Does Arthritis Pain Relieving Gel Work? A Comprehensive Pharmacological Guide

October 12, 2025 •

4 min read

Research has confirmed that topical diclofenac gel can provide effective pain relief for osteoarthritis in superficial joints like the hands and knees, leading many people to ask, "Does arthritis pain relieving gel work?". These products offer a targeted approach to managing mild-to-moderate arthritis discomfort, often with fewer systemic side effects than oral medication.

Quick Summary

This article examines the effectiveness of arthritis pain-relieving gels, detailing how different active ingredients like NSAIDs, capsaicin, and menthol function. It compares topical gels to oral alternatives, discusses which joints are best treated topically, and outlines best practices for safe and effective use.

Key Points

Topical NSAID gels are effective for specific joints: Gels containing NSAIDs like diclofenac have strong clinical evidence for treating mild-to-moderate osteoarthritis in hands, knees, and other superficial joints.
Less systemic side effects than oral NSAIDs: By delivering medication locally, topical gels minimize the risk of gastrointestinal, cardiovascular, and kidney complications associated with oral NSAID use.
Effectiveness depends on the joint: Gels work best on joints close to the skin's surface, but are less suitable for deeper joints like the hip or back.
Different gels have different mechanisms: Beyond NSAIDs, gels with capsaicin deplete pain signals over time, while counterirritants like menthol distract from pain with hot or cold sensations.
Consistent application is key: Significant pain relief from topical NSAIDs or capsaicin may require up to seven days of regular, consistent application.
Safety precautions are essential: Always follow dosing instructions, avoid using gels on broken skin, and wash hands after use to prevent contact with eyes or mouth.

The Science Behind Arthritis Pain Relieving Gels

Arthritis pain-relieving gels function differently from oral painkillers, which circulate throughout the entire body before reaching the affected joint. Topical gels deliver active ingredients directly through the skin to the localized area of pain. The medication penetrates the joint and surrounding tissue, where it can reduce inflammation and block pain signals. The efficacy of these gels depends heavily on their active ingredients, which can be categorized into a few main types.

Types of Topical Arthritis Pain Relievers

Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are considered among the most effective topical treatments for arthritis. The active ingredient, commonly diclofenac (found in brands like Voltaren), works by inhibiting the body's production of prostaglandins, which are compounds that cause pain and inflammation. Because they are applied locally, topical NSAIDs result in significantly lower systemic exposure compared to oral NSAIDs, reducing the risk of gastrointestinal, cardiovascular, and renal side effects.
Capsaicin: Derived from chili peppers, capsaicin works by temporarily depleting a chemical called substance P, which transmits pain signals to the brain. This creates a sensation of warmth or burning that can temporarily distract the brain from the deeper joint pain. Capsaicin-based gels, like Capzasin, often require consistent use over one to two weeks to achieve significant pain relief.
Counterirritants: Gels containing menthol or camphor, such as Icy Hot or Biofreeze, work by creating a hot or cold sensation on the skin's surface. This sensory input effectively distracts the brain and overrides the underlying pain signals. While they don't treat the inflammation itself, they can offer temporary distraction and relief for minor aches.

Are They Effective? Understanding the Evidence

Numerous studies and systematic reviews have explored the effectiveness of arthritis pain-relieving gels, particularly topical NSAIDs, for managing osteoarthritis pain. For joints that are close to the surface of the skin, like those in the hands and knees, topical NSAIDs have demonstrated significant efficacy, with some studies showing comparable effectiveness to oral NSAIDs for localized pain. The primary benefit, especially for older patients or those with co-morbidities, is the reduced risk of systemic adverse effects associated with long-term oral NSAID use.

Best-Suited Conditions and Joints Topical gels are most effective for targeted, localized pain relief in smaller joints, including the:

Hands and wrists
Elbows
Knees
Feet and ankles

For deeper or larger joints, such as the hips, spine, or shoulders, topical gels are less effective as the active ingredients struggle to penetrate the muscle and tissue to reach the source of pain. In these cases, a physician may recommend other treatments. It is important to remember that not all gels are created equal, and individual response to treatment can vary. For example, the Arthritis Foundation highlights that while topical diclofenac is well-supported by evidence for osteoarthritis, the effectiveness of other topical ingredients like salicylates is less conclusive.

How Topical Gels Compare to Oral Medications


Feature	Topical NSAID Gels (e.g., Diclofenac)	Oral NSAIDs (e.g., Ibuprofen)
Mechanism	Delivered directly to the affected joint through the skin.	Absorbed into the bloodstream and circulates throughout the body.
Systemic Effects	Minimal systemic absorption; significantly lower risk of systemic side effects.	High systemic absorption; higher risk of gastrointestinal, cardiovascular, and renal issues.
Targeting	Best for superficial joints like hands, knees, ankles.	Can treat pain in any joint, including deeper ones like the hips and back.
Onset of Action	May take up to seven days of consistent use for significant relief.	Often provides relief more quickly for widespread pain.
Application	Applied directly to the skin, requires no swallowing.	Taken as pills or tablets by mouth.
Side Effects	Primarily localized skin irritation (redness, itching, dryness).	Potential for stomach ulcers, bleeding, heart attack, and stroke, especially with long-term use.

Best Practices for Using Arthritis Gel

To maximize the effectiveness and safety of your arthritis pain-relieving gel, follow these best practices:

Read Instructions Carefully: Always follow the specific dosing and application instructions on the product packaging, including using any provided dosing cards.
Apply to Clean, Intact Skin: The gel should only be applied to clean, dry, and unbroken skin. Avoid using it on cuts, rashes, or infected areas.
Wash Hands Thoroughly: Wash your hands with soap and water immediately after application, unless you are treating pain in your hands.
Avoid Other Products: Do not apply sunscreens, cosmetics, or other topical products to the treated area, as this can interfere with absorption.
Be Patient: For NSAID gels like diclofenac, it may take up to a week of regular application to feel the full effects.
Do Not Combine: Never use multiple topical pain relievers on the same area at the same time, and always inform your doctor about all medications you are taking, both oral and topical.

When to Consult a Doctor

While over-the-counter arthritis gels are a convenient option, it's wise to consult a doctor before starting treatment, especially if you:

Have significant pre-existing health conditions, such as heart, kidney, or liver disease.
Are taking other medications, particularly blood thinners or oral NSAIDs.
Experience severe or persistent side effects, such as a rash or worsening pain.
Do not find relief after consistent use for the recommended period.

Conclusion

Yes, arthritis pain-relieving gels can work effectively for targeted, localized relief, especially for mild to moderate osteoarthritis in superficial joints like the hands, knees, and ankles. Topical NSAID gels, such as diclofenac, are backed by extensive clinical evidence and provide a favorable safety profile compared to their oral counterparts due to reduced systemic exposure. While other gels containing capsaicin or counterirritants can also offer relief, their mechanisms and long-term effectiveness differ. To ensure the best results, it's crucial to follow application instructions carefully and discuss your pain management plan with a healthcare professional, who can help determine the most appropriate treatment for your specific needs and health profile. For more information on pain management, the Arthritis Foundation provides excellent resources.

Frequently Asked Questions

For NSAID-based gels like diclofenac (Voltaren), it may take up to seven days of consistent, regular use to achieve significant pain relief. Gels with counterirritants like menthol may provide more immediate, temporary relief.

Yes, for many people, topical gels are safer than oral NSAIDs. They result in lower systemic absorption of the active ingredient, significantly reducing the risk of gastrointestinal, cardiovascular, and renal side effects compared to oral pills.

Topical arthritis gels are generally not recommended for deep joints like the back or hips. Their active ingredients are most effective for superficial joints closer to the skin, such as the hands, knees, and ankles.

NSAID gels contain anti-inflammatory medication (like diclofenac) that treats both pain and inflammation at the source. Menthol gels are counterirritants that work by creating a hot or cold sensation to distract the brain from the pain signals, but they do not reduce inflammation.

The most common side effects are local skin reactions at the application site, including redness, itching, swelling, or dryness. These are typically mild and less frequent than the systemic side effects of oral NSAIDs.

Many effective arthritis pain-relieving gels, such as Voltaren (diclofenac sodium 1%), are now available over-the-counter (OTC). However, some stronger or compounded versions may still require a prescription.

Yes, products like Voltaren or its generic versions often come with a dosing card. It is crucial to use this card to measure the correct amount of gel for each application, as directed by the instructions.