What is the rub on gel for arthritis, and how does it work?

October 6, 2025 •

3 min read

An estimated 58.5 million adults in the United States have doctor-diagnosed arthritis, and many find relief from symptoms using a topical treatment. A common and effective option for localized pain is a rub on gel for arthritis, which delivers active ingredients directly to the source of pain.

Quick Summary

Rub-on gels for arthritis contain active ingredients like NSAIDs, counterirritants, or capsaicin to reduce joint pain and inflammation. They offer targeted relief with fewer systemic side effects than oral medications.

Key Points

Diclofenac is a topical NSAID: The most common rub on gel for arthritis, often known by the brand name Voltaren, contains diclofenac sodium, which reduces inflammation and pain directly at the joint.
Counterirritant gels distract from pain: Products containing menthol or camphor create a heating or cooling sensation on the skin, distracting the nerves from the underlying joint pain for temporary relief.
Capsaicin reduces pain signals: Derived from chili peppers, capsaicin works by depleting a nerve chemical that sends pain messages, offering relief that builds over time with consistent use.
Topical treatments have fewer systemic side effects: Compared to oral pain medication, gels deliver active ingredients directly to the source of pain, minimizing exposure to the rest of the body.
Proper application is key: Always follow application instructions, use dosing cards where provided, and avoid applying gels to broken or irritated skin.
Results may take time: While counterirritants work quickly, anti-inflammatory gels like diclofenac can take up to seven days of regular use to become fully effective.

Understanding topical gels for arthritis

Topical gels for arthritis provide a convenient way to apply medication directly to a painful joint, such as the knees, hands, or ankles. Unlike oral medications that circulate throughout the body, these gels allow for a more concentrated delivery of the active ingredient to the affected area, often resulting in fewer systemic side effects. The primary types of gels differ based on their active ingredients, each working through a distinct mechanism to combat pain and stiffness.

The diclofenac gel (Topical NSAID)

Diclofenac sodium is a widely used nonsteroidal anti-inflammatory drug (NSAID) found in effective rub-on gels for arthritis, such as Voltaren Arthritis Pain Gel.

How it works: Diclofenac reduces pain and inflammation by blocking the body's production of prostaglandins. This helps reduce swelling and stiffness at the joint.
Best for: This type of gel is effective for osteoarthritis pain, particularly in smaller joints closer to the skin like the hands and knees.
Application: Diclofenac gels have specific instructions for application frequency and dosage, which should be followed carefully.

The counterirritant gel (Menthol and camphor)

Counterirritant gels, containing ingredients like menthol and camphor, are found in products such as Biofreeze and Icy Hot. They work differently from topical NSAIDs.

How it works: These gels create a heating or cooling sensation on the skin, which helps distract the brain from the deeper arthritis pain. They offer temporary relief but do not reduce inflammation.
Best for: Counterirritants are suitable for minor aches and can provide relief for arthritis, sprains, or muscle strains. They are generally safe and available over-the-counter.

The capsaicin gel

Capsaicin, an ingredient derived from chili peppers, is used in some arthritis gels. These can be found in over-the-counter or prescription strengths.

How it works: Capsaicin desensitizes nerve endings and reduces substance P, a chemical that transmits pain signals to the brain. This effect requires consistent application over several weeks.
Best for: Capsaicin gels are often used for persistent pain, such as osteoarthritis in the hands or knees. They may cause a burning sensation initially, which typically decreases with regular use.

Applying an arthritis gel safely

Proper application ensures effectiveness and minimizes side effects. Key tips include:

Always follow the product's specific instructions regarding frequency and duration of use.
Use any provided dosing tools to measure the correct amount.
Apply the gel to clean, dry skin, avoiding broken or irritated areas.
Wash hands thoroughly after application to prevent accidental contact with sensitive areas.
Do not cover the treated area with bandages, heating pads, or tight clothing.
Be aware that some gels, like diclofenac, may take up to a week of regular use to provide noticeable relief.

Comparison of arthritis rub-on gels


Feature	Diclofenac (Topical NSAID)	Counterirritant (Menthol/Camphor)	Capsaicin
Mechanism	Blocks pain-causing chemicals (prostaglandins) and reduces inflammation.	Creates a hot or cold sensation to distract from pain.	Depletes substance P, a pain-signaling chemical.
Effectiveness	Clinically proven for mild-to-moderate osteoarthritis pain in specific joints.	Best for mild, temporary aches and muscle soreness.	Requires consistent use over weeks; effective for persistent joint pain.
Onset of Action	Takes up to 7 days of regular use for full effect.	Works almost immediately to provide sensory relief.	Takes up to 2-4 weeks to provide maximum relief.
Systemic Side Effects	Low risk compared to oral NSAIDs, but risks still exist (stomach bleeding, heart attack).	Minimal systemic side effects; primarily minor skin irritation.	Minimal systemic side effects; primary side effect is a burning sensation.
Common Brands	Voltaren, AleveX, generics.	Biofreeze, Icy Hot, Bengay.	Capzasin-HP.

Conclusion

Topical gels provide a targeted approach to managing arthritis pain. Diclofenac gels reduce inflammation, counterirritant gels offer quick sensory relief, and capsaicin gels work by affecting nerve signals over time. These topical options often have fewer systemic side effects compared to oral medications. Proper application is essential for safety and effectiveness. It is always advisable to consult a healthcare provider to determine the most suitable treatment, especially if you have other medical conditions or are taking other medications.

For more detailed information, the Arthritis Foundation offers extensive resources on managing arthritis pain and treatment options. Read more from the Arthritis Foundation.

Frequently Asked Questions

The most effective rub-on gel depends on the type and severity of your pain. Diclofenac gel (Voltaren) is clinically proven to reduce inflammation and is often recommended for mild-to-moderate osteoarthritis pain in joints like the hands and knees.

It is important to follow the specific instructions on the product packaging or from your healthcare provider regarding how often to apply diclofenac gel.

It is crucial to consult your doctor or pharmacist before using an arthritis gel if you are also taking oral pain medication, especially other NSAIDs like aspirin or ibuprofen. Combining them can increase the risk of side effects.

Common side effects include skin irritation, redness, itching, or swelling at the application site. More serious, though less common, side effects, particularly with diclofenac gels, can include stomach bleeding or heart problems, and should be discussed with a doctor.

If your diclofenac gel comes with a dosing card, follow the instructions provided to measure the correct amount for the affected joint. There are often specific measurements for different body areas. Apply the gel and then clean and dry the card for future use.

No, you should not cover the treated area with a bandage or apply heat, such as from a heating pad, after applying most arthritis gels. This can increase absorption and risk side effects.

It is recommended to follow the instructions on the product packaging or consult a healthcare provider for guidance on how long to use an over-the-counter arthritis gel.