DEAR DR. ROACH: Can you comment on why Voltaren gel is not recommended for use in the neck and shoulder area? All I could find online is that it hasn’t yet been tested for that. — J.M.
ANSWER: Diclofenac (Voltaren) is an anti-inflammatory medication that may be taken by mouth, or used topically in a gel. It’s a potent medication that is very effective for many people and is often used for arthritis pain. For superficial joints — like hands, wrists and even knees — it can be very effective. However, the joints of the cervical spine in the neck, and most of the shoulder joint, are deeper than the Voltaren can penetrate. Voltaren is not appreciably absorbed into the blood, so all of its actions are local.
It’s very safe, so you can certainly try it to see if it will work. If your pain is being caused by a more superficial source, it may well give you relief. However, since there is no indication for neck and shoulder pain, insurance may not cover it.