Safe, Effective, Prescription Pain Relief

Julian Whitaker, MD

Jean, a longtime patient at my clinic, and her daughter were out shopping for something to wear to an important event they were hosting. As they walked through the mall, Jean’s right knee suddenly gave out. Excruciating sharp pain shot down the inside of her knee, and if her daughter hadn’t been there, she would have collapsed to the floor. They managed to get her home, but she was unable to bear weight on that leg without intense pain.

Her husband took Jean to see an orthopedist who, after examination and X-rays, told them that she probably had a tear of the meniscus (cartilage) and would likely require surgery. Then he ordered an MRI to confirm the diagnosis. Jean, who had spent months planning the event, which was scheduled for the following day, was crushed. She asked if she could get a steroid shot in the knee to get her through the next evening, but the orthopedist declined, saying he had to see the MRI results before proceeding with treatment.

So Jean and her husband went home and tried a treatment that she had received from her Whitaker Wellness physician for an earlier bout of back pain: a prescription anesthetic mixed with a little DMSO, applied directly on the affected area. To Jean’s delight, the pain decreased dramatically after the first application. And although she was on her feet during much of the event—including a lot of time on the dance floor—she sailed though the evening pain-free.

Topical Painkillers Beat Oral

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. We order them from a compounding pharmacy, mixed into highly absorbable creams that patients simply rub into the painful area several times a day.

I like to throw in a little DMSO (dimethyl sulfoxide). DMSO, which comes in gel and cream form, not only has anti-inflammatory properties, but it also serves as a carrier that escorts the drug through the skin and into the area where it’s needed. This certainly isn’t a requirement, but in my experience, topical painkillers work better when used in conjunction with DMSO.

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 sciatica, arthritis, fibromyalgia, sprains, and strains.

The best-studied use, 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. Although I’m not suggesting that topical pain relievers are a slam-dunk for everyone with these difficult pain syndromes, I can tell you that we’ve had good results at the clinic.

Although prescription painkillers come straight out of conventional medicine—I learned about them at a conference required by the California state medical board—most physicians are unfamiliar with their topical use. This is probably because they’re not in the product line of any large pharmaceutical company and have to be individually formulated by compounding pharmacies. If you’re suffering with chronic pain, I recommend that you talk to, and perhaps educate, your doctor about the benefits of this safe, effective therapy.

Recommendations

• Topical pain relievers require a prescription and must be ordered from a compounding pharmacy. To learn more about them and the other pain-relieving therapies offered at the Whitaker Wellness Institute, call (866) 944-8253 or click here.
• To order DMSO, which does not require a prescription, call (800) 810-6655.

Reference

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

Modified from Health & Healing with permission from Healthy Directions, LLC. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.