With increased awareness about the possible side effects, many are hesitant to take pain killers. Popping the pill is never the answer unless the situation warrants it. However, pain seldom disappears on its own and requires some form of intervention. The use of topical pain relievers such as pain relief sprays, ointments, creams, patches and gels are common for most superficial musculoskeletal pains. Experts explain the different components in the types of topical pain relievers and how each of them works to provide relief.
Components of pain relief sprays and ointments
Several of the topical pain relievers contain analgesic or anesthetic agents which provide relief.
“The most important factor that determines the efficiency of pain relievers such as ointment, gel spray, etc. are the contents or ingredients present in each of these drug delivery methods,” says Dr Siddharth M Shah, consultant orthopedics and joint replacement surgery, SL Raheja Hospital, Mahim, Mumbai.
He goes on to list the common ingredients found in topical pain reliever gels, ointments, and sprays.
- Diclofenac: It is a nonsteroidal anti-inflammatory drug with pain-relieving properties and a common ingredient in topical gels or ointments. It helps relieve back pain, shoulder pain, and neck pain.
- Methyl salicylate: It is a counter irritant similar to wintergreen oil. Because of its counter irritant properties, when applied to the skin, it provides a distraction from feeling the pain.
- Capsaicin: It is a substance found and extracted from chillies. It also works as a counter irritant when applied on the skin and causes a warm and burning sensation resulting in increased blood flow to the area, which will help relieve pain especially those that are muscular in origin.
- Menthol: It provides a cooling effect on the skin.
- Lignocaine: It is a drug present in certain specialized gels and functions as a local anesthetic. It works by making the nerves numb and reduces pain.
“The components of the topical pain relievers don’t enter the bloodstream, hence side effects of them are far lesser than the regular analgesics,” says Dr Siddharth Potluri, orthopedic surgeon, Apollo Clinic, Telangana.
Pain relief ointments vs pain relief sprays
Since the contents in topical pain relievers are similar, there is not much difference in their relief action. The difference lies in the ease of use and the area where it is used.
“Sprays can also be easily used on regions like the back which could be hard to reach while using ointments,” says Dr Potluri.
“Sprays are less messy as they just require you to press the nozzle and spray the contents at the painful area, unlike that of an ointment,” says Dr Shah. “While spraying, the contents are delivered under high pressure, triggering a quicker onset of action which makes it slightly more effective. They normally contain menthol in them, which provides a cooling effect. So, in general, whenever a quick relief from pain is desired then sprays can be useful. However, some of the newer gels and ointments can provide quick relief too.”
Ointments are applied on a specific area, whereas sprays when sprayed from a distance gets sprayed over a reasonable large area of the body.
Topical pain reliever use: dos and don’ts
Rubbing/massaging after application: It is a common practice to apply an ointment or a gel and rub or gently massage that area for better pain relief. However, when done incorrectly it can increase the pain.
“When preparations contain counters irritants like capsaicin or even methyl salicylates (found in some sprays), one should avoid vigorous rubbing or massaging which can cause skin irritation and increase the blood flow to that area causing faster absorption of the drug into the body and sometimes into the blood stream which can have side effects. Any inflammation present can worsen too,” says Dr Shah.
Dr Potluri adds, “It is important to not massage or rub as excessive rubbing can damage the skin and cause injury. They work just by application.”
Topical applications should be used only on intact skin and not broken or injured skin.
Combining with fomentation: The hot water fomentations have their health benefits in treatment of pain; however, they should not be combined with topical applications.
“Topical applications should not be combined with heating pads or hot water fomentation, as some of the counter irritants themselves create warmth on the skin. And using heat therapy is harmful, as it may cause skin irritation. The excess heat can increase blood flow and the drug gets absorbed faster into the blood stream, which is not ideal as topical applications are meant to act on the surface layers,” explains Dr Shah.
Suppose if someone continues to massage gently and thereafter experiences a minor pain or burn, ice packs may come in handy.
“Using an ice pack for a few minutes constricts the blood vessels and helps to reduce the inflammatory response locally, which will help to reduce the irritation,” adds Dr Potluri.
Watch for stop signals: Not all topical applications will suit all skin types. “If there is any skin irritation with using any of the topical pain relievers, one must discontinue using it and reach out to a specialist,” Dr Shah advises.
Takeaways
- Topical pain relievers-ointments, creams, gels, sprays, patches, etc. are applied on the skin to provide pain relief.
- Both pain relief ointments and sprays work similarly because of the analgesic and anesthetic components they contain – diclofenac, methyl salicylate, capsaicin, menthol, and lignocaine.
- Sprays are much more convenient to use and can be applied on regions like the back which can be difficult while using an ointment. They are also slightly quicker in action.
- It is recommended to not massage or rub after application, especially if they contain counter irritants.
