Pain relief creams like Bengay, IcyHot and Tiger Balm have been around for decades as potent examples of how certain active ingredients rubbed into the skin can soothe even resistant, deep-seated pain. Today’s modern pain creams can address very specific kinds of chronic pain, including nerve, joint and musculoskeletal pain, with powerful, personalized ingredients.

What is pain relief cream?

Humans have created and used topical pain relief for thousands of years — ancient Egyptians, for example, used to mix opium into their creams to find relief. Today’s creams have edged away from opioids and can now be created to target particular kinds of pain and sites of the body. 

Compounding is the science of mixing up medications following specific formulas. As more pain-fighting ingredients are discovered or developed, compounders gain increasingly precise tools to use against their patients’ pain. Most compounded pain creams aim to dull or numb pain, to reduce the inflammation thought to be causing the pain, to confuse the body’s pain signalling system by introducing other unique sensations or to use a combination of those strategies.

According to the National Academies of Sciences, Engineering, and Medicine, the following pain cream ingredients appear to be most clinically effective:

• Lidocaine (a topical anesthetic that numbs body tissues)
• Diclofenac (a nonsteroidal anti-inflammatory drug (NSAID) that helps lessen body tissue irritation and subsequent pain)
• Naproxen (another NSAID) that reduces some of the hormones involved with inflammation and subsequent pain

Other components can include wintergreen oil, capsaicin, aloe, chamomile, lavender, St. John’s wort, arnica, or other active ingredients, plus ingredients that help keep the cream shelf-stable and spreadable. The amount of active ingredients and the exact combination of medications included in a prescription compounded pain cream help determine the cream’s strength and staying power. 

How are pain relief creams different from other pain management options?

Prescription pain creams are formulated for specific pain needs. Depending on the specific case, they can be just as effective as some oral medications or injections, but offer the potential advantages of being spreadable and relatively easy to apply. Frequently, pain creams have fewer side effects than many other pain management methods, and are often gentler on the digestive system than oral medication. 

Doctors sometimes prescribe topical pain creams for patients who have difficulty swallowing pills. Unlike pills, creams can be applied directly to the area experiencing pain, and thus offer localized treatment. In some cases, compounded pain creams can be part of an overall pain treatment strategy that may work especially well for people over 65 or for people with sensitive stomachs. 

Pain creams can also be adjusted. Every time compounders mix up a new batch, for example, they can alter the formula they’re following to match whatever needs the patient currently has. If someone is noticing persistent knee pain, for example, the compounder might increase the dose of active ingredients and might change the cream’s base to help convey the active ingredients deeper into the tissues of the knee joint. 

On what parts of the body might pain cream work best?

Though no single pain reduction approach is perfect for every person, compounded pain creams can work very well for specific kinds of pain. Since creams are spreadable, they can be rubbed directly into painful areas, and are suitable for areas of the body that move a lot, such as the following areas: 

Neck and upper shoulders

The neck contains a number of bones, ligaments, tendons, and muscles that can be subject to numerous kinds of aches and pains, including a crick in the neck, but that also respond well to compounded pain creams. The neck also has relatively thin skin, allowing compounded cream to be absorbed well. A compounded cream could be a good choice for neck pain, since it might be able to address multiple potential kinds of pain at once. 

The shoulders are also subject to strains and to holding stress that can contribute to chronic pain when muscles get tense and stay clenched. The right compounding can help address muscular tension while also reducing pain. Creams can also relieve some of the pain from sports injuries and repetitive stress injuries, which often occur in the shoulders.

Elbows

Elbows can hurt in a wide range of ways, unfortunately. Bursitis (joint inflammation), tennis elbow (a repetitive use injury) and different kinds of arthritis often affect elbows. Elbows also move a lot, which means that pain patches are liable to fall off. 

Compounded pain creams can be rubbed in, so they may work better. Creams that contain lidocaine can help numb throbbing pains; NSAIDs can help lower osteoarthritis pain. (Voltaren is an over-the-counter NSAID pain cream you might recognize, for example.) Depending on what’s causing your elbow pain, a compounded pain cream may lessen the hurt. It’s important to use compounded creams only as prescribed by your doctor, as some creams may not address the root cause of pain. 

Hands

Hands also move constantly, so it’s no surprise, sadly, that arthritis often settles into them, often affecting the knuckles and wrists. Compounded pain cream might be a good fit for hand and wrist pain, since even the act of rubbing in the cream could help bring relief, while the cream itself can deliver anti-inflammatory ingredients through the relatively thin skin of the hands to the small joints that are often most impacted. 

A note though: if you have scraped or otherwise damaged any skin on your hands, hold off on using cream, as creams are developed to be used on intact skin. If you have a lot of calluses over your hands, you may need higher doses of active ingredients, or may want a formula that maximizes the cream’s ability to be absorbed by the skin, since factors such as skin thickness can affect how well a pain cream tends to work.

Knees

Like elbows, knees are major joints, and it’s tough to avoid moving them. Again, compounded creams could help, because they can be rubbed directly into the skin around the knees, delivering pain relief directly to possibly inflamed tissues. As with shoulders, knees tend to become injured fairly frequently, sometimes in complicated ways.

Feet

Feet hurt too often, unfortunately. They’re complex, with a lot of small moving parts that work together to bear a lot of weight. They’re also sensitive, since they’re full of nerves to help detect irregularities in the surfaces you’re walking on, helping you maintain your balance and help discover any injuries before they advance too far. 

Some of those elements make feet well-suited for treatment with compounded pain creams, however. Much of the skin over the feet is relatively thin, so pain cream ingredients can often be absorbed relatively well. Injuries and chronic pain arising in the feet may affect multiple ligaments, tendons, nerves, muscles or joints, and there may be more than one reason for the pain, so a compounded pain cream could potentially address multiple problems at once. 

What tips help me get the most out of my compounded pain cream?

As with most medications, certain tips help you capitalize on your treatment. With compounded pain cream, the following tips may help:

• Use creams only as prescribed. They’re meant to be applied only in certain amounts and only at certain time periods, or overdoses may occur. Prescription pain creams are personalized, and so they’re not meant to be shared with others.
• If you notice rashes or itchy spots, talk to your doctor, and definitely mention any signs of a potential allergic reaction. 
• Apply creams to clean, dry skin that’s intact, without any scrapes, burns or other injuries that breach the skin.
• Make sure a cream will work for your type of pain and the area of your body you’re concerned about. Certain kinds of deep-tissue pain in thicker areas of the body, such as thighs and hips, might not be the most responsive to certain compounded pain creams.
• Don’t use heating pads with compounded creams unless advised by your doctor, since the heat may accelerate the uptake of active ingredients too much.
• Some areas of the body are hard to reach, but there’s a technique that might help: spread the cream on the back of your hand, which makes it much easier to spread on your back, for example.
• Try not to take oral NSAIDs if you’re also absorbing NSAIDs through your skin. That’s one of the reasons it’s important your doctor and care team have a clear picture of all the medications you’re taking, including any natural medications, botanicals or supplements, since some of these can interact with NSAIDs and other active ingredients.
• If the texture of your pain cream isn’t ideal for you, or you’d rather not have cream soaking into your hands, apply the cream while wearing gloves.

How Clearing can help with chronic pain

Clearing offers prescription compound creams that can’t be found over the counter as part of our overall approach to chronic pain management. Other components of Clearing’s approach include a personalized exercise program, CBD cream, nutraceuticals and access to advanced pain specialists (the exact combination of components offered to you can vary depending on your diagnosis and situation). Find out more today!