Pain Management with Transdermal Therapy

The compounding cream market has exploded across the country in the past few years. There are numerous pharmacies promoting these products, many different combinations of topical medications available, and the cost of these formulations is quite high. This can be quite intimidating to a physician, especially when there is inadequate time available for them to thoroughly evaluate these products and pharmacies for effi cacy and patient safety. The author had doubts about these compounding formulas when they fi rst appeared on the market and wanted to determine if these products were really effective and if there was a place for them in today’s medical management of pain. Were we really getting a bang for our buck with these topical combinations? After signifi cant research and personal clinical applications, the author feels there is a defi nite place for these compounding products, especially in pain management, but again like many new medical advances, they are being over-utilized and often times rendered ineffective due to improper usage. These compounding creams can be very benefi cial for treating pain when prescribed appropriately. The author has had success with many topical formulations, and has seen them make a big difference to many patients in the pain management protocol. There are many advantages to topical therapy versus oral pain management and the author feels that transdermal therapy can be a very positive adjunct to treatment protocols. This article will review some of the diffi culties we face as physicians in managing pain and the societal and economic consequences of pain. Common medications being utilized in compounding creams will also be reviewed so you can familiarize yourself with their indications and use them effectively. Finally, some literature evaluating the success and effectiveness of topical medications will be evaluated.