Compounded Pain Creams May Not Offer Relief

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Compounded topical pain creams were no better than a placebo at easing sore, aching joints and other discomfort, according to a 2019 study in the Annals of Internal Medicine.

A compounding pharmacy is one where a pharmacist will alter or tailor a conventional medication to suit the needs of a specific patient. Many create customized topical creams for customers, using pain medications that are normally taken orally, such as ketoprofen, for arthritis-type pain, or gabapentin (Neurontin), for nerve-related pain.

In the study, 399 patients with localized, persistent pain of greater than six weeks duration were randomly chosen to receive either a compounded topical pain cream, designed for the type of pain they suffered, or a topical cream containing no medication (placebo). The patients applied the creams three times daily for up to three months. At the end of the study, there was no difference in pain levels in the two groups.

The study’s authors speculate that the compounded creams probably flunked because they contained drugs that act on the central nervous system, which the drugs can’t access when applied to the skin. However, don’t dismiss topical pain creams altogether. There’s some evidence that those containing nonsteroidal anti-inflammatory drugs (NSAIDs), capsaicin, or lidocaine may offer some relief.