Can Topical Agents Help With Neuropathy?

Today's post from diabeticconnect.com (see link below) talks about topical pain relief, which for many neuropathy patients, is a desirable alternative to pills, although it has to be said that the ingredients of topical creams are often the same as some pill alternatives. It all depends on your history of neuropathy really and where it affects you most on your body. What's worked and what's failed and whether your doctor will offer the option of topical creams or not. For some, the medications that are absorbed through the skin give more relief, if only because they avoid stomach problems; while for others they just feel better and give you the idea that your pain is being tackled at source so to speak. The point is that if we're guinea pigs anyway (as far as neuropathy medications go) and we're working through lists to find that one thing that works best for us, why not try topical creams. That said, medications such as capsaicin have to be applied very carefully and if you're forced to use stronger agents like fentanyl patches, you need to do it under supervision - just because it's a cream doesn't make it any less powerful. Apart from that, the possibility of side effects still exists with topical agents. Talk it over with your doctor and do your own research and then make a decision based on what works best for you.

Topical Pain Agents for Pain Relief  By Lana Barhum
  
Learn your topical treatment options to manage painful diabetic neuropathy.
 
Lana Barhum is a legal assistant, patient advocate, freelance writer, blogger, and single parent. She has lived with rheumatoid arthritis and fibromyalgia since 2008 and uses her experiences to share expert advice on living successfully with chronic illness.

When you’re experiencing pain in your joints and muscles, topical pain relievers are a good alternative for pain management. These medications are delivered through a variety of dosage forms, including patches, gels, lotions, creams, sprays, and ointments. Topical agents have been used for decades to help prevent and treat a wide variety of health conditions, including pain from arthritis, diabetes, and other chronic conditions.

Topical pain medications are absorbed through the skin and are best for relieving joint and muscle pain close to the skin's surface, including the hands, elbows, knees, and feet. If you are reluctant to take pills, you may opt for an over-the-counter cream or patch. You could also have your doctor prescribe a stronger topical medication.

So, what are your options? And will they work to manage your pain?

Non-steroidal anti-inflammatory agents

Diclofenac is a topical non-steroidal anti-inflammatory medication available for topical pain management. Diclofenac is available in both patch and solution/gel formulas. The patch (Flector Patch) was first approved by the FDA in 1998 and can be used for the treatment of sprains and strains, but the solution/gel (Voltaren Gel) was designed for arthritis pain. Diclofenac works by reducing substances that cause inflammation and pain in the body. It is only available as a prescription and carries the same risk as other non-steroidal anti-inflammatory drugs (NSAIDs). 

Topical anesthetics

Topical anesthetics are local anesthetics that are used to numb the surface of a body part. They are available in creams, ointments, lotions, and sprays. Transdermal patches that contain lidocaine can offer chronic pain relief but are only available with a prescription. The lidocaine transdermal patch (Lidoderm) works by stopping the nerves from sending pain signals to the brain. You should only use one patch a day. Using too many patches or wearing a patch for too long may result in overdose, in which too much lidocaine is absorbed into the blood. In case of an overdose, discontinue use and call 911. 

Counterirritants

Counterirritants contain substances that create a hot or cold sensation in one location to temporarily lessen pain and inflammation. Counterirritants are generally non-prescription and available for topical use to manage muscle pain. Counterirritants contain capsaicin, methyl salicylate, menthol, and/or camphor. Capasagel, Benjay, Icy Hot, Biofreeze, and Tiger Balm are all brand-name topical pain agents containing one or more of these ingredients, but there are other brands including generics. These products are intended for short-term use of mild pain. Use of heat with these products should be avoided.

Narcotic analgesics

The FDA has only approved two narcotic analgesics for chronic pain. Fentanyl patches have been around since the 1990s and buprenorphine patches were approved in 2010. Both of these medications carry a high risk for abuse and misuse. The Fentanyl patch is usually prescribed to patients who are dependent on opioids (medications that reduce the intensity of pain signals to the brain) and require continuous opioid treatment. Buprenorphine patches are usually given to those who require long-term chronic pain management.
Treatment considerations

Topical medications are available in a variety of dosage formulas and more are being researched to improve pain management. Not everyone will experience good pain relief from using topical pain agents.

Here is what you can do to get the greatest effect from using these medications:

• Follow usage instructions carefully.

• Wash your hands before applying them.

• Do not apply patches, creams, gels, sprays, or lotions to damaged skin.

• Never use topical pain agents with heating pads or tight bandages.

• Do not use non-prescription topical pain agents for more than seven days.

• Monitor yourself for signs of toxicity (tinnitus, nausea, vomiting). Products containing methyl salicylate can absorb into the bloodstream.

• If you are allergic to aspirin or take blood-thinning medicines, check with your doctor before taking topical pain agents containing methyl salicylate.

http://www.diabeticconnect.com/diabetes-information-articles/general/1883-topical-pain-agents-for-pain-relief