Safe, Effective Pain Relief

Safe, Effective Pain Relief

Julian Whitaker, MD

I’m no fan of pain-relieving drugs. Chronic use of aspirin, ibuprofen, and other NSAIDs can cause gastrointestinal ulceration and bleeding, and are responsible for as many as 16,500 deaths per year in this country alone. “Safer“ COX-2 inhibitors are somewhat easier on the GI tract, but they are linked to increased risk of heart attack and death from cardiovascular causes. Tylenol (acetaminophen) can damage the liver, especially when used in conjunction with excess alcohol, and opiates are addictive with a significant potential for abuse.

Topical drug application, however, is another story. This delivery system has two major advantages over the oral route. First, you’re able to target the affected area, so you get faster relief. And second, systemic absorption is minimal, so you don’t have to worry about these dangerous side effects.

The topical drugs we’ve had the most success with at the clinic are ketamine, an anesthetic that curbs pain, and ketoprofen, an NSAID that reduces inflammation. They’re mixed into creams that patients simply rub into the painful area several times a day. I also like to throw in a little DMSO. This certainly isn’t a requirement, but in my experience, DMSO just seems to make it work better.

Helps Multiple Types of Pain

Who can benefit from this treatment? Jeff, a personal trainer, injured his neck after an intense workout. He couldn’t even turn his head to look over his shoulder—until he started using this therapy. I’ve personally used it successfully for low back pain, and we’ve had positive reports from patients suffering with sports injuries, sciatica, arthritisfibromyalgia, sprains, and strains.

The best-studied application, however, is for relief of neuropathic pain—deep, often intense pain caused by damage to or dysfunction of the central or peripheral nervous system. Diabetic neuropathy, reflex sympathetic dystrophy, post-surgery pain, post-herpetic neuralgia, carpal tunnel syndrome, and nerve compression are all examples of neuropathic pain, and they are frequently chronic and hard to treat.

I’m not suggesting that topical pain relievers are a slam-dunk for all difficult pain syndromes, but I can tell you that we’ve had good results at the clinic. Furthermore, the relative safety of this therapy warrants a trial for most everyone with neuropathic or musculoskeletal pain.

This therapy comes straight out of conventional medicine. I learned about it at a conference at the University of California San Francisco on pain. However, most physicians are unfamiliar with the topical use of ketamine and other painkillers. They aren’t in the product line of any large pharmaceutical company, so they aren’t advertised or pushed by drug reps and they have to be formulated by compounding pharmacies. If you’re suffering with acute or chronic pain, I recommend that you talk to your doctor about the benefits of this safe, effective therapy.


  • Topical pain relievers require a prescription and must be ordered from a compounding pharmacy, such as McGuff Compounding Pharmacy, (877) 444-1133, and Wellness Health Pharmacy, (800) 227-2627. These pharmacies can also provide additional information on topical painkillers.
  • DMSO creams and gels are sold in some health food stores or can be ordered online or by calling (800) 810-6655. (For topical use, I recommend a 70 percent concentration.) To use, rub a small amount into the affected area until absorbed. Repeat two or three times a day as needed.


  • Lynch ME, et al. Topical 2% amitriptyline and 1% ketamine in neuropathic pain syndromes: a randomized, double-blind, placebo-controlled trial. Anesthesiology. 2005;103(1):140–146.

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