While oral analgesics may be the preferred treatment option for some patients, others may prefer to apply a topical product. Some customers may find that rubbing a cream or gel onto a sore muscle is effective at relieving pain. Alternatively, spray formulations can be useful for hard to reach areas.

Whatever formulation they choose, advise customers to read the manufacturer's instructions carefully and apply the product as directed. Topical products should not be applied to broken or infected skin, or near the eyes, mouth or mucous membranes.They should also not be applied alongside heat pads or underneath tight bandages. Remind customers to wash their hands thoroughly after application.

Topical NSAIDs

Topical non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac can help to relieve pain and reduce the redness and swelling caused by inflammation. Compared to oral NSAIDs, topical products carry reduced risks of potential side effects such as stomach irritation, and there is growing evidence of their effectiveness at treating chronic conditions, including OA. In fact, NICE guidelines state that oral paracetamol and/or topical NSAIDs should be considered before oral NSAIDs for OA.

However, topical products may not be suitable for children, pregnant or breastfeeding women, or people with aspirinsensitive asthma. If in doubt, check with the pharmacist. Ibuprofen is the most common OTC topical NSAID and is available in gel (e.g. Nurofen 5% Gel) and spray formats (e.g. Ibuleve Speed Relief Spray).

The NSAID diclofenac is available in topical products including Voltarol Emulgel P and Voltarol Pain-eze Emulgel. Movelat Relief Cream is a mild to moderate anti-inflammatory and analgesic topical preparation that contains mucopolysaccharide polysulphate and salicylic acid.

Rubefacients and counter-irritants

These ingredients act as irritants and produce a warm feeling in the affected area, which some people find soothing. Common examples found in OTC products include salicylates and nicotinates along with menthol, camphor, eucalyptus and turpentine oil. There are various OTC brands available, including Algesal and Deep Heat.

Such products are available in cream and spray formulations. Capsaicin occurs naturally in cayenne pepper and warms the skin when applied to sore muscles and joints. OTC products include Radian B Muscle Rub and Ralgex Cream, which contain capsicum oleoresin.

Such products should not be applied to broken or inflamed skin and users should avoid contact with their eyes, lips and other sensitive areas. Hands should be washed thoroughly after application and use should be discontinued if persistent skin irritation develops.

Complementary treatments

Arnica ointment is a popular OTC treatment, particularly for bruises and swelling after contusions. Products include Weleda Arnica Ointment and Nelson's Arnicare range. Tiger Balm is another complementary treatment option, which can be used by adults and children from two years of age to soothe sore and aching muscles.