Voltaren Gel: 5 Important Things Doctors Wish You Knew

Voltaren gel (diclofenac sodium topical gel) is a popular over-the-counter and prescription treatment for joint and muscle pain. Below are five key insights—backed by clinical evidence and expert opinion—that doctors wish every patient understood before using Voltaren gel.

1. How Voltaren Gel Works—and When It Helps

Voltaren gel is a topical nonsteroidal anti-inflammatory drug (NSAID). Instead of swallowing a pill, you apply it directly to your skin over the painful area. Clinical studies, including a Cochrane review of topical NSAIDs for chronic musculoskeletal pain (Derry et al., 2016), show that Voltaren gel can:

• Reduce pain and improve function in osteoarthritis of the knee and hand
• Work as effectively as some oral NSAIDs, but with lower overall drug levels in the bloodstream
• Provide relief within a week, with maximal benefit often seen in 2–3 weeks of consistent use

Common uses include:

• Knee, hand or elbow osteoarthritis
• Strains, sprains and minor sports injuries
• Tendinitis or bursitis

Doctors often recommend Voltaren gel for mild-to-moderate pain when you prefer to avoid or minimize oral NSAID side effects.

2. Applying Voltaren Gel the Right Way

Proper application maximizes benefit and minimizes side effects.

1. Clean and dry the skin – wash the area with mild soap, pat dry.
2. Measure your dose – use the provided dosing card or follow package instructions (e.g., 2 g of gel per knee, up to 4 times daily).
3. Apply a thin layer – gently rub it in until the gel disappears.
4. Wash your hands – unless you’re treating your hands, to avoid accidental contact with eyes or mouth.
5. Avoid covering – don’t bandage, wrap or apply heat over the treated area unless directed by your doctor.

Key tips:

• Space applications evenly (e.g., morning, midday, evening, bedtime).
• Do not shower or bathe for at least 1 hour after application.
• Do not exceed the maximum daily dose listed on the label or prescribed by your doctor.

3. Understanding Potential Side Effects and Risks

Topical NSAIDs generally carry fewer systemic risks than oral forms, but they are not free from side effects.

Local reactions (up to 30% of users):

• Skin redness, itching, rash or a burning sensation
• Dryness or flaking

Systemic effects (rare but important):

• Gastrointestinal irritation or ulceration (especially if you use high doses or have a history of ulcers)
• Increased blood pressure, fluid retention
• Kidney effects (reduced renal blood flow)
• Cardiovascular risks (heart attack or stroke) with long-term, high-dose use

Rainsford (2009) highlights that although diclofenac in topical form has lower systemic levels, prolonged or excessive use can still lead to toxicity. Always use the lowest effective amount for the shortest possible duration.

4. Who Should Be Cautious or Avoid Voltaren Gel

While Voltaren gel is safe for many, certain groups need extra care:

• Liver disease: People with cirrhosis or significant hepatic impairment may have altered diclofenac metabolism (D’Amico et al., 2006). Even topical use can raise liver enzymes.
• Kidney disease: Reduced renal function increases the risk of NSAID-induced kidney injury.
• Heart disease or high blood pressure: NSAIDs can worsen hypertension and increase cardiovascular risk.
• Pregnancy and breastfeeding: Avoid in the third trimester; discuss risks with your doctor if you’re pregnant or nursing.
• Children and adolescents: Voltaren gel is not approved for use in those under 14 years of age.
• Allergy to NSAIDs: If you’ve ever had hives, asthma, or other reactions to aspirin or NSAIDs, do not use Voltaren gel.

Always inform your healthcare provider about all prescription and over-the-counter medications, herbs, and supplements you’re taking to avoid interactions (e.g., with blood thinners, ACE inhibitors, or diuretics).

5. When to Seek Medical Advice and Next Steps

Voltaren gel can be a helpful part of your pain-management plan, but it’s not a cure. If your pain:

• Persists or worsens after 2–3 weeks of proper use
• Is accompanied by swelling, redness, or deformity
• Follows a severe injury or fall
• Comes with fever, chills, or unexplained weight loss

…you should talk with a healthcare professional promptly. For quick guidance, you might consider doing a free, online symptom check for joint or muscle pain to see if you need further evaluation.

Final Thoughts

Voltaren gel offers targeted relief with a lower risk of systemic side effects compared to oral NSAIDs. To get the most benefit with the least risk:

• Use only as directed
• Apply correctly and regularly
• Monitor for side effects
• Communicate openly about your health conditions and medications

This information is intended to help you use Voltaren gel safely and effectively. If you have any concerns, especially about potential liver, kidney or heart issues—or if you experience any serious or life-threatening symptoms such as difficulty breathing, severe skin reactions, sudden vision changes or chest pain—speak to a doctor right away.