Topical Analgesics for Pain

Topical analgesics can be a useful treatment addition for some people living with chronic pain. Here's what you should know about the various types of topical analgesics and their effectiveness at treating chronic pain.

Overview

Topical analgesics are pain medications that are applied directly to the skin instead of being swallowed or injected. They may come in creams, lotions, gel or patch form. Topical pain medications work in different ways for different conditions, though they are commonly used to treat musculoskeletal pain and some types of neuropathic pain. While some may require a healthcare provider’s prescription, many are available for over-the-counter purchase.

Types

• Counter-irritants: Topical pain medications that stimulate nerve endings when applied to the skin, and are used to treat musculoskeletal pain. Counter-irritants produce hot, cold or tingling sensations. These new sensations are thought to interfere with the sensation of pain. Capsaicin cream, for example is a topical counter-irritan,t
• Topical NSAIDs: Topical NSAIDs include salicylates, which are chemically similar to aspirin, and medications like diclofenac. Topical NSAIDs penetrate the tissues beneath the skin with anti-inflammatory medication, reducing swelling at the pain site. They also inhibit pain transmission from sensory nerves. These topical pain medications are used to treat musculoskeletal pain.
• Local anesthetics: Patch forms of local anesthetics can be applied to the skin, and may be worn for several hours for pain relief. These topical medications can relieve certain types of neuropathic pain.

Side Effects

Because they are designed to act locally where the medication is directly applied, the levels of medicines are very low in the body's circulation. Therefore, topical pain medications rarely produce the same degree of side effects as pill forms of medication. They do, however, carry a risk of skin irritation or swelling. Once they are removed or washed away, the irritation usually goes away within a few hours. Symptoms may be worse if topical pain medications are applied in excess of instructions, or are left on the skin for longer than advised.

Effectiveness for Chronic Pain

While chronic pain sufferers might find temporary relief with topical pain medications, many are not effective on their own for long-term pain management. So why use them? Well, for some people, topical pain medications offer tolerable pain relief with few side effects, something they may not get from other oral pain medications. They are also useful for people who do not tolerate typical painkillers well.

Topical creams like NSAIDs and counterirritants may also be used along with other medications to manage chronic musculoskeletal pain, such as arthritis. Local anesthetics may be used to manage breakthrough pain caused by nerve damage. Talk to your healthcare provider to find out if topical analgesics are right for you and your pain.