Topical Pain Relief

What is topical pain relief?

Topical pain relief agents are applied directly to the skin to relieve pain.  There are a variety of topical formulations available: cream, gel, ointment, balm, patch, and spray.  The goal of using a drug topically is to reduce inflammation and nerve pain only at the affected area of the body.  Another benefit of topical pain relief is to avoid the side effects of oral pain medications.  Topical pain relief is especially useful for mild arthritis that affects a few joints, neck or low back sprain/strain, muscle and joint pain, as well as some types of nerve pain.

What are common topical pain relievers?

Most topical pain relievers contain local anesthetics, analgesics, or counterirritants alone or some combination of more than one of these agents.

Local anesthetics relieve pain by blocking nerve pain impulse transmission.  Local anesthetics work on the site at which they are applied and produce a numbing sensation.  The effect of local anesthetics is short lived as it only lasts around 15 to 45 minutes.

Analgesics relieve pain by reducing the swelling and inflammation that produces pain.  Most often, the analgesics used in topical pain relievers are non-steroidal anti-inflammatory drugs (NSAIDs).

Counterirritants relieve pain by stimulating nerves.  The pain relief effect is a result of producing a less severe pain to counter the intense pain caused by arthritis, injury, trauma, etc.  Counterirritants produce the pain relief effect by causing a cooling sensation or by causing heat due to increased blood flow to the area.  Still other counterirritants obtain pain relief by causing minor irritation to the skin which produces a tingling or prickly sensation.

Some topical pain relievers are available over-the-counter but others require a prescription.

Over-the-Counter (OTC) topical pain relief products:

• Local anesthetics commonly used in OTC preparations are benzocaine and lidocaine and can be found in products such as Solarcaine and Americaine gels and sprays.
• Counterirritants most often found in OTC products are methyl salicylate, camphor, menthol, histamine, capsicum, and capsaicin.  Some examples of products containing counterirritants are Aspercreme (menthol), Icy Hot (menthol), Capzasin (capsaicin), and Aspercreme (trolamine salicylate).  A variety of combination products are also available.

Prescription topical pain relief products:

• Topical analgesics are commonly used to treat pain due to arthritis and muscle and joint injuries.  Voltaren (diclofenac) gel is a commonly prescribed topical pain reliever for patients with arthritis in specific joints who do not wish to take oral medications.  Compounded products with topical analgesics are also available with a prescription.  Often compounded creams, ointments, and gels contain ketoprofen, an NSAID that is no longer taken orally, and can be applied to joints and muscles in small amounts but have adequate pain relieving properties.

Are topical pain relief products right for me?

It is important to remember that although these products are topical, they still contain drugs that can be harmful when used inappropriately.  You should consult with a pharmacist or doctor to determine if topical pain relievers are for you, then examine the directions and package inserts carefully before using a topical pain relief product.