The simplest, cheapest and most effective treatment for any muscular ache (presuming that the muscle has not been torn or damaged and does not need any sort of physical support) is aspirin. There are products which are specifically advertised for the treatment of rheumatic pains but which contain aspirin. Cojene, Fjnnon Calcium Aspirin and 30 Days Rheumatic Tablets are but three of the aspirin-based products recommended by their manufacturers for the relief of rheumatic pains. In my opinion these are no better than other forms of aspirin described on p134.

More popular than aspirin but probably less effective are the rheumatic balms, ointments, embrocations and rubbing liniments which are available. These work in several ways: they may irritate the skin thereby distracting the patient from the deep muscular pains, they may simply smell good and have a placebo effect, or they may help because they provide a good excuse for some gentle massage. It is certainly true that rubbing an affected part of the body can do wonders, and rubbing oils do make massaging easier to perform. Those liniments which irritate the skin dilate superficial blood vessels and therefore produce redness and warmth. Similar effects can be obtained by applying heat to the muscles either through a hot-water bottle or a warm bath. The heat increases the circulation in the skin and also deeper in the tissues.

It is important to remember that rubbing oils and other substances should not be used on cracked, cut or infected skin.

Choosing a liniment or balm, rub or embrocation is largely a matter of taste, or rather smell. I don’t feel that there is a great deal to choose between the following products on purely medical grounds: Algesal, Algipan, Aradolene, Aspellin, Atlas Athletic Embrocation, Balmosa, Bajolin, Bengue’s Balsam, Boots Embrocation, Boots Menthol and Wintergreen Embrocation, Boots Pain Relieving Balm, Buxton Rubbing Bottle, Crema/gex, Cremalgin, Cremathurm R, Deep Heat, Eade’s Anodyne Rheumatic Balm, E/liman’s Embrocation, Embrolin, Fibrosine Balm, Fiery Jack Rubbing Cream, Fisherman’s Friend Rubbing Ointment, Garlisol Rheumatic Balm, George’s American Marvel Liniment, Glenol Rubbing Oils, Goddard’s White Oil Embrocation, Gonne Analgesic Cream, Infurno Embrocation, Infuruo Massage Cream, Intralgin, Kil-pain Menthol and Wintergreen Cream with Mustard, Menthol and Wintergreen Cream, Mentholatum Balm, Mentholatum Deep Heat Rub, Nasciodine Medicated Massage Cream, Panigo Balm, Parkinsons White Embrocation, Radian A Spirit Dressing, Radian B Spirit Liniment, Radian Massage Cream, Ralgex Balm, Ra/gex Embrocation Stick, Samaritan Menthol and Wintergreen Cream, Seven Rubbing Oils, Sloan’s Liniment, Soothene Ointment, Tiger Balm, Transvasin and Vadarex Wintergreen Ointment. Algipan and Deep Heat are among the most popular of these remedies.

Choosing a rub (the words balm, embrocation, rub and liniment are interchangeable for all practical purposes) can be done on a price and weight basis. Compound Methyl Salicylate Ointment BPC (oil of wintergreen) is a relatively cheap non-branded rub. Many of the branded rubs contain methyl salicylate as an important ingredient. Since this substance has the actions of aspirin but is well absorbed through the skin it can have a direct effect on the troubled muscles.

Witch hazel, often used for cooling and soothing bruises and sprains, is another ingredient of branded products and can be bought as Witch Ha^el BPC. Turpentine Liniment BP and White Liniment BPC are also available and effective.

It is fashionable today to put everything into spray cans. So there are sprays available for use on aching muscles. These are often used with miraculous effect on wounded footballers! Products in this category include Aerocol Pain Relieving Spray, Dubam, PR Spray, Ralgex Analgesic Spray and Skefron. Bath salts which are designed to help people with muscular ailments include, among others, Luma Medicated Bath Salts, Radian Bath Salts and Radox. Hot baths, with or without added ingredients, will almost certainly provide some relief.

Copper bracelets and bangles have long been popular but there is no scientific evidence that I know of which shows that these are more effective than other old wives’ cures. Those fascinated by the unusual may be interested to know that the following have been recommended for the prevention of rheumatism: carrying the right foot of a hare in the left pocket; putting a nutmeg, mole’s paw, piece of brimstone, female hedgehog jaw, potato, magnet or cork in any pocket; swallowing a spider or carrying one round in a small box; and making a necklace out of chestnuts gathered by rheumatism-free children. Sufferers seeking a solution have been advised to eat celery, drink poppy tea, tie an adder’s skin around the leg, thrash affected parts of the body with stinging nettles, drink tea made from willow bark, or arrange to be stung by bees. Drinking tea made from willow bark is particularly interesting since it was from the willow tree that aspirin was first isolated.

There are an enormous number of herbal remedies available for the treatment of rheumatic and other muscular ailments. I know of no evidence suggesting that any of them are more effective than ordinary aspirin tablets. Nor is there any evidence that convinces me that electrical massagers are more effective than ordinary hand massage. They are certainly more expensive. I do not recommend enzyme preparations such as Chy moral for the home treatment of muscular or soft tissue disorders.

One of the best-known remedies for rheumatic pains is Fynnon Salt. The main ingredient of this product is sodium sulphate which is a laxative. There is no medical evidence that I know of which supports the use of laxatives in the treatment of muscular aches and pains or any form of rheumatism. Other health salts which are described on pp89-90 also contain laxatives.

Any muscular ache or pain which does not improve after five days’ treatment with aspirin or paracetamol tablets, or which is not relieved by massage within a similar period of time, should be treated by a doctor. Muscular damage resulting from injury may need to be examined by a doctor without home remedies being applied. Any pain, swelling or limitation of movement which deteriorates rather than improves after treatment should be treated professionally.