Custom pain creams do little to ease pain – Study

February 8, 2019

Compounded medicines are custom-made by pharmacists such that patients get a specific dose or formulation for pain relief, a better option than mass-produced creams, though more expensive.

A US study focused on pain creams made from medicines often prescribed in pill form – muscle relaxants, anticonvulsants and non-steroidal anti-inflammatory (NSAID) drugs. Around 400 patients with three distinct pain syndromes received either a medicated compounded cream or an unmedicated placebo cream:

  • Patients with neuropathic pain – pain due to nerve damage, including phantom limb pain experienced by amputees; they received anticonvulsant compounded creams.
  • Patients with nociceptive pain – pain not due to nerve damage, but from an injury or infection; they received compounded creams with muscle relaxants and NSAIDs.
  • Patients with “mixed” pain – pain caused by a variety of things; they received compounded creams similar to those for nerve damage or nociceptive pain.

While no patients reported serious side effects afterwards, but more of them experienced skin irritation and redness with compounded pain creams than with placebo creams. However, reports of pain reduction after a month were nearly identical across the three groups.

Senior study author Dr. Steven Cohen of Walter Reed National Military Medical Center, Maryland, has said that while some pain relief agents like NSAIDs are known to be effective, it was shocking that the pain difference in the study did not reach statistical significance.

Unfortunately, the study may have had too few patients to detect much pain relief differences.Many participants had also unsuccessfully tried conventional pain relievers before, so it is likely that the compounded pain creams would be ineffective too.

Dr. Nebojsa Nick Knezevic, a pain researcher at Advocate Illinois Masonic Medical Center, Chicago adds that current topical creams are still safe to use, but more randomized trials with a different combination of medications are needed.

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