If you're hard core into pain relief, I can recommend this. I have arthritis in almost every joint in my body. I see a pain specialist who prescribes a cream that I have to fill at a compounding pharmacy. If you can get all of that accomplished, this is what works wonders for me:
Ketoprofen/Piroxicam/Tetracaine 20/2/2% Lipod
It's a miracle cream. Works in about 5 minutes. It's relatively expensive, but not unaffordable, and you only have to use a tiny bit. A tube lasts a long time. It probably is not covered by insurance.