Creams Versus Pills for Pain

Pain relievers applied to the skin can be just as effective as those taken orally

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Gel and cream pain relievers are gaining in popularity. This method of pain relief has fewer side effects than their pill counterparts and may work just as well.

A recent review looked at the use of pain relievers absorbed through the skin to manage pain.

The review found that the pain relieving medications diclofenac and ibuprofen were effective in treating muscle, tendon and ligaments and joint conditions like osteoarthritis when absorbed through the skin.

The medication lidocaine also effectively treated nerve-related pain when applied to the skin.

"Ask your doctor if topical analgesics are best."

Charles E. Argoff, MD, of the Department of Neurology at Albany Medical College, searched existing databases for studies on topical analgesics (pain relievers absorbed through the skin). Dr. Argoff identified a total of 65 studies that associated long-term, short-term and neuropathic pain with topical analgesics.

Neuropathic pain is a type of pain caused by nerve damage and often seen in patients with trauma, diabetes and amputations.

The most common drugs included in the studies were nonsteroidal anti-inflammatory drugs (NSAIDs) including diclofenac, ibuprofen, ketoprofen, piroxicam and indomethacin. The next most common drugs were lidocaine, capsaicin, amitriptyline, glyceryl trinitrate, opioids, menthol, pimecrolimus and phenytoin.

Eighteen of the studies used the pain relievers for short-term soft tissue injuries, 17 studies involved neuropathic pain and six involved pain induced for the purpose of the experiment only. Five of the studies used the pain relievers for long-term joint related conditions, five involved skin or leg ulcers and two used the medication for chronic knee pain.

Dr. Argoff concluded ibuprofen relieved chronic knee pain and short-term soft tissue injuries pain just as effectively when applied to the skin as when ingested.

The use of diclofenac topically to treat joint pain was shown in a study of temporomandibular joint disorder, a painful condition of the jaw. The study showed diclofenac applied to the skin worked just as well as when taken orally.

Lidocaine was the only drug in the studies that effectively relieved neuropathic pain.

No other drugs included in the review showed strong evidence of relief when used topically.

Pain relievers applied through the skin had fewer side effects, such as stomach and heart irritation, than orally administered pain relievers.

Dr. Argoff recommended the further study of NSAIDs and lidocaine for short-term and long-term pain relief.

The study was published in Mayo Clinic Proceedings.

Financial support for the study was provided by Mallinckrodt Inc., a company that manufactures pharmaceuticals and other health-related items.

Dr. Argoff is associated with over a dozen pharmaceutical companies and health research groups.

Reviewed by: 
Review Date: 
March 12, 2013
Last Updated:
March 14, 2013