What is Topical Pain Relief and How Does it Work?

Table of Contents

• Introduction
• History of Topical Pain Relief
• The Modern Topical Analgesic
• Different Forms of Topicals
• How Does Topical Pain Relief Work
• Is My Topical Pain Relief Dangerous
• Warnings & When to See a Doctor
• Conclusion
• Topical Pain Relief FAQ
• References

Introduction

If you haven't heard of topical pain relief before, you've come to the right place. Topical analgesics have other names, like: pain rub, pain cream, pain ointment, pain salve, pain gel, etc. This article is meant to be a fairly short, but sweet, introduction to topical analgesics for pain to answer your questions as well as help you make the right choice in what to use!

History of Topical Pain Relief

People have been rubbing relief on their skin for millennia and probably ingesting some form of painkiller for even longer. Plant herbs were one of the original sources for pain relief. (Also around that time, there was ritualistic chanting, goat sacrifices, and music to help exorcise the pain demons out of the body. Oh, and I almost forgot about bloodletting/leeching.) Herbal medicine, though, has stood the test of time and is still heavily used today.

Medicinal plants were crushed, mixed, cooked, and applied directly to the skin, to help reduce pain, prevent infection, and help the afflicted heal quickly. All sorts of poultices, plasters, and the like, were slathered on folks everywhere. Of course, other topicals were tried, such as fried frogs and electric fish, but they fell out of favor along with the other less effective treatments.

Things got better for pain sufferers when opium was discovered in the poppy plants. Then, it got worse due to the addictive nature of morphine and other opiates. Alternatives needed to be found.

Through the advancement of medicine, trial and error, and the resilience of the human body, we've come to this point with a good deal of knowledge on what works and what doesn't.

The Modern Topical Analgesic

Another idea that evolved from the practice of medicine is that of over the counter medications and prescription medications. Each of the two broad categories have their place.The below chart outlines a few key elements to help you select: 

 For the purpose of this article, we are mainly discussing the OTC topical pain relief products.

Different Forms of Topical Pain Relief Products

Topical pain relief comes in a variety of formats: balm, salve, cream, plaster, ointment, gel, lotion, oil, roll-on, spray, patch, etc. Each has benefits and disadvantages, but in the end, the customer tends to choose based on personal convenience. Some users would rather a hands-free application and lean towards using a stick or roll-on. Others want to massage the product into the skin and opt for a balm or salve format in a more finger-friendly container.

With the different formats available, there is one important concern that few people have considered. Some forms WILL WORK BETTER than others and it depends on the individual. Your skin is the gatekeeper that dictates how awesome your pain reliever is. If you have oily skin, a more water or alcohol based topical may have better penetration. If you have dry skin, an oil-based solution may be better for you. The skin's differing composition & permeability factors enhance or prevent your favorite topical agent from doing it's best work. So, try different forms and see what form gives you knockout pain relief! 

Another criteria is whether or not the pain cream is suited for chronic or acute pain⁽¹⁾. Though many topical analgesics can be used for long term, it is best to check with your doctor and/or the manufacturer on what is right for your condition.

All that being said, it is possible to enhance the penetration of your best pain reliever. For more information on how to maximize the effectiveness of your favorite topical analgesic, check out: The 5 Things You Need to Know to Get the Most Out of Your Topical Pain Reliever. Next, let's figure out what happens once you apply the product to your skin.

How Does Topical Pain Relief Work

So, you've got knee pain. The first thing you should do is apply your favorite all natural topical pain reliever, Battle Balm, to your knee. (If you need to use something else, we forgive you.) In any case, you put the product directly on the body part that hurts. The direct application of the agent to the site is the same whether you have pain from arthritis⁽²⁾, swelling, muscle strain, or other physical condition.

Once applied, the pain relief product begins to penetrate and be absorbed through that wonderfully permeable membrane we call skin. (Note that the skin is an organ of the body, and to be healthy, you need to use high quality products.)

Here's where things get interesting. The ingredients for your favorite product can be natural or pharmaceutical-made. Depending on the ingredient, different pain relieving effects are available to the user. Each can have one or more mechanisms of action once absorbed into the skin. Some of the categories of product are: rubefacients (skin irritants that improve blood flow), NSAIDs (anti-inflammatory & COX-2 inhibitors), & capsaicin (neuropeptide agent stimulating pain and heat neurons). Ok, so maybe it's not that interesting. At some point, we'll elaborate on each of the mechanisms of action, but first we'll see how many folks get this far into this article and are actually reading it!

Is my Topical Pain Relief Dangerous

If you read the labels for any topical pain relief product (which you should be doing, anyway), you'll see that they are "For temporary use only." This is an important statement that must be reiterated here. 

All topicals, even natural ones, are designed for the pain sufferer to either use for the short-term, and/or combine with other therapies to facilitate a long-term pain relief solution.

There are a myriad of reasons why brands advocate for moderate analgesic use. Liability is one reason why companies, including ours, do not want customers to overuse their products. Long-term use of any analgesic is not a good idea. (I'm also talking about prescription-based pharmaceuticals, as well. Those tend to be more damaging than OTC products.) If possible, seek out products that have low to no side effects on your health. The more natural products tend to be more forgiving to the body.

Another concern is abuse. Let's face it. Even with instructions in bold print, many people still won't read them unless something is wrong. That's why the term RTFM exists. No one reads anymore! So, yes, your topical pain relief is dangerous if you don't know what you're doing and if you don't bother to learn about what you're using! But, that's why we are also here to help you!

Existing health conditions can be another factor that can make your pain reliever dangerous. Here's one example. When you apply pain relief to your skin, it must be processed by the liver in some way, shape, or form. This means that the product ingredients eventually needs to mingle with other body parts, i.e., blood, liver, kidneys. If you have weak liver or kidney function, your body may have trouble breaking down the active ingredients in your topical and removing it from your body. A buildup of these byproducts can lead to complications. Temporary use and moderating your usage helps to reset your favorite balm's efficacy and maintain your health!

To reduce the danger factor even more, keep topicals away from armpits, genitals, and eyes. One more thing! We don't advise the use of ANY topical pain relief product during pregnancy. No one knows exactly how any medication affects fetal development. It may be different in the future, but right now, there's no accurate data to draw concrete conclusions that these products will not harm babies in utero.

Warnings & When to See a Doctor

We will make this section simple. If you are not comfortable with the topical pain relief product you are using, consult a doctor and the manufacturer. If you are taking other medications, especially blood thinners, heart medications, or liver medications, consult your doctor. If you have a history of any organ damage or poor function, consult your doctor. If you are on any current medication(s), consult your doctor. 

If you see any abnormal skin discoloration, swelling, discontinue use immediately and wash treated area with soap and water.

Remember, you are taking topical pain relief to enhance your life. Make sure that what you take is adding to your health, not taking away from it!

Conclusion

The ins and outs of topical pain relief are not that simple. Although the application is pretty straightforward, there are many things working in conjunction to provide you the knockout pain relief that you feel.

It all boils down to 5 things to remember when buying a topical pain relief cream. 1) Read the labels. 2) Understand the ingredients so you know what is going onto and into your body. 3) Learn about the side effects and know what to look for. 4) Try different products based upon ingredients and mechanism of action. 5) When in doubt, seek out professional advice.

This article is in no way a complete representation of the entire topical analgesic industry. It serves only to help you, the customer, be more informed and start to look at the bigger picture in your overall pain management solution! Good luck! We're always here to help. Don't hesitate to contact us!

Topical Pain Relief Frequently Asked Questions

 Below are some of the most commonly asked questions about topical pain creams. Drop us a line if you have other questions. We'd be happy to answer them!

What is topical pain relief?

Topical pain relief is a term for a topical analgesic or painkiller product that you would apply to your skin to relieve pain at the site of application.

How long does it take for topical analgesics to absorb?

Generally, topicals will take about 30 minutes to absorb into skin. Times will vary depending on: permeability of product, permeability of skin, skin cleanliness, skin integrity, skin temperature, quality of product ingredients, and a few other factors.

In what situation is a topical pain reliever appropriate?

Most people can use topical pain creams, balms, etc., safely. They tend to be a good choice for pain due to soft tissue injury. If you are unsure, please consult a medical professional.

Do topical pain relievers enter the bloodstream?

Topicals enter the skin at the site of application and will then be processed by the body. Compared to pain pills which are ingested, topicals avoid the gastrointestinal tract and very little gets absorbed systemically in the bloodstream.

What are the benefits of topical pain relief?

As touched on earlier, topicals don't enter the GI system and won't irritate the digestive system. Topicals have less side effects overall. Topical pain relief is more targeted to the site of injury or discomfort. It is generally easier to access and can be used for multiple pain types, such as arthritis, or muscle strains.

What are the disadvantages of topical pain relief?

Topical ointments, etc., can irritate sensitive skin. Depending on ingredients, some topical analgesics can clog pores, restrict skin hydration, and cause adverse reactions. It is not recommended to use topicals on broken skin.

Are topical pain relievers a scam?

Topical analgesics work and they work very well for many pain conditions. There's a reason that topical pain relief has a long and storied history. But, some people think topicals should work for everything without understanding their own pain condition or the limitations of analgesics in general.

Can you use too much topical pain cream, gel, ointment, etc?

Yes. One of the first ways to notice that you're using too much of your topical is skin irritation at the site of application. Most topical pain creams etc., have a "For temporary use..." paragraph in their usage description. This should be adhered to and it's best to cycle the application of your product, if you will be using a topical over the longer term.

References

1. Topical therapies in the management of chronic pain Stanos SP, Galluzzi KE. Topical therapies in the management of chronic pain. Postgrad Med. 2013 Jul;125(4 Suppl 1):25-33. doi: 10.1080/00325481.2013.1110567111. PMID: 24547601.

2. Role of Topical Pain Creams in Pain Management National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on the Assessment of the Available Scientific Data Regarding the Safety and Effectiveness of Ingredients Used in Compounded Topical Pain Creams; Jackson LM, Schwinn DA, editors. Compounded Topical Pain Creams: Review of Select Ingredients for Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020 May 13. 2, Role of Topical Pain Creams in Pain Management.

3. Topical analgesics for acute and chronic pain in adults Derry S, Wiffen PJ, Kalso EA, Bell RF, Aldington D, Phillips T, Gaskell H, Moore RA. Topical analgesics for acute and chronic pain in adults - an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017 May 12;5(5):CD008609. doi: 10.1002/14651858.CD008609.pub2. PMID: 28497473; PMCID: PMC6481750.