mexico, Europe or Asia. Now we purchase it OTC.
Every year we have our “wellness” exams, which include blood tests. Our kidney functions are still fine.
Adverse Effects from Topical NSAIDs:
A. Topical NSAIDs such as diclofenac (Voltaren gel, Pennsaid, Flector) can provide helpful relief for sore joints. Often, topical medication does not trigger the same complications as oral NSAIDS such as diclofenac, ibuprofen, meloxicam or naproxen.
That said, some people are very sensitive to adverse effects of these medicines. Readers have reported heartburn and gastritis as well as elevated blood pressure after applying Voltaren gel.
Learn More:
You’ll find much more information about topical NSAIDs as well as the pros and cons of oral NSAIDs, including celecoxib, indomethacin and ketoprofen, in our 104-page book, The Graedons’ Guide to Alternatives for Arthritis. In it, we also discuss the drawbacks and advantages of Voltaren gel.
Topical NSAIDs such as Voltaren gel are widely available over the counter in many countries, including the U.S.
Sandra
There is a an rx for Voltaren. The OTC Voltaren which I think is only 1%. That’s why the article says both!!!!
Rex
Voltaren contains diclofenac which is toxic to pets.
“Depending on the amount [of diclofenac] ingested and the pet’s health history, oral ingestion of the topical formulations can result in gastrointestinal upset, irritation, possible ulceration in the stomach and small intestine, and even acute kidney injury. Cats are much more sensitive than dogs.”
The above quote is from https://www.aspcapro.org/resource/topical-creams-and-pets-dangerous-combination
Barbara
Confusing. The headline implies more information than it delivers because you need to download a booklet for more information, and it’s OTC in the USA.
Dena
Voltaren caused me to begin having dangerously high blood pressure. My doctor put me on BP meds, then kept upping it. After 18 months, I read an article on it causing HBP. I got off of Voltaren and HBP meds, and in three months I had constant normal blood pressure. Been steady for last 4 years. This gel should be used with caution.
Richard
Earlier versions of Voltaren said not to use this gel on areas like the neck. Is Voltaren approved for use at the hair-line at the back of the neck?
Deborah
I don’t think they require a prescription anymore. I’ve seen it available at Costco for the last 3 years.
Leonorah
After an endoscopy several years ago I discovered I had an ulcer from years of taking high doses of aspirin for my rheumatoid arthritis. Is Voltarin systemic? Could I use it without worrying about an ulcer popping up?
Michele W
Voltaren works well but I’ve also had success with Penetrex and frankincense.
Lisa
Unfortunately, all the brands smell flowery and give me migraines. I so wish there was an over-the-counter one without artificial scent.
Cathie
In one place, your article says Voltaren gel is available without Rx. At the end, it states that Rx is required.
Ruth
My doctor prescribed this medication and the very time I used it I immediately got heartburn and it flared up my acid reflux so badly 😢 I thrashed it. ..People with digestive issues should never use this
Richard
Contrary to the last sentence in the article, Voltaire gel is available OTC here. However, when I read the label my enthusiasm for trying it disappeared.
Mary
You do not need a Rx for voltaren gel in the usa. It is otc and less potent than the OTC voltaren I purchase in Canada. Why the article says you need a Rx in the States I have no idea. This is false
Cindy`
I’m a skier with 2 knees that have suffered every possible kind of injury, over and over. I had some clients that take Voltaren and liked it, so I bought some to try.
But GEEZ, the label scared me half to death. “May cause liver damage…” “Wash hands thoroughly after use”… So many warnings! Man, I put the lid right back on that tube and gave it away immediately.
Anyway, with gin-soaked raisins, turmeric, grape juice n’ Certo, celery seeds, fish oil, boswellia and glucosamine/chondroitin, I’m good to go! No problem!
Sandra
My experience with Voltaren was not a good one. My blood pressure was normally around 120/65 at the time. I take my blood pressure most mornings now that I’m elderly, and I have health issues. Within a day or two of starting Voltaren, my blood pressure was about 155. I was a little concerned, so I took my blood pressure during the day, and it kept rising. When it reached 180/?, I went to the emergency room. It registered 190/? at that time. They put me in a bed, and after several hours it began to come down. They released me when it came down to 145/?. When I returned home I read that Volerten can cause high blood pressure. I never used it again. My blood pressure has never been that high again.
Karen
Topical NSAIDS are toxic to pets. Be careful to wash your hands after applying, and don’t allow pets to come into contact with the application area.
Lynne
Missouri
Could you tell me what Canadian pharmacy you used? My insurance does not cover pain meds very well.
lubsie
Sooke, BC Canada
When my shoulder and elbow tendons flared up a few years ago, my pain was almost too much to bear. The specialist I went to see gave me such simple advice that worked. He said to cut carbs plain and simple. On day 10, all my pain just dissolved (including the osteoporosis knee pain). I was able to swim & knit once again. When I got lazy or sloppy eating more than 100 carbs per day, the inflammation returned. It was time to get religion and stick to the most simple philosophy….keep your carb count below 100….healing without fancy, expensive prescriptions and best of all, no side effects.
farmerjim
Louisa, VA
I’ve been doing trigger point massage for almost a couple decades now. Trigger points are contraction knots which form in muscles — a small number of muscle fibers — and they are also known as ‘painful points, or ‘yipe points’. Press on them and they hurt. They can also be disappeared by massaging for about 30 seconds at a bearable level of pain — tho most often it will take massaging the trigger point several or more times. Trigger points are also weird because most of them have the pain felt in one location, and the trigger point is in another part of the muscle. This ‘referred pain’ can any where from less than an inch up to 2 or 3 feet from where the pain is felt
If the pain is just above the knee or behind the patella — at least in the early stages of a few years — is generally caused by trigger points in the Rectus Femoris muscle. Above the knee pain is caused by a painful point an inch or so below the groin line on the leg. Pain behind the patella is cause by a trigger point about two palm widths above the patella. Both these trigger points are found just above the Femur (upper leg bone)
A second muscle, Vastus Medialis can also cause pain behind the patella. This trigger point is an inch or two above the patella and medial to the Femur. A second trigger point in this muscle — about a full palm width above the top of the patella — causes pain on the medial side of the knee (also d*****d painful). Massage at a 45 degree angle to the humerus.
A third muscle — Vastus Lateralis — causes pain on the lateral side of the knee. These trigger points are where the pain is felt, rather than several inches away. There are also several possible trigger points in this muscle about two palm widths above the knee — try massaging in to the humerus at a 45 degree agle, or straight in to the side of the humerus. If there are trigger points there, you can massage them out
These are the major muscles which can cause knee pain. There are also another 3 minor muscles which can cause knee pain, either by themselves, or in addition to to trigger points in the major muscles. What all these muscles have in common is that they have tendons which attach either to the knee, or to the joints around the knee. The contraction knot pulls on the tendons, which in turn pull at their attachment points in the knee joint, causing mild to debilitating pain.
Massage the trigger points by pressing into them with fingers (or a knuckle) and move your massage across these contraction knots. Do this with your leg in a position so the muscle you are massaging is as relaxed as you can make it. A tense or tightened muscle doesen’t massage well. Massage back and forth in the direction of the muscle fibers, not across the fibers.
Good skill — farmer jim
NORMA
Springville, Al.
I love Voltaren gel. Especially for sore neck and shoulder pain which also affects my sleep. The gel works very quickly. I highly reccomend it.
Cliff
MW IN
With so many ED supplements the market now, I’ve found that you dare not eat any kind of a meal before taking these supplements as they will not work because the blood in your system will automatically go to you stomach to help you digest the meal you just ate, and very little, or no blood, will be available to assist you in getting an erection.
Louise
I use a topical gel containing arnica for mild joint arthritis that works well.
Lou
San Antonio
I’ve used Voltaren Gel for years, mostly on my right thumb and left wrist for arthritis with great success. My doctors have told me to go ahead and use it on my spine for arthritis, and it works well there too. I’ve not had any side effects.
Barb
Mississippi
I am an 82 yr old female w/severe arthritis in a knee. I do not take any medications; at times the pain was so bad I would have agreed to anything. But, I discovered a compressed knee sleeve, which I purchased for around $20, and it pretty much keeps me pain free.
Amelia R.
Erie PA
Voltaren has been really helpful for me , and when I use regularly it keeps me biking and hiking in relative comfort. I’d say it’s delayed knee replacement surgery for at least 5 years so far. However, I do react to it with an itchy rash that requires topical steroid ointment to control. It’s possible I am seeing an increase in blood pressure from it as well. I recently took a hiatus from using it daily for the last two months, due to the rash , and have noticed my blood pressure is a bit lower.
Ann
Canada
Our family doctor ordered Voltaren gel for me. I opened the package and the first point on the usage page was to not use it if you are on a blood thinner such as Warfarin. I take Warfarin. I checked with the pharmacist and she said I should not take it. So I didn’t.
George
Florida
The day before yesterday was the last day of using, for just about exactly a week, Voltaren gel for a very recently diagnosed arthritis of the feet and ankles.
It didn’t seem to make a clear difference at first, but the day after I stopped using it (that is to say, yesterday), I did seem to have less incidence of pain — in fact, for a substantial portion of the day, no pain — in one foot than I’d had before (though the pain was originally minor in the first place).
The main issue for me is that it seemed to make me feel weird in the head — it seemed to be affecting my brain in some way, although it didn’t lessen my mental abilities, as far as I can tell — I just had that weird feeling, and I’m glad to have stopped using it. Apparently, enough of it got into my bloodstream as to cause this reaction (unless something else was in play that did so).
Carole
Ohio
I think that, if people know the possible side effects of drugs and make the decision to use them anyway, it is for them to say. I take meloxicam every day to function. Without it I hurt all the time. I get kidney function tests every year and they are stable. But I am living every day as best I can.
Kat
Florida
I’ve been using the Voltaren gel for about a year on my knees; that’s helped me put off knee replacements, which I need. This is important right now as my husband has had some major medical problems in the past year that require me to be his caregiver, and do 90% of the work and cooking around the house (we’re both retired and he usually did about 50% of the work/cooking). I also have to help him get up from most chairs in our house, even with a lift chair. I’ve had no adverse reactions to the gel; it’s really been a lifesaver for us both.
Kay
Douglasville, ga 30134
I was given a sample of Voltaren Gel by my doctor for knee pain. It did nothing to relieve my pain. A knee replacement did. Doctor seemed surprised, as she thought it would help, but it didn’t.
Leslie
Georgia
I suffer from arthritis in my right thumb and hand. At one point, I couldn’t even hold a pen, as the pain was so excruciating. I did a lot of research and tried many of the natural alternatives to NSAIDS, none of which worked for me. Finally, I stumbled across SAMe. I read that it could take up to 2-3 weeks to work, and like clockwork, it kicked in at 2 weeks. I am getting these amazing results with just 400mg of SAMe every day, and a therapeutic dose is 1-3 pills a day! SAMe has been proven in documented studies to provide the same analgesic effect as aspirin. I am just curious why this information isn’t more readily available!
I also understand that SAMe is used for the treatment of liver disease so there is no worry on my part that it will damage my internal organs. I hope this is correct. This is a miracle supplement for osteoarthritis sufferers! I can now write with no pain at all!
Mat R.
FL
I use 200 mg of Advil at night but my use is to prevent urination. Yes, my BP is slightly elevated in morning. Should I be concerned?
Joy T.
Texas
I tried it for 1 month, and it did nothing for me. I really wanted it to work.