Patches come in different sizes and adhere to the specific site of pain. They can cover large areas such as the lower back or smaller areas such as the neck, arms or legs. They come in both prescription and non-prescription strengths. The various types of pain patches, each with different ingredients and each works a bit differently.
These patches are best used for minor to moderate aches and pains caused by overexertion or arthritis. They are often used on joints, back, and neck.
|Name||Ingredients||How it Works|
|Aspercreme||Lidocaine 4%||Anesthetizing agent, numbs nerve endings|
|ThermaCare||Heat discs made of activated charcoal, iron powder, sodium chloride, sodium thiosulfate, and water.||Air activates the heated discs, providing relief through heating the affected area.|
|Salonpas||Camphor, menthol, methyl salicylate (NSAID)||Topical analgesic|
|Salonpas-Hot||Capsaicin (an active component of chili, cayenne, and jalapeno peppers)||Decreases pain transmission|
Prescription patches such as Lidoderm® contain a higher concentration of lidocaine. As mentioned above, this agent works by numbing nerve endings. This option is often used to treat pain associated with post-herpetic neuralgia from shingles and diabetic peripheral neuropathy.
Non-Prescription Creams, Gels, Foams, and Liquids
Cream, gel, foam and liquid pain relief products offer an alternative to patches. These forms typically include the same or similar ingredients as the patches. The active ingredients will work the same in any form. The option you choose is completely based on personal preference.
Custom-Compounded Topical Pain Medication
One of the most versatile treatment options is a compounded topical pain medication. Available by prescription, these medications are custom made for a patient’s specific type of pain. They are often made with 2-5 different types of medications to target each type of pain present. This customization is essential for those who experience a combination of pain types (neuropathic, central and peripheral). We discuss these in detail below. Your doctor or pharmacist can help you identify your type of pain. From there, the doctor, pharmacist, and patient work together to design a custom medication.
The type of pain you have determines what the doctor and pharmacist recommend for delivery and ingredients. It’s even possible to have more than one type of pain, necessitating the use of multiple medications. Below we describe the different types of pain. You should discuss your symptoms with your doctor to determine which type you have.
This type of pain, also known as nociceptive, is most common and caused by some type of injury or inflammation in your body. This triggers the nociceptors to send a signal to your central nervous system and brain indicating there is pain. Examples include arthritis, broken bones, and cuts.
This type of pain, also known as non-nociceptive, is often due to an error in processing pain signals coming to the brain. Examples of this pain include fibromyalgia, irritable bowel syndrome, tension headache, or idiopathic low back pain.
Localized to the specific site of pain
Can be compounded with multiple different medications that work in different ways
Likely fewer drug interactions due to lower absorption into the bloodstream
|Medication||Type||Pain Type||Best for acute or chronic pain?||Over the Counter (OTC) or Prescription|
|Capsaicin||Decrease pain impulse transmission||Neuropathic||Chronic||OTC|
|Clonidine||Pain impulse inhibitor||Neuropathic||Chronic||Prescription|
|Amitriptyline||Pain impulse inhibitor||Central/Neuropathic||Chronic||Prescription|
|Carbamazepine||Pain impulse inhibitor||Central Neuropathic||Chronic||Prescription|
|Doxepin||Pain impulse inhibitor||Central/Neuropathic||Chronic||Prescription|
|Gabapentin||Pain impulse inhibitor||Central/Neuropathic||Chronic||Prescription|
An Important Note About Topical Pain Medication
Your Next Steps
NSAID Prescribing Precautions, American Family Physician
Topical Treatment of Neuropathic Pain Using Compounded Medications, The Clinical Journal of Pain
Pain Management Compounding, Professional Compounding Centers of America (PCCA)