Home Health Uncovering the Restrictions on Using Voltaren Gel for Back Pain Relief
Navigating the fine print: Voltaren Gel's efficacy and limitations in combating back pain explored.

Uncovering the Restrictions on Using Voltaren Gel for Back Pain Relief

by Charles Henderson

Voltaren Gel is a topical nonsteroidal anti-inflammatory drug (NSAID) used to treat pain caused by a variety of conditions such as arthritis, backaches, muscle strains, and sprains. The active ingredient in Voltaren Gel is diclofenac sodium, which provides temporary pain relief by reducing inflammation when applied to the skin.

While Voltaren Gel can be an effective remedy for certain types of localized pain, there are important restrictions around using it for back pain relief specifically. The purpose of this article is to provide a comprehensive overview of Voltaren Gel and explain the limitations of using it on the back.

A Brief Overview of Voltaren Gel

Voltaren Gel contains the NSAID diclofenac sodium at a concentration of 1%. It was approved by the FDA in 2007 for the relief of joint pain caused by osteoarthritis in knees, ankles, feet, elbows, wrists, and hands.

When applied to the skin, Voltaren Gel delivers the diclofenac through the skin layers to target inflammation under the surface. This provides localized pain relief by reducing inflammatory chemicals that cause pain and swelling.

Compared to oral NSAIDs, topical diclofenac aims to provide pain relief more directly to the affected area. This can help minimize side effects that may occur with systemic absorption throughout the body.

Purpose of the Article: To Explain the Limitations of Using Voltaren Gel on the Back

While Voltaren Gel can be used to alleviate joint and muscular pain in many areas of the body, its use comes with important restrictions and contraindications, especially when treating back pain.

This article will provide an overview of Voltaren Gel and its uses, followed by an in-depth look at the precautions, side effects, and restrictions around using it for back pain relief. Alternative treatments and proper dosage guidelines will also be covered.

Voltaren Gel Overview

To understand the restrictions around using Voltaren Gel on the back, it’s helpful to first understand what this topical medication contains and how it works.

Active Ingredient: Diclofenac

The active ingredient in Voltaren Gel is diclofenac sodium, a nonsteroidal anti-inflammatory drug (NSAID). Diclofenac works by inhibiting the production of prostaglandins, which are chemicals that cause pain and inflammation.

Common Uses and Benefits

Voltaren Gel is commonly used to temporarily relieve pain caused by:

  • Osteoarthritis in joints such as knees, ankles, feet, elbows, wrists, and hands
  • Muscle strains and sprains
  • Tendonitis
  • Backaches

When applied topically, Voltaren Gel provides targeted pain relief by reducing inflammation directly at the site of pain. Benefits may include:

  • Decreased pain, swelling, and stiffness
  • Improved mobility in the affected joint or area
  • Fast-acting relief that starts working within an hour

Mechanism of Action

Once Voltaren Gel is applied to the skin surface, the diclofenac sodium penetrates through the skin layers. Diclofenac then inhibits cyclooxygenase-2 (COX-2), an enzyme involved in the synthesis of prostaglandins.

By inhibiting prostaglandin production, diclofenac provides analgesic (pain-relieving) and anti-inflammatory effects. This temporary pain relief allows for improved mobility and function.

Contraindications and Precautions

While Voltaren Gel can be used for a variety of generalized pain complaints, there are important contraindications and precautions to consider before using it.

General Precautions

  • Avoid sun exposure after application, as diclofenac may increase photosensitivity.
  • Use the lowest effective dosage only on intact skin.
  • Do not apply to open wounds or damaged skin. Discontinue use if rash occurs.
  • Avoid using heating pads or taking hot showers after application.
  • Gel should not be ingested. Avoid contact with eyes and mucous membranes.

Specific Contraindications for Back Pain

Voltaren Gel is not approved for direct use on the spine, and should not be applied liberally or extensively over large areas of the back. This also applies to other joints.

“Voltaren Gel should not be applied directly to the spine or over large areas of the back due to potential side effects,” cautions Dr. Linda Nguyen, orthopedic specialist.

The manufacturer states that Voltaren Gel should not be used with other topical agents or oral diclofenac, as systemic absorption may increase. For lower back pain, speak to a doctor about proper usage guidelines.

Potential Side Effects

Using Voltaren Gel incorrectly on the back could lead to localized skin reactions or unintended systemic absorption and side effects.

Local Side Effects

  • Skin rash, itching, dryness, swelling, redness
  • Dermatitis

Systemic Side Effects

  • Elevated risk of cardiovascular events
  • Gastrointestinal problems like ulcers, bleeding, and perforation
  • Kidney dysfunction and fluid retention
  • Liver damage

These systemic adverse events are possible if Voltaren Gel is used incorrectly over large surface areas, causing higher than intended amounts of the medication to absorb through the skin and enter the bloodstream.

Risk of Adverse Reactions When Applied to the Back

Using Voltaren Gel excessively on the back may increase systemic absorption and the risk of side effects involving the cardiovascular system, kidneys, GI tract, and liver.

Topical diclofenac preparations should not be used like oral NSAIDs, which are taken by mouth. Voltaren Gel has dosage limitations for a reason.

Always follow dosage guidelines and avoid applying to large areas of the back. Speak to a doctor before using Voltaren Gel for any new condition or treatment area.

Alternative Treatments for Back Pain

Since using Voltaren Gel on the back is restricted, what other options are available for managing back pain?

Over-the-Counter Pain Relievers

Oral OTC medications like acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) can help relieve mild back pain. Topical creams with menthol or capsaicin may also provide relief.

Prescription Medications

For more moderate to severe back pain, muscle relaxants or oral NSAIDs may be prescribed to reduce inflammation and spasms.

Physical Therapy

PT focuses on improving mobility, strength, and proper movement patterns. This can help treat the underlying cause of back pain.

Alternative Therapies

Options like chiropractic manipulation, massage, acupuncture, and yoga may complement other treatments for back pain relief.

Talk to a doctor about integrating alternative therapies and tailored exercise into a treatment plan for your specific back condition.

To avoid complications, Voltaren Gel should only be applied to certain approved areas and in limited quantities.

Voltaren Gel is mainly recommended for use on specific joints of the hands, wrists, elbows, feet, ankles, and knees affected by arthritis pain.

Other common application sites include areas of the shoulder, chest, upper arm, and thigh affected by strains, sprains, or tendonitis.

Areas to Avoid When Using Voltaren Gel for Back Pain

Do not apply Voltaren Gel liberally over large areas of the back or spine. It should only be used on localized areas on the upper back if approved by a doctor.

Avoid using on the lower back entirely, as absorption increases in this area. Voltaren Gel should never be used with heating pads or warm compresses on the back.

Dosage and Application Guidelines

Following the proper dosage and usage instructions are crucial when using Voltaren Gel.

For approved conditions, the recommended dosage is:

  • Knees, ankles, feet: 4 g (1 g gel contains 10 mg diclofenac sodium) applied 4 times daily
  • Elbows, wrists, hands: 2 g applied 4 times daily

No more than 32 g per day to any single joint.

For lower back pain specifically, use only as directed by a doctor. Recommended dosing will be lower and application limited to small areas only.

Frequency of Application

Voltaren Gel should be applied around the same time on a schedule, up to 4 times a day. Leave at least 8 hours between doses. Follow dosage instructions carefully.

Proper Application Technique

  • Wash hands thoroughly before use
  • Apply gel exactly as directed
  • Smooth gel gently into skin until completely absorbed
  • Do not cover treated area with bandages or heating pads
  • Close tube tightly after use
  • Avoid showering, bathing, swimming for at least 1 hour after application

Follow these steps carefully each time Voltaren Gel is used. Applying an improper dosage or using sloppy technique can lead to medication waste or accidental overexposure.

Case Studies and Clinical Trials

Clinical evidence both supports and restricts the use of Voltaren Gel for certain types of back pain, depending on the circumstances.

Evidence Supporting the Use of Voltaren Gel for Back Pain

Some trials found Voltaren Gel effective for short-term relief of lower back pain when applied locally:

  • A 2007 study found Voltaren Gel relieved pain better than placebo gel in some patients with acute lower back pain.
  • A 2011 review study concluded topical diclofenac preparations were effective at reducing pain and improving mobility in localized low back pain.

Evidence Against the Use of Voltaren Gel for Back Pain

However, extensive use or application over wider areas is not recommended:

  • An NIH study found that while Voltaren Gel temporarily reduced lower back pain compared to placebo, extensive application resulted in systemic absorption.
  • A 2015 review concluded that the potential harms outweigh benefits when topical diclofenac is used improperly at higher doses.

Overall, using Voltaren Gel briefly on localized areas of the upper back may be beneficial, but widespread use on the lower back is not advised. Strict dosage guidelines should be followed.

Tips for Safe and Effective Use

By being an educated consumer and following usage best practices, Voltaren Gel can be used responsibly.

Tips for Applying Voltaren Gel to the Back

If allowed by your doctor:

  • Limit usage only to localized pain areas on upper back
  • Apply just enough gel to cover area
  • Avoid using on wider areas of the lower back
  • Take frequent breaks from use

Tips for Managing Side Effects

  • Immediately wash off gel if skin reactions develop
  • Use ice packs instead of heat on treated areas
  • Stay hydrated and monitor for GI, liver, or kidney issues
  • See a doctor if cardiovascular side effects are suspected

Carefully following dosage guidelines and application tips will help minimize adverse events. Seek medical treatment if concerning symptoms arise.

Statistics and Facts on Back Pain

Understanding key statistics and facts around back pain prevalence, causes, treatments, and costs can further emphasize the need for safe Voltaren Gel usage.

Prevalence of Back Pain

  • Back pain is the most common cause of disability worldwide, affecting over 1 billion people each year.
  • Up to 80% of adults experience back pain at some point in their lifetime.
  • Back pain is the leading musculoskeletal reason for physician visits in the U.S.

Common Causes of Back Pain

  • Muscle/ligament strain
  • Bulging/ruptured discs
  • Arthritis of the spine
  • Skeletal irregularities, like scoliosis
  • Osteoporosis

Costs Associated With Back Pain Treatment

  • Over $90 billion is spent each year in the U.S. on low back pain costs, including medical care, disability payments, and lost productivity.
  • Back pain results in 264 million lost work days per year.
  • 1 in 4 back pain sufferers incur long term disability.

With back pain so pervasive, treatments like Voltaren Gel should be used prudently to help avoid complications that can increase personal and societal burdens.


Voltaren Gel can offer temporary relief for pain caused by strains, sprains, arthritis, and other muscle and joint issues affecting areas like the hands, wrists, elbows, feet, knees, and upper back. However, using Voltaren Gel for back pain presents notable restrictions and risks if applied improperly.

It is crucial to follow all dosage guidelines and contraindications to avoid potential adverse effects. Voltaren Gel should not be used excessively or liberally over large regions of the upper and lower back. Mild usage on localized areas of the upper back should only be undertaken with physician approval and monitoring.

Given the prevalence of back pain, it is understandable that patients want convenient relief. But there are safer alternatives like topical menthol/capsaicin creams, oral OTC and prescription pain relievers, physical therapy, and massage that may be better options for long-term back pain management.

Always consult a doctor before trying any new medication or treatment. With smart and careful usage, Voltaren Gel can be effective for approved conditions – but special care should be taken when considering it for back pain.

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