TransDermal (through the skin) Solutions for Chronic Pain
   by James Occhiogrosso, N.D.

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Localized pain associated with conditions like arthritis, muscle injuries, low back pain, fibromyalgia, and other conditions is often treated with over-the-counter oral preparations that include and non-steroidal anti-inflammatory (NSAID’s). In addition, prescription pain relievers and muscle relaxants are frequently used for more severe cases.

Prior to using any of these products, it is essential to have a thorough medical evaluation of persistent pain to rule out any serious underlying medical condition. Unfortunately, since these drugs are readily available, many people take them without getting medically evaluated first, and are unaware of the potential they have for serious harm.

Most over-the-counter pain-relieving preparations sold today are in the form of capsules or tablets that you take orally. This oral route means that the stomach and intestinal tract as well as the kidneys and liver must process the drug. Thus, such drugs taken orally can have damaging side effects. Often, significant side effects can cause more problems than the condition they are trying to resolve.

What many pain sufferers do not realize is that many herbal and nutritional items can also help relieve chronic pain. Often, over-the-counter drugs are combined with herbal and nutritional items in transdermal (through the skin) preparations. These preparations are often an excellent alternative to oral pain relievers. By being absorbed directly through the skin, they can work quickly and effectively. Such combination trans-dermal products do not have to be processed by the digestive system, and can thus use lower doses of the over-the-counter drug and achieve a positive effect with significantly less side effects.
Table 1 below lists readily available over-the-counter pain relievers and their documented side effects. When any of these are taken orally, there is significant danger of side effects. Such side effects sometimes occur with a relatively small dose. Transdermal preparations, by bypassing the digestive route, eliminate most of the side effects.

Table 1 — Common over-the-counter pain relieving oral preparations

Product Name Substance


Side Effects

Advil, Motrin Ibuprofen NSAID Life-threatening heart or circulation problems. Stomach or intestinal bleeding or perforation. Blood pressure increase.
Tylenol Acetaminophen Drug Life-threatening liver damage
Bayer, St. Josephs Aspirin NSAID Same as Ibuprofen plus increased risk of intestinal bleeding/perforation
Orudis Ketoprofen NSAID Same as Ibuprofen plus increased risk of kidney damage
Aleve Naproxen NSAID Same as Ibuprofen plus increased risk of intestinal bleeding/perforation

Products like Excedrin Extra Strength, Excedrin Migraine, and Vanquish combine both acetaminophen and aspirin. All in the above table are used to relieve pain caused by muscle aches and stiffness, and reduce fever and inflammation.

The current recommended maximum dose of acetaminophen is four grams daily for a limited time period. People who take higher doses or who already have abnormal liver function increase their risk of serious liver problems. Acetaminophen is also an ingredient in some prescription pain relievers like Vicodin and Percocet. To reduce your risk of liver problems, make sure you know the total dose you are getting from all sources. In June of 2009, due to recurring liver toxicity, an FDA advisory panel recommended lowering the recommended maximum dose of acetaminophen.

When taken orally, all NSAIDs increase the risk of serious stomach or intestinal problems that can include bleeding and/or perforation. Serious NSAID induced gastrointestinal effects can occur suddenly and can be life-threatening. These risks increase with age, higher doses, and the use of alcohol. Also, many of the drugs in the table above can also interfere with other drugs a person is using causing a drug interaction that increases the risk of serious side effects.

Transdermal (through the skin) Pain Relieving Preparations

Transdermal preparations are specifically designed for absorption through human skin. This method of delivery has several major advantages over oral absorption. The first is that the substance does not need to pass through the gastrointestinal tract, the liver, or other body systems, minimizing the potential for side-effect damage. Second, transdermal preparations have the distinct advantage of being able to deliver a drug, herbal remedy, or combination of both directly to a painful area instead of processing it through the entire body. Thus, they do not have the potential for damaging side effects encountered with oral preparations. Table 2 below lists some common natural substances used in our trans-dermal pain relieving creams.

Table 2 — Common Natural Pain Relievers Used in Trans-Dermal Creams  

Substance Name Type Description
Aloe Vera Herbal Extract The familiar aloe plant has many medicinal properties. Most people are aware of its ability to help heal wounds, but it also has documented pain-relieving properties. Aloe contains many different nutrients, including proteins, enzymes, vitamins, and various minerals. It also contains many plant sterols and polysaccharides that have known anti-inflammatory, pain relieving, and tissue healing properties.
Bromelain Food/Herbal Extract Bromelain is a natural anti-inflammatory enzyme that is derived from pineapples. It is the number one herb used by herbalists worldwide for the treatment of pain and inflammation and has been approved by the German commission E for more than 15 years.
Capsaicin Food/Herbal Extract Capsaicin is the active substance that makes chili peppers hot to the taste. It works by interfering with the transmission of pain signals from local nerves to the brain. There is significant research supporting the use of capsaicin for osteoarthritis and rheumatoid arthritis. It is also known to help relieve pain associated with muscle and joint pain, diabetic neuropathy and other nerve pain.
Chondroitin Sulfate Complex carbohydrate found in connective tissue, cartilage and tendons Chondroitin sulfate is an important natural compound that is part of the structure of cartilage. It provides much cartilage elasticity and resistance to compression. Aging can cause loss of chondroitin sulfate from the cartilage in and around joints and is a major cause of osteoarthritis. Chondroitin sulfate is important in maintaining structural integrity of the tissue in and around joints.
Glucosamine An Amino building block. Part of the structure of cells. Glucosamine is commonly used for the treatment of osteoarthritis. Transdermal preparations can deliver it directly to painful areas. It is a major component of joint cartilage, and may help rebuild cartilage. There are no reported safety issues, but the evidence for its effectiveness is inconclusive.
Feverfew Herbal Extract A well known and studied herb commonly used by herbalists for the treatment of migraines,  tension headaches, and peripheral nerve pain, as well as for relieving accompanying symptoms like nausea.
MSM A natural organo-sulfur compound found in many plants and some foods. A natural source of sulfur. Sulfur deficiency can occur from eating too little protein. MSM is a natural anti-inflammatory agent. Studies have found it has benefits for treatment of osteoarthritis, particularly of the knee joints. No serious side effects were reported from the use of MSM in the published clinical trials, but there is also no long-term use data for humans.

Some of the transdermal products we have available combine traditional pain-relieving drugs with herbs and other natural ingredients. These skin creams use the lowest possible doses of the pain-relieving drugs, ibuprofen, ketoprofen or lidocaine, along with various natural substances shown in table 2 above. Thus, the drug and the natural substance work together to enhance the overall effect. Our all-natural creams, MSM/Glucosamine and Capsaicin are drug-free and use only natural substances.

Almost anyone can use a transdermal product, but they should not be used on broken skin. They are especially suitable for those with sensitive stomachs, gastrointestinal ulcers or bleeding, difficulty swallowing pills, or an unusually sensitive digestive tract. Many people that have allergies or sensitivities to traditional oral pain relievers find transdermal preparations particularly useful, especially for localized pain relief of osteoarthritis and similar conditions.
As with all of our transdermal creams, no animal products or by-products are used in these products or in the manufacturing process and no animal testing is performed.

Natural Alternatives to Pain Relieving Drugs

There are many natural pain relievers. Two of the most powerful—and infrequently mentioned for this purpose—are Vitamin D and Fish Oil. Several studies (See our newsletters) have also shown both substances to be quite valuable for reducing pain. Chronic pain sufferers would be wise to try relieving their pain using natural alternatives like these along with our transdermal creams before turning to oral over-the-counter or prescription drug remedies. Many of these alternatives have solid science behind their actions. 

Click here to visit our Transdermal Pain Relieving Creams page. 


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