Here's the #1 Cream for Arthritis, According to Experts

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When your fingers, hips or knees are achy and swollen from arthritis, actions as simple as opening a jar of marinara sauce or grabbing your dog’s leash and taking him for a walk can become a major challenge.

Over-the-counter pain relievers, such as ibuprofen, can help, but they can take a while to work. If you need immediate relief, creams, gels and other topical treatments applied directly to sore spots can soothe the pain faster. “We like to use the topicals better as a first-line defense because they have fewer systemic effects than an oral anti-inflammatory, like ibuprofen,” says Michael Nieto, M.D., a sports medicine physician at Orthopaedic Specialty Institute in California.

Topical pain relief can help with both osteoarthritis (when the protective cartilage around the joints wears away) and rheumatoid arthritis (an autoimmune disease that attacks the joints, causing inflammation and pain).

We spoke with experts, as read hundreds of reviews, to find the best arthritis creams out there. You'll see we use the term "cream" to describe different types of topicals, including gels, sprays and patches. It may take a little trial and error to see which one works best for your pain. But, typically, the skin covering the shoulders, hips and lower back is thick, so a cream or gel may not be able to penetrate far enough to get to the joint or muscle. Typical topicals will probably be most effective on joints in thin-skinned areas, like knees and knuckles. Below, we're also answering some common questions about joint pain and pick the right treatment.

Topical 1% Gel

Both Dr. Nieto and Aly Cohen, M.D., an integrative rheumatologist in Princeton, New Jersey, cited Voltaren gel as a powerful pain reliever for people with arthritis. Its main active ingredient is 1% diclofenac, an NSAID, which, until recently, was only available by prescription. It works double-duty by relieving both the pain and inflammation associated with arthritis. “For deeper joints, anti-inflammatories, tend to work better [than other topicals],” Dr. Nieto explains.

Ultra Strength Topical Pain Relief Cream

This cream contains three active ingredients: cooling menthol and camphor, plus methyl salicylate (an NSAID analgesic). It’s indicated for minor backaches, arthritis and muscle pain from strains or sprains. Because it contains an NSAID, check with your doctor first to make sure it doesn’t interfere with other medications and to rule out any liver issues.

Lidocaine Maximum Strength Pain Relief Cream

This numbing cream contains 4% lidocaine — the max amount you can get without a prescription. The product gets top marks from reviewers, with many citing how quickly it works on all sorts of pain, not just from arthritis. Reviewers also say the relief allows them to sleep through the night and lasts longer than expected.

High Potency Arthritis Pain Relief Creme

As you may have guessed from the product name, this cream contains capsaicin, which temporarily overrides pain by producing a warming sensation on the skin. (Since the product gets its heat from a substance derived from chili peppers, be extra mindful to scrub your hands after applying it—especially before you touch your eyes!) Though it has rave reviews from those who can put up with the sting, others say it can sting or burn sensitive skin, so do a patch test first on a tiny spot of skin before slathering it all over.

Arnicare Cream

This homeopathic product with thousands of 5-star reviews uses the plant Arnica montana as its active ingredient. Arnica is a plant in the sunflower family that’s used as a natural remedy for pains, sprains and bruises. Some research has found that arnica does have pain-relieving properties comparable to other analgesics. It contains more than 150 bioactive compounds, with anti-inflammatory, antimicrobial and other beneficial qualities.

Pain Relief Gel

Biofreeze takes the cool to another level with this easy-to-apply roller-ball gel. Although menthol is the main active ingredient, it also contains other anti-inflammatory pain-busters, such as arnica and camphor. (There are also other herbal ingredients, including burdock and Boswellia Carterii, which don’t have a ton of quality research supporting their efficacy but are regularly used for inflammation and pain in Eastern and alternative medicine.) Users says that the roll-on is especially helpful if sore finger or wrist joints make it challenging to rub on a topical. Bonus: Your fingers stay mess-free.

Arthritis Pain Patch Large

Salonpas makes a range of pain patches— theses, designed specifically for arthritis, contain cooling menthol plus the NSAID methyl salicylate. At around $3 per patch, they are not cheap, but they can stay on for up to 12 hours, giving you long-lasting relief. The large-size patches are designed for the back, knee, neck, or shoulders, and are flexible enough to bend with your body.

Original Medicated Pain Relief Liquid

If you love the cooling feel of menthol, this quick-drying roller ball has a lot of it, at 16% — which produces the tingly cold-and-then-hot sensation. As with other topicals, some reviewers report it can burn the skin, particularly if you apply too much at a time or take a hot shower soon after applying. But thousands of reviewers say the icy sting really works.

Pain Relieving Spray

If you like to spray on your pain relief like you spray on your kids' sunblock, this is a good one to try: The primary active ingredients are menthol and camphor, and it also contains essential plant oils Boswellia carterii, rosemary, peppermint and Thymus mastichina (marjoram), which may help with pain and inflammation. Fans of the spray say it provides surprisingly effect relief, but advise you to spray it on in a well-ventilated space away from other people or pets.

What should I look for in an arthritis cream?

There are a few different types of topicals, and while they can all be effective, they work in different ways:

• Counterirritant: These work by producing a new sensation of tingling cold or soothing heat to distract from the pain, explains Dr. Cohen. She notes that since these products can’t penetrate very deeply, they’re best for joints close to the skin’s surface, like ankles, knees and hands. Common active ingredients in cooling topicals are menthol or camphor. Other products contain warming capsaicin, which gets its heat from chili peppers. With these products, pain relief typically lasts as long as the hot or cold sensation does.

• Numbing creams: These contain lidocaine, which blocks danger signals at nerve endings. Previously available by prescription only, products with 4% lidocaine are now available over the counter, Dr. Cohen says. (If you need a dose higher than that, check with your doctor about getting a Rx.)

• Anti-inflammatory topicals: Much like numbing products, these topicals get absorbed through the skin to bring relief to the joint by soothing pain and quelling inflammation. These topicals come with the same caveat oral NSAID pills do, Dr. Cohen says: “If someone is using that every day consistently, even at the levels that are prescribed on the box, they have to be wary of any issues of systemic absorption, which could contribute to liver abnormalities, just as you would if you were taking an Advil.” But Dr. Nieto says they’re okay for most people to use, as long as they are careful with the dose. “In people who have GI disease or cardiac disease, a lot of times we’re trying to avoid the systemic anti-inflammatories, but the topicals are usually safe for them to use,” he says.

Are arthritis creams safe to use?

Yes, both experts say. “The main side effects I see in my clinic would just be skin redness or a little bit of minor skin irritation,” Dr. Nieto says. Dr. Cohen recommends testing them any new product on a small area of skin first to make sure you don’t have a reaction, and skipping products if you’re also using a heating pad on that area, which can irritate the skin.

How often should I apply arthritis cream?

Topical treatments are really meant for short-term use, both Dr. Nieto and Dr. Cohen say. Follow the instructions on the box—most allow for three to four applications a day, for up to one week. If you have chronic pain from arthritis, be sure to talk to your primary care doctor or a rheumatologist. They can pinpoint the root of the pain and recommend other longer-term treatments.

What else can I do to treat arthritis pain?

Topicals can offer in-the-moment pain relief, but they won’t be a long-term fix, They work best in tandem with other treatments, the experts say. These options include physical therapy, cortisone injections, compression products, acupuncture, massage, and stretching. Dr. Nieto recommends his patients try a cocktail of treatments rather than just one. “I think they all have a role, and most people find benefit from all of them,” he says.

Why trust Good Housekeeping?

Stephanie Anderson Witmer, the author of this article, has written about health for Good Housekeeping, Prevention and other magazines and digital brands for more than 20 years. For this article, she interviewed two doctors who treat patients with arthritis, read the research about effective ingredients, and scoured the internet for products with the best reviews from people with arthritis.

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