Are there any arthritis creams available in the USA?

Topical Arthritis Creams Available in the USA

Yes, there are several effective topical arthritis creams available in the USA, with topical diclofenac and capsaicin being the most evidence-supported options for arthritis pain relief. 1

FDA-Approved Topical NSAIDs

• Diclofenac is the only commercially manufactured topical NSAID currently available in the United States and comes in various formulations (gel, solution, patch) 1
• Topical diclofenac has been shown to be superior to placebo and equivalent to oral diclofenac in reducing pain associated with osteoarthritis of the knee 1
• Topical NSAIDs have markedly fewer gastrointestinal adverse events compared to oral NSAIDs, though they may cause more local skin reactions 1, 2

Capsaicin-Based Products

• Topical capsaicin (0.025% to 0.075%) is available over-the-counter and works by depleting substance P, a neuropeptide involved in pain pathogenesis 1, 3
• Capsaicin cream has demonstrated effectiveness in reducing arthritis pain, with studies showing mean reductions in pain of 57% for rheumatoid arthritis and 33% for osteoarthritis after four weeks of treatment 3
• Capsaicin may need to be applied continuously for 2-4 weeks before experiencing full therapeutic effect due to its mechanism of action 1
• Common side effects include burning or stinging sensation at the application site 1, 3

Other Topical Options

• Menthol-containing products are available over-the-counter and provide cooling sensation that may temporarily relieve pain 4, 5
• Combination products containing multiple active ingredients (menthol with other counterirritants) are commonly available 5
• Herbal-based topical therapies such as arnica gel and comfrey extract gel have shown some evidence of effectiveness in clinical trials 6

Clinical Recommendations for Use

• Local treatments are preferred over systemic treatments, especially for mild to moderate pain and when only a few joints are affected 1
• The European League Against Rheumatism (EULAR) recommends topical NSAIDs and capsaicin as effective and safe treatments for hand osteoarthritis 1
• For knee osteoarthritis, the American College of Rheumatology/Arthritis Foundation gives a "strong for" recommendation for topical NSAIDs 1
• Topical treatments are particularly beneficial for elderly patients (≥75 years) who should preferably use topical NSAIDs over oral NSAIDs including celecoxib 7

Safety Considerations

• Topical NSAIDs carry warnings about potential allergic reactions, especially in people allergic to aspirin 2
• Although topical NSAIDs have better safety profiles than oral NSAIDs, they still carry warnings about potential liver damage if used excessively 2
• Avoid applying topical products on wounds, damaged skin, or mucous membranes 2, 4
• Do not bandage tightly after application of topical products 4
• Stop use and consult a doctor if condition worsens, symptoms persist for more than 7 days, or excessive skin irritation develops 2, 4

Practical Usage Tips

• Apply topical products as directed, typically 3-4 times daily for optimal effect 3
• Wash hands thoroughly after application unless treating hand arthritis 2
• For capsaicin products, be aware that initial burning sensation is normal and typically diminishes with continued use 1, 3
• Topical treatments can be used alone for mild cases or as part of a comprehensive treatment approach for more severe arthritis 1

In summary, topical arthritis creams provide a valuable treatment option for many arthritis patients, particularly those who wish to avoid systemic side effects of oral medications or who have contraindications to oral therapies.