Topical Agents

The number of agents used topically for the control of pain is growing. At this point, however, the Lidoderm patch is the only topical agent approved by the U.S. Food and Drug Administration (FDA), and that approval is for the treatment of postherpetic neuralgia. Lidocaine seeps into the skin and anesthetizes peripheral pain generators.

A second topical agent with widespread acceptance is capsaicin, which, in concentrations of 0.025 to 0.075% is effective in the management of pain arising from a variety of conditions. Applied multiple times a day, cap-saicin slowly destroys the C-fibers thought to be important in pain transmission. A single application of 5 to 10% capsaicin under regional anesthesia provides pain relief for weeks or months. This approach is currently under investigation. (The second author holds a patent on this technique.)

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Dealing With Back Pain

Dealing With Back Pain

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