Sunday, February 28, 2010

Consider topical analgesics

Better known by brand names such as Bengay or Asperchreme, these product are essentially aspirin (in the form of Methyl-salicylate) in a cream, plus other additives that cause sensations of heat and cold (in that order).

As I have discussed elsewhere, long term oral NSAID use (ibuprofen, naproxen, etc) has some significant potential downsides, (heart burn, and eventually, ulcers) which is not true for topical creams. It is certainly worth giving then a try, though they are probably better for mild pain - I don't find them sufficient for severe pain.

There are lots of varieties, but they all pretty much contain the same three chemicals, though in slightly different ratios. Interestingly, some products will only list 1-2 of the chemicals as active ingredients, but often the other 1-2 will then show up as inactive ingredients. I guess they are  trying to differentiate themselves, but it seems pretty dishonest to me. Also, they don't have to list how much of the 'inactive' ingredients they include, making less clear what you are actually getting.

The three chemicals are:
(1) Methyl-salicylate(sometimes another salicylate bonding is used, such as Trolamine) is just a way to deliver aspirin. It is the most important ingredient in these kinds of creams. This means if you have habituated to aspirin already these products probably won't do much good. For this reason I advise avoiding aspirin in pill form. Better to save its effectiveness for topical use, where the chance of stomach complications are much lower.

(2) Camphor - another topical analgesic, which produces a cooling feeling.

(3) Menthol - another cooling agent, which has the side effect of making the skin more permeable, allowing the salicylate to penetrate deeper. Menthol is also responsible for the strong smell of these products. For once, the 'fragrance' actually has something to do with the effectiveness of the product and isn't just added to improve marketability.

In addition to pain relief, there are a couple of other notable aspects of applying these creams. First, they all smell (of wintergreen (menthol), usually, though sometimes other fragrances are added as well). You'll get used to it. More notably, they burn a bit when applied. This actual contributes to the pain relief a bit, and becomes less bothersome as you get used to the creams.

You can limit the burning sensation to the area of application by wearing gloves. Unfortunately I've found that nitril gloves don't block absorption completely. Another cheaper option which actual seems to offer better protection is to use a sandwich bag to cover your hand. It is a bit more awkward at first, but much easier to put on and take off than a regular glove, and a heck of a lot cheaper. Once you are done with the bag, you can leave it in-between your skin and your cloths to prevent the cream from rubbing off.


Other pain creams

There are a few other options that are not aspirin based. You can now buy ibuprofen in a topical cream. This is a recent development, so hopefully the price will come down as more places carry it.  There are also some prescription NSAID creams, but these can be quite expensive and I have not tried them.
For something entirely different consider one of the hot-pepper rubs. These burn like crazy, but do seem to reduce pain after the burning subsides (which can take a while, perhaps as long as an hour). While a small tube will set you back $10, you only need a small dab, so it's relatively affordable. If you give this a try be sure to use as little as possible the first time, as the burning can take 30 minutes to develop and you really don't want to overdo it.  I find it makes my skin pretty sensitive so try to use it at a time when you don't have to wear clothing over the affected area.

5 comments:

Healthtec Software said...

Yes camphor has a cooling effect which is also probably used in cough drops and also hair oil and body talc for the same relaxing effect.

Electronic Medical Records

Unknown said...

Nice blog - great way to share your experiences with others... since back pain is pretty common!

I looked through some of your other posts and one thing that struck me was your post on why surgery is not necessary for bulging discs / herniated discs. I totally agree. I have a friend who suffered from intense back pain and she actually healed... naturally without any surgery. Which is GREAT on so many accounts!

She followed the approaches from a natural healing site online - www.howtohealmyback.com)... maybe you'll find some things helpful for you too!

Thanks again for your tips. :)

BodyBoon said...

Lumbar girdle, effective for back pain?

Those who are suffering from backache because of his work could benefit from lumbar girdles. At least this is the conclusion of a Netherlands study conducted among home-care workers.
Many people with back pain turn to body cinchers and back girdles, however so far there was little evidence for it. Do these gadgets are actually more effective or an invention without the support of science?
To address the problem, a team of researchers in the Netherlands tested different models of girdles in a group of employees of a company that provided home cleaning and sanitation services. The 360 volunteers (who were already suffering from back pain previously) received advice on healthy work habits that could prevent low back injuries, such as how to lift heavy things. Moreover, half the participants were given a lumbar girdle, which should be worn the days when they thought they could have back pain.
The findings of this study would appear in 'Annals of Internal Medicine. "The lumbar support can be valuable tool in new strategies for preventing back pain in the workplace," the researchers advise.
Their study showed that volunteers who took the girdle had an average of five days less of back pain every month. Thus, during the 12 month follow-up volunteers who wore lumbar girdles suffered pain during an average of 72 days, while those who only received advice, experimented backache during 124 days, "which is a clinically relevant reduction of 45%," the authors clarify. Overall, 74% of the volunteers were satisfied with the girdles, whose costs ranged from 50 to 75 Euros.
This is a contribution of BodyBoon. (Source “elmundo.es” Madrid Espana).

morahanmichael said...

I have suffered from back pain for more than thirty years, about 4 months ago I tried yoga and have now done 12 classes. Thank you Mr Iyengar I have been doing Iyengar yoga classes and they sure have worked for me.No more pain some times for more than a week and I have been able to keep working as a truck driver.
I push catering carts on and off aircraft so if I am not careful I can hurt my back. I would recommend any back pain sufferers to look at yoga it worked for me.
michael

Unknown said...

I totally agree with those back relief treatments. I also find tiger balm to be very effective for temporary and sometimes permanent relief!