Voltaren vs. Natural Pain Creams for Knee Arthritis: What the Evidence Actually Says
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Short answer
- Voltaren gel is a topical NSAID. Topical NSAIDs for knee and hand osteoarthritis carry a strong recommendation in the 2019 American College of Rheumatology / Arthritis Foundation guideline.
- Topical capsaicin has a conditional recommendation for knee osteoarthritis in the same guideline.
- Natural creams built on MSM, DMSO, arnica or herbal blends rest on much thinner evidence: the published MSM and DMSO studies are small, and no guideline we found names these creams as a recommended option.
- That does not make a natural cream useless for everyone. It means you should judge one by its label, price, refund terms and how your body responds, and check with a pharmacist first.
What U.S. arthritis guidelines recommend for topical pain relief
If you search "natural alternative to Voltaren gel," most results are product pages. Few start with the question that matters most: what does the medical evidence actually support? The most widely cited U.S. guidance for osteoarthritis comes from the American College of Rheumatology (ACR) and the Arthritis Foundation. Their 2019 guideline is summarized below.
| Topical option | What it is | Guideline position (knee OA) | Worth asking a pharmacist |
|---|---|---|---|
| Topical NSAID (e.g., diclofenac gel, sold as Voltaren Arthritis Pain) | Anti-inflammatory drug applied to the skin | Strong recommendation (knee and hand OA) | Use alongside oral NSAIDs or blood thinners? Any kidney, stomach or heart concerns? |
| Topical capsaicin | Chili-pepper-derived compound; causes a warming/burning sensation | Conditional recommendation (knee OA) | Skin sensitivity; avoid contact with eyes; how long before it helps? |
| "Natural" creams and drops (MSM, DMSO, arnica, willow bark, hemp oil, aloe, menthol blends) | Varies widely by brand; many use ingredient blends | Not among the topical options highlighted in the guideline coverage we cite; evidence for MSM and DMSO comes from a small number of short trials | What is the concentration? Is there a published trial of this product? |
The same guideline also gives prominent weight to non-drug approaches, including exercise (tai chi is one of the options it names). If you only change one thing, a supervised or guided movement routine is often better supported than any cream.
What research says about common "natural cream" ingredients
MSM (methylsulfonylmethane)
MSM and DMSO are chemically related sulfur compounds, and they are often studied together. A published meta-analysis of DMSO and MSM trials in knee osteoarthritis is open access, and it is worth reading the abstract and limitations yourself. The key point for shoppers: these analyses pool a small number of short studies, so they are a long way from the guideline-backed evidence behind topical NSAIDs. Most MSM trials also use oral MSM, not creams, so you cannot assume a cream gives the same result.
DMSO
DMSO is a solvent that moves readily through skin. According to Medical News Today, the FDA has not approved it for arthritis; its only FDA-approved use is for interstitial cystitis, a bladder condition. Because it can carry other substances through the skin, it deserves its own safety checklist; see our guide: DMSO pain drops: questions to ask your pharmacist first.
Arnica, willow bark, hemp oil, aloe, menthol
These show up on almost every natural-cream label. A long ingredient list does not tell you whether a finished product works. What matters is the amount in the product, whether the maker publishes it, and whether that exact formula was ever tested. If the label says "proprietary blend" with no amounts, you cannot compare it to anything.
A 7-point label check for any natural pain cream
- Full ingredient list with amounts. "Proprietary blend" hides doses.
- No disease claims. Words like "cures," "reverses," or "ends arthritis" are a red flag. The FTC's Health Products Compliance Guidance explains that health claims need solid scientific support.
- A real company address and contact. A P.O. box with no phone is a warning sign.
- Refund terms you can find and read before buying. Note the window, whether you must return the product, and who to contact. See our guarantee comparison.
- Independent testing or batch information, if offered.
- A patch-test instruction. Responsible makers tell you to test a small area first.
- A medication warning. Any product that says "no interactions, safe with everything" is overclaiming. Ask a pharmacist.
How to try a natural cream sensibly
- Do a patch test on a small area and wait 24 hours.
- Before you start, rate your pain 0–10 and write it down; re-rate daily for two weeks. Without a baseline, it is easy to fool yourself either way.
- Do not stop a prescribed treatment because of a product page.
- Do not layer several topical products on the same skin without asking a pharmacist.
- Save your order confirmation and the refund terms, and note the deadline on your calendar.
- Stop and call your doctor if you get a rash, blistering, or swelling.
Where our reviews fit
If you have read the evidence above and still want to look at natural options, these are our reviews. We review them using the manufacturers' published information and public research, not our own clinical testing, so treat them as a starting point for your questions.
Frequently asked questions
Is there a natural alternative to Voltaren gel?
Several natural creams are marketed that way, but Voltaren gel is a topical NSAID, a drug class with a strong recommendation in the 2019 ACR/Arthritis Foundation osteoarthritis guideline for knee and hand OA. The evidence for MSM, DMSO, arnica or herbal blends is much thinner, so compare labels, refund terms and your own response, and check with a pharmacist.
Does MSM cream work for knee arthritis?
Published reviews of MSM and DMSO in knee osteoarthritis pool a small number of short trials, and many MSM studies used oral MSM rather than creams. That is not the same strength of evidence as guideline-backed options, so results from a cream cannot be assumed.
Can I use a natural cream together with Voltaren?
Ask a pharmacist before layering topical products on the same skin. Some ingredients, such as DMSO, can carry other substances through the skin.
How long should I try a new cream before deciding?
Track your pain on a 0–10 scale before you start and for about two weeks afterward, and stay inside the product's refund window. If you see no change or get skin irritation, stop and talk to your doctor or pharmacist.
Related on NaturalPainLab
Sources
- RheumNow: ACR/Arthritis Foundation osteoarthritis treatment guidelines (summary of the 2019 guideline; topical NSAIDs for knee and hand OA listed as a strong recommendation, topical capsaicin for knee OA as a conditional recommendation)
- BioSpace: new osteoarthritis treatment guidelines conditionally recommend topical capsaicin for knee OA
- Meta-Analysis of the Related Nutritional Supplements Dimethyl Sulfoxide and Methylsulfonylmethane in the Treatment of Osteoarthritis of the Knee (open access, PubMed Central)
- Medical News Today: DMSO for arthritis
- FTC: Health Products Compliance Guidance
This page is general information, not medical advice. Talk to your doctor or pharmacist before starting or changing any treatment, especially if you take prescription medication.