KESTNER: Instead of a pill, consider a topical pain reliever

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For decades, Americans have sought pain relief in a bottle of pills. This practice is so universal that it is almost instinctive to reach for a pill when pain becomes uncomfortable.

In other parts of the world, people rely on other means of applying medication to a sore back or aching joint.

In China, some experts estimate that as many as half the population routinely uses patches or topical applications of medication for pain relief.

In our office we have used pain relieving creams and patches from Asian sources for more than two decades with good results. We have also used products produced domestically.

It is estimated that in Europe as many as one third of the population is reliant on topical applications more than pills.
This trend is growing in America.

Topical applications include any type of healing or medicinal cream, gel, lotion or patch that is applied onto the skin near the source of pain or pathology.

You may have seen advertisements increasing for products such as pain relieving creams and patches. This type of product often uses an ingredient such as menthol, camphor or other aromatic component to relieve pain.

In many cases the pain relief that is obtained from these types of applications can be swift and effective. The relief may last anywhere from an hour to several hours, depending upon the product and the patient’s unique condition.

Topical preparations may sometimes be confused with what are known as transdermal medications.

Topical medications are typically applied very close to the site of the pain or pathology.  Examples might be menthol creams for pain relief or antibiotic creams to inhibit infection at the site of a cut or abrasion.

In our office we have also used topical creams that have a benefit in speeding healing from trauma such as bruising, sprains or strains.

Transdermal medications are similar in the way they are applied, but the purpose is quite different.  Trans in this case means to move across and dermal refers to the skin. A transdermal medication is intended to be absorbed into the bloodstream and is targeting a tissue or organ that may be distant to the application site.  In the case of transdermal medication the skin is merely used as a conduit for the medication to reach the capillaries and therefore the bloodstream.

Primary considerations for where to use a transdermal medication include how well the medication can be absorbed at particular locations and also avoiding areas where the skin may be irritated or damaged.

Topical medications are intended mostly for localized effect and do not often result in significant transportation of the ingredient through the bloodstream. They are also less likely to result in skin irritation or systemic side effects compared to transdermals.

That is another big advantage of using tropical preparations rather than pills, liquids or tablets that are taken orally. The oral medications much be broken down in the gastro-intestinal system and may impact the liver or kidneys or other organs, topical pain relieving creams, gels or patches are applied directly to the area of pain and thereby bypass the routes that are most likely to result in systemic side effects.

This can be a significant advantage for most patients, but especially so for patients that has stomach or digestive issues or that may be taking several medications.

Topical applications do have some negatives such as brief effectiveness compared to some oral medications. In some cases patients may not particularly like a fragrance associated with some ingredients or may object to the feeling of some products on their skin.  However, many products are available with either a pleasant fragrance or fragrance-free versions. Product bases have been improved in the past decade to include sprays, gels, dry applications or lotions that are easily absorbed.

There are enough advantages for most people with muscle or joint pain to consider trying a patch or topical pain relieving cream or gel instead of over the counter pills that I routinely recommend this option.

These medications should only be used for temporary pain, however. I recommend that anyone that has pain for more than a few days to be evaluated.

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