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Every day, millions of people rely on aspirin, ibuprofen and other oral nonsteroidal anti-inflammatory drugs, or NSAIDs, to treat chronic musculoskeletal pain (like arthritis or low back pain) or neuropathic pain (deep, often intense pain caused by damage to or dysfunction of the central or peripheral nervous system, such as diabetic neuropathy).

But I’m no fan of these pain-relieving drugs. Using them on a continual basis can cause gastrointestinal, or GI, ulceration and bleeding. These drugs are also 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. Acetaminophen, such as the Tylenol brand, can damage the liver, especially when used in conjunction with excess alcohol; and opiates are addictive with a significant potential for abuse.

Try topical prescription painkillers instead

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. Second, systemic absorption is minimal, so you don’t have to worry about the dangerous side effects.

The topical drugs we’ve had the most success with at the Whitaker Wellness Institute are ketamine, an anesthetic that curbs pain, and ketoprofen, an NSAID that reduces inflammation. A compounding pharmacist mixes these medications into creams that patients simply rub into the painful area several times a day.

Helps multiple types of pain

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 to successfully relieve low back pain, and we’ve had positive reports from patients suffering with a variety of concerns, from sciatica, arthritis and fibromyalgia to sprains and strains.

The best-studied application, however, is for relief of neuropathic pain. Diabetic neuropathy, reflex sympathetic dystrophy, post-herpetic neuralgia, carpal tunnel syndrome and nerve compression are all examples of neuropathic pain, and they are frequently chronic and hard to treat. Until now.

DMSO delivers added benefits

When using topical pain relievers, I also like to throw in a little dimethyl sulfoxide, or DMSO. This certainly isn’t a requirement, but in my experience, DMSO just seems to make this therapy work better.

DMSO is among the most interesting therapies I’ve ever come across. For starters, it’s one of the few compounds that can be administered orally, intravenously, intramuscularly or topically.

Rubbed on the skin – the most convenient method of use – it is quickly absorbed into the deeper tissues. And when it’s mixed with a drug or other substance, DMSO efficiently delivers it into the underlying area where it’s needed.

But DMSO is much more than a carrier. A powerful anti-inflammatory and analgesic in its own right, it is a popular treatment for sprains, strains and joint and muscle aches.

DMSO is remarkably safe, but it does have one adverse effect. Because of its abundance of sulfur compounds, it stinks to high heaven. Just ask my wife – she won’t come near me after I’ve been using it! The odor is worst with intravenous DMSO, but with frequent topical applications, sensitive noses can smell it. But don’t let that dissuade you from trying this amazing therapy.

Safe and effective pain relief

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

This approach to pain management comes straight out of conventional medicine. I learned about it at a conference at the University of California San Francisco.

Most physicians, however, 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.

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.

How to find these therapies

Topical pain relievers require a prescription and must be ordered from a compounding pharmacy, such as McGuff Compounding Pharmacy, (877) 444-1133, and Wellness Pharmacy, (800) 227-2627. These pharmacies can also provide additional information and protocols for topical painkillers.

DMSO creams and gels are sold in some health food stores or can be ordered online. 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. If odor is a problem, simply cut back – or use just a dab to enhance the effectiveness of a topical prescription pain reliever.

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