Several types of over-the-counter creams can help manage bursitis pain, with topical anti-inflammatory gels being the most effective option for reducing both pain and swelling. The best choice depends on where your bursitis is, because creams work significantly better on joints close to the skin surface, like the knee, elbow, and shoulder, than on deeper joints like the hip.
Topical Anti-Inflammatory Gels
Topical NSAIDs (nonsteroidal anti-inflammatory drugs) are the strongest over-the-counter cream option for bursitis because they target inflammation directly, not just pain. Diclofenac gel, sold under brand names like Voltaren, is the most widely available. You rub it into the skin over the inflamed bursa, and the active ingredient penetrates to reduce swelling in the tissue underneath.
The advantage over popping an ibuprofen pill is significant. Topical NSAIDs deliver their effect locally, with only about 5% of the drug entering your bloodstream. That dramatically lowers the risk of stomach problems. One study found that switching from oral to topical NSAIDs reduced the rate of severe gastrointestinal side effects from 26% to 17%. The tradeoff is mild: the most common side effects are dry skin and itching at the application site.
Menthol and Capsaicin Creams
If you want something that works differently, or want to layer pain relief alongside an anti-inflammatory gel, counterirritant creams are a solid second option. These come in two main varieties.
Menthol-based creams (like Biofreeze or Icy Hot) create a cooling or warming sensation on the skin that blocks pain signals traveling to the brain. They don’t reduce inflammation, but they can take the edge off, especially during flare-ups. Most are applied three to four times daily.
Capsaicin cream works through a different mechanism. Capsaicin, the compound that makes chili peppers hot, depletes a chemical your nerves use to send pain signals. It takes consistent use over one to two weeks before you notice real results, and the initial burning sensation can be intense. If you stick with it, many people find it provides meaningful, ongoing relief. Capsaicin creams typically come in concentrations between 0.025% and 0.1% over the counter.
Lidocaine Creams and Patches
Lidocaine is a numbing agent that blocks nerve impulses in the area where you apply it. Over-the-counter lidocaine creams and patches (usually 4% strength) can temporarily dull bursitis pain, particularly when the area is very tender to touch. They don’t address inflammation at all, so they’re best used for short-term relief during acute flare-ups rather than as a daily strategy.
Prescription-strength lidocaine patches (5%) are sometimes recommended for more persistent pain. Doctors also commonly mix lidocaine with a corticosteroid for direct injection into a bursa, which is a different treatment approach than what you’d use at home.
Why Location Matters
Here’s something most people don’t realize: topical creams work best on bursae that sit close to the skin’s surface. The Mayo Clinic notes that topical pain products are most effective for joints in the hands and knees, where skin is thinner and the target tissue is shallow. Bursitis in the elbow (olecranon bursitis), kneecap (prepatellar bursitis), or outer shoulder responds well to creams because the inflamed bursa is just beneath the skin.
Hip bursitis is a different story. The trochanteric bursa sits deep beneath layers of muscle and fat, making it much harder for topical medications to reach in meaningful concentrations. If you have hip bursitis, a cream might provide some surface-level comfort, but oral anti-inflammatories or a corticosteroid injection from your doctor will likely be more effective.
How to Apply Bursitis Creams Safely
A few important rules will help you get the most benefit with the least risk. Apply the cream generously over the affected area, but avoid broken, irritated, or sunburned skin. The FDA specifically warns against applying topical pain products heavily over very large areas of skin, as this increases the chance of the active ingredient entering your bloodstream at higher-than-intended levels.
Don’t wrap the treated area with plastic wrap, bandages, or tight clothing. Covering treated skin traps the medication against your body and can increase absorption to potentially dangerous levels. This is especially true for lidocaine products, which can cause serious side effects when applied over large areas and then covered. Keep treated skin open to the air.
Most over-the-counter creams can be applied three to four times per day. Space applications evenly and wash your hands thoroughly after use, particularly with capsaicin cream (touching your eyes after applying it is memorably unpleasant). If you’re using both a topical NSAID and a counterirritant, apply them at different times rather than layering them simultaneously, and check that neither interacts with other medications you take.
Choosing the Right Cream for Your Situation
- For active inflammation and swelling: A topical NSAID like diclofenac gel is the strongest choice because it addresses the underlying inflammation, not just pain.
- For quick, temporary relief: Menthol-based creams provide fast-acting pain masking and are useful while waiting for anti-inflammatory treatments to kick in.
- For chronic, ongoing bursitis pain: Capsaicin cream, used consistently for at least two weeks, can reduce pain signaling over time.
- For acute tenderness: Lidocaine creams or patches numb the area and help when the bursa is too painful to touch or sleep on.
Keep in mind that creams treat symptoms, not the cause. Bursitis that doesn’t improve within a couple of weeks with rest, ice, and topical treatment may need a corticosteroid injection or physical therapy to fully resolve.