IMAGE - Shefford Osteopathic Clinic logo

Opening Hours:
Monday to Friday: 9:00 – 5:30, Saturday: 9:00 – 12:00

Do Topical Pain Relief Creams and Gels Really Work?

Most of us have pulled a muscle before and used topical pain relief to ease the pain.  Maybe your joints ache when it gets cold and a pain relief gel does the trick?  If you’re developing arthritis, chances are you’ve reached for a topical pain relief method at some point.

Whatever the case may be, topical pain relief creams and gels can alleviate some of your pain — when applied directly to the skin right over the pulled muscle or sore joint.

Here’s what you need to know about the 4 types of topical pain relief products…

1.  Analgesics or aspirin-like rubs

These are products that contain salicylates —  which are the same pain relieving ingredient that you would find in aspirin. They work by blocking the transmission of nerve impulses.

Pro: If you have arthritis, analgesics actually reduce joint inflammation in addition to relieving the pain as they are absorbed into the skin.

Con: If you are allergic to aspirin, you should not use products containing salicylates without consulting your doctor first. Nor should you use them if you are already taking blood thinners.

Examples: BenGay, Aspercreme, and Sportscreme – but these are not easily found on our supermarket shelves.

2. Topical anti-inflammatories

These are available as gels, gel patches, sprays, or foams. They contain an anti-inflammatory medicine such as ibuprofen, diclofenac, felbinac, ketoprofen, or piroxicam and come in various brand names – Ibuleve Gel, Deep Relief, Neurofen Gel, Voltarol Pain-Eze.

When anti-inflammatories are taken by mouth they work by blocking (inhibiting) the effect of chemicals (enzymes) called cyclo-oxygenase (COX) enzymes. COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces pain and inflammation.

Topical anti-inflammatories work in the same way but, instead of having an affect on all of the body, they only work on the area you have applied them to. When they are applied they are taken into (absorbed into) your skin. They then move deeper into areas of the body where there is inflammation (for example, your muscle). They relieve pain and reduce swelling affecting joints and muscles when rubbed into the skin over the affected area. Using a topical preparation means that the total amount of anti-inflammatory in your body is very low. This in turn means that you are much less likely to have a side-effect to this medicine.

Pro:  Reduces inflammation in both joints and muscles thereby helping to receive the pain.

Con:  Don’t use if you know you are not able to use the active ingredients such as Ibuprofen etc.  Patches over time can irritate the skin if used over the same area repeatedly.

3.  Products that make your skin feel hot or cold

These types of products are called counter-irritants because their job is to irritate your skin and thus take your mind off the pain. In doing so, you get almost immediate pain relief. These products often contain ingredients such as menthol, eucalyptus oil, or oil of wintergreen in order to produce that irritating sensation that then feels soothing.

Pro: The immediate soothing sensation that you feel.

Con: The soothing effects don’t last very long.

Examples: Deep Freeze, Deep Heat and Biofreeze

4.  Creams created from chili pepper seeds

Capsaicin is taken from chilli peppers which is the same ingredient that causes that burning sensation in your mouth when you eat chili peppers. It works mainly by reducing Substance P, a pain transmitter in your nerves. Results from RCTs assessing its role in treating osteoarthritis suggest that it can be effective in reducing pain and tenderness in affected joints, and it has no major safety problems.

Pro: You can “feel the burn” immediately after applying, so it definitely “feels” like it’s working.

Con: You have to apply them for a few weeks straight before you really begin to feel consistent pain relief. Also, the burning sensation can be irritating enough that people stop using them.

Examples: Capsaicin Gel

All topical products should be kept away from the eyes, mouth and mucous membranes and should not be applied to broken skin. Hands should be washed after use. Topical heat products should not be used on young children, whose skin is more sensitive than adults and in whom adverse reactions are more likely.

 

Do Topical Pain Relief Products Really Work?

So, are these topical pain relief creams and gels actually effective in terms of relieving pain?

As it turns out, the aspirin-like rubs are perceived to be the best when it comes to relieving pain on a consistent basis with most studies being on these products.

I can’t find any independent research in the use of Ibuprofen or Diclofenac topically, but they are regularly prescribed by GP’s.

There is little evidence to say that the counter-irritants work or don’t work.

The creams created from capsaicin seem to work for osteoparthritis, but you need to use them for some time and skin irritation can be common.

While it appears that these topical pain relief gels and creams do offer short-term relief, unfortunately, there is not enough evidence to suggest that they can be helpful when used long term.

If you find that you are using them more and more often for arthritis or some other pain, the truth is your condition may be worsening and you should have it checked out by your doctor.

IMPORTANT: Topical pain relief products are not intended to take the place of your prescription arthritis medication.

Worth Mentioning…

The effectiveness of topical pain relief products can be influenced by other medical conditions including:

  • Broken or inflamed skin, burns, open wounds
  • Atopic dermatitis or eczema (skin disorders)
  • Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency (a type of anemia)
  • Severe liver or kidney disease
  • Methemoglobinemia (defective iron in the red blood cells; inhibits oxygen delivery to tissues)
  • Intolerance to certain oral medications
  • Asthma

Always follow the instructions and if you get any side effects, see your GP immediately.