When pain medicines are taken by mouth, there can be adverse events associated. This may include common side effects such as constipation. However, once in a while something more serious may happen such as an ulcer or an overdose.

Topical analgesics that are applied to the skin are an excellent method of achieving pain relief with a lower side effect profile. When a medication is applied topically, it often provides substantial relief while having only little bit even enter the bloodstream.

There are three types of topical pain relievers often prescribed at Arizona pain clinics. One are numbing agents, another involves actual analgesic pain medication, and the third is counter-irritants.

The first, numbing agents, are designed to simply numb locally. This may include Lidocaine patches over a painful region. The medication seeps in a bit, and very little actually enters the bloodstream. One great application for Lidocaine patches is post-surgical around the incision.

Voltaren is the brand name for Diclofenac

Another medication that does well with local administration is diclofenac gel. Diclofenac by mouth is an NSAID that works well, however, there are instances of GI problems and potential kidney issues with chronic use. However, the topical route has been shown to be much safer and is FDA approved in a 1% solution. Studies have shown it is significantly more effective than placebo and great for arthritic pain (Drugs. 2009).

The second type of topical analgesics are actual medications that you want to get absorbed in the bloodstream. This includes fentanyl, clonidine, nitroglycerin, testosterone and more. These come in a gel form or a patch. The fentanyl patch for instance, stays on for a couple days and the medication gets into the bloodstream for systemic pain relief. One note here – Lidocaine patches can be trimmed to fit the area of treatment. A fentanyl patch should not be cut as all the medication will leak out.

Because of the serious potential adverse events with opiates or anti-inflammatory drugs taken by mouth, the topical analgesics are often used because there are minimal systemic side effects. You don’t have the risk of ulcers or kidney problems or fatalities due to respiratory depression (except with a drug meant to achieve systemic penetration like Fentanyl).

When it comes to counter-irritants, one very common one is known as capsaicin. This is a compound derived from chili peppers that desensitizes painful areas through repeated

Capsaicin is available over the counter.

doses. This could be very useful on a painful knee, shoulder or any extremities. This medication has extremely low side effects and may reduce pain nicely.

There also counter-irritant’ that are hot and cold products that have menthol or camphor as the active ingredients. Most of these are over-the-counter products such as Icy Hot or BenGay and the like. Another type of counterirritant includes topical products that have salicylates or benzyl nicotinate in them.

Overall, topical analgesics are an excellent way to reduce the need for oral medications and reduce side effects. There are various methods of increasing penetration through the skin for some of them, such as iontophoresis. This is a method kind of like ultrasound that pushes cortisone deeper into the skin that it would otherwise go.

Arizona Pain Specialists offers comprehensive Phoenix pain management at 4 locations that span the East & West Valley along with Phoenix itself. The Arizona pain doctors are Fellowship Trained, Board Certified and Award Winning. There are also physical rehabilitation doctors, acupuncture and chiropractic treatments offered.

The pain doctors accept Medicare, Major Medical like BCBS, Aetna, United, Cigna, Humana and many more. They are APIPA doctors in Phoenix along with Mercy Care and PHP. Workers Compensation and Personal Injury claims are accepted as well. Call today at (602) 507-6550 for more information and scheduling!