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10/Aug/2022

Creams, sprays, liniments, ointments, patches, rubs & gels

If you open most medicine cabinets or bathroom cupboards, you’ll more than likely find a tube or jar of a pain-relieving rub. With varying degrees of smelliness!!😱

Many of us turn to these products when we wake up with a stiff neck or overdo it in the garden. The soothing ointments, creams, sprays, liniments, patches, rubs and gels that we apply directly to our skin (topically).

But what are they? How do they work? Are they effective? And are they safe?

First, there’s a vast array of topical products available in many forms and using different ingredients. Many are available to buy over-the-counter from your chemist or supermarket. However, some require a prescription.

Let’s look at some of the more common varieties.

Counterirritants

These products use ingredients such as menthol, methyl salicylate, eucalyptus oil and camphor. They’re called counterirritants because they create a burning, cooling or ‘tingling’ sensation in the area where they’re applied that distracts you from your pain.

Medicated products

Many topical products contain non-steroidal anti-inflammatory drugs (or NSAIDs) such as ibuprofen, diclofenac or piroxicam. NSAIDs block the action of specific enzymes (cyclooxygenase or COX) that are involved in inflammation.

Topical NSAIDs may be an option for you if you can’t take oral NSAIDs due to other health issues (e.g. high blood pressure) or the risk of complications (e.g. stomach problems), as less medication is absorbed into the bloodstream.

If you’re using a topical NSAID, you should avoid taking NSAIDs orally (pills or tablets) unless you’ve discussed this with your doctor. Although the amount of medicine that enters your body through the skin is less than when taking them orally, there’s still the risk of getting too much when using both forms.

Corticosteroids, or steroids, simulate the naturally occurring hormone cortisol. One of the many functions of cortisol is to suppress or reduce inflammation. Steroid creams come in varying strengths. They rarely have serious side effects if used correctly, so it’s essential that you follow the instructions carefully. If you have any concerns, discuss these with your doctor or pharmacist.

Capsaicin

Capsaicin is the substance found in chilli peppers that gives them their heat and spicy kick, making your mouth tingle and burn. Applied to the skin as a cream, it works by interfering with the pain signals between your nerve endings and brain.

Benefits of using topicals

Most topicals, when used correctly, provide quick, temporary pain relief and have fewer potential side effects than oral pain-relieving medicines.

They may be a good option if you only have pain in a few joints or muscles, as they work in the immediate area you apply it to, rather than affecting your whole body.

Topicals also provide the soothing benefit of a mini-massage when you apply them to your skin. Seriously, how good does it feel when you rub the cream into your sore neck, and you feel the muscles loosening? Or when you apply a warm gel to your stiff, aching knee? Bliss. 😊

Another benefit of topicals is that they’re very portable; you can have some at home, in your drawer at work, in your handbag or gym locker, and use them as needed.

Do they work?

Many people swear by these products for quick pain relief. And there’s solid evidence that they can provide pain relief for acute pain, such as strains and sprains. However, research shows only modest benefits for chronic pain. But, if you feel better when using these products, and you’ve discussed it with your doctor, they’re safe to use and are better tolerated than oral medicines.

Potential side effects

Topicals, both medicated and non-medicated varieties, can cause side effects. They include skin irritation, redness, rash, or a burning, stinging or itchy sensation in the area it’s been applied.

Very rarely, some people may experience nausea, breathlessness, indigestion or an allergic reaction to the topical. If you experience any of these symptoms, stop using the topical and talk with your doctor or pharmacist for advice.

Cautions

As with any medication, there are things you need to be aware of to prevent any problems from occurring:

  • Taking oral and topical medicines containing the same ingredients (e.g. NSAIDs) at the same time may increase the risk of side effects. Talk with your doctor about this risk.
  • Always read the consumer medicine information carefully and follow the instructions. Take note of how to apply the topical, how often and how much. Don’t go overboard and slather it on. You can get too much of a good thing!!
  • Wash your hands thoroughly after applying.
  • Be careful to avoid contact with your eyes or other sensitive areas 😖.
  • Don’t use these products on wounds or damaged skin.
  • Don’t use with heat packs as this may cause burns.
  • Only use one topical medicine at a time.
  • Check the use-by-date and discard any out-of-date products.

Contact our free national Help Line

Call our nurses if you have questions about managing your painmusculoskeletal condition, treatment options, mental health issues, COVID-19, telehealth, or accessing services. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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17/Dec/2020

…when it comes to complementary, alternative and ‘natural’ treatments

Many Australians use complementary or alternative treatments to manage their health condition (e.g. arthritis, anxiety) or to improve their overall health and wellbeing. But what are these treatments and what do you need to consider before trying them?

Complementary and alternative treatments include a wide range of therapies, medicines, products or practices that aren’t currently considered to be a conventional or mainstream medical treatment. They include acupuncture, meditation, massage, herbal treatments, yoga, aromatherapy and naturopathy.

The word complementary usually refers to treatments that are used alongside conventional medicine, whereas alternative usually means the treatment is used instead of conventional medicine.

To make things easier (and less wordy), we’ll use the term complementary treatment when referring to all types of complementary or alternative treatments in this article.

Why do we use complementary treatments?

People are attracted to these treatments because they often have a more holistic approach and treat the entire person, rather than just their condition or symptoms. They also appear to be more natural and safer than conventional medicine.

But it’s important to understand that as with any treatment, complementary treatments may cause harm and make you unwell if they’re not taken correctly, if they interact with one of your other medications, or if the practitioner you see isn’t properly trained or qualified. That’s why you should discuss your use, or intended use, or any complementary treatments with your doctor.

Do they work for musculoskeletal conditions?

While many people feel that using complementary treatments has been beneficial for their health and wellbeing, there isn’t as much evidence to support its use for musculoskeletal conditions as there is for conventional medicines.

For many complementary treatments there just aren’t enough well-designed randomised controlled trials to show whether or not these therapies are effective. And if they are effective, for which conditions or symptoms.

However some types of complementary treatments show promise and may be helpful for managing your condition. More and more research is now focusing on these treatments. But at the moment the evidence is still lacking so it’s best to take your time, do your research and make sure the treatment is right for you.

Tips for starting a new complementary treatment

Let your doctor know what you’re doing. Keep them informed about any things you’re taking or considering taking (e.g. supplements, homeopathic treatments, herbal medicines) as well as any other therapies you’re trying or considering trying (e.g. acupuncture, yoga).

Continue taking your medications as prescribed. Don’t stop taking any medications without first discussing it with your doctor. Some medications need to be gradually reduced, rather than simply stopped, to avoid side effects.

Think about what you want to get out of the treatment. Are you hoping to control symptoms like pain or fatigue? Sleep better? Reduce or stop taking certain medications? Manage your anxiety? When you have a clear goal from the beginning of your treatment, you can monitor your progress and see if there are any improvements. After starting a new treatment, write down any changes you notice for a month – remember to include any medication changes, changes in your exercise program, the amount of sleep you’re getting and anything else that could affect your symptoms. At the end of the month, you’ll have a clearer picture of whether or not the treatment is working. If it’s not, it may be time to look for an alternative.

Do your research and ask lots of questions. Some treatments may help you manage your condition or symptoms, while others will have no effect. Visit websites such as MedlinePlus and The Cochrane Library to learn more about the treatment. And talk with your doctor and the therapist. Find out if:

  • there’s any current evidence that the treatment is effective and safe for people with your condition?
  • the treatment’s been shown to be effective in repeated scientific studies with large numbers of people?
  • the research used a control group? A control group is a group of people who don’t have a particular treatment compared with a group of similar people who do. This helps to show that any results are due to the treatment and not some other factor.
  • potential risks, side effects and interactions with other treatments are clearly identified?
  • you can continue to use your current effective treatments, as well as the complementary treatment?
  • the treatment’s something you can afford and can access easily?

If you answered no to any of these questions, you should be wary of the treatment. Discuss it with your doctor or specialist before you go any further.

Check the qualifications of the person providing the treatment.

  • Do they receive regular training and updates?
  • Have they treated other people with your condition or health issues?
  • Are they a member of their peak body?
  • Are they accredited?

Buy Australian. Australian complementary medicines are subject to strict safety and quality regulations. This may not be the case in other countries. In Australia the Therapeutic Goods Administration (TGA) ensures the safety of medicines and other therapeutic treatments.

Call Medicines Line on 1300 MEDICINE (1300 633 424). As well as information on your prescription and over-the-counter medicines, they can also help you find out more about herbal medicine, vitamins and minerals.

After doing your research, if you have any doubts about the treatment, don’t use it.

Talk with your doctor or contact our MSK Help Line weekdays on 1800 263 265 helpline@msk.org.au for information about other treatment options.

Call our Help Line

If you have questions about things like managing your pain, your musculoskeletal condition, treatment options, COVID-19, telehealth, or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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27/May/2018

A book by people like you

Chronic pain is a common and complex problem that affects 1 in 5 Australians.

It’s exhausting, a bit tricky and hard to know where to start.

Fortunately, with our book Managing your pain: An A-Z guide you can start anywhere!

Medications, sleep, laughter, fatigue, breathing. Think of it as a ‘choose your own adventure’ to getting on top of your pain.

The book emphasises practical strategies tried and tested by people like you – consumers living with musculoskeletal conditions. There are also a bunch of quotes and useful insights to keep it real.

You might also like…

We also have a helpful kids pain book called The worst pain in the world. It’s beautifully illustrated and loaded with practical advice for children living with pain (not just those with arthritis). It also gives kids who don’t live with pain an understanding of what their friends or family are going through.




Musculoskeletal Australia (or MSK) is the consumer organisation working with, and advocating on behalf of, people with arthritis, osteoporosis, back pain, gout and over 150 other musculoskeletal conditions.

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