Physiomontreal - Medical Conditions

What is a physiotherapist?

Medical conditions

Preventing pain at work

Injury prevention

"Hot" or "Cold" ?

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Apply analgesic creams

Which one do I choose?

Every individual is different and responds to different sorts of medication. Those creams proven through independent research to be effective are creams are: Aspercreme, Myoflex - the active ingredient is 10% trolamine salicylate

Other creams available that my patients found effective are the following:

BenGay, IcyHot - the active ingredient is 30% methyl salicylate
Zostrix, Capsin - the active ingredient is 0.075%, capsaicin.1.27% pure menthol (Absorbine)

Rub on skin creams for injuries: real relief or just quackery?
(Medicine and Science in Sports and Exercise, vol. 20(2), Supplement, #141,1988)

Muscle soreness and joint pain are frequent problems for athletes; the maladies can reduce workout intensity or volume in experienced athletes and discourage individuals who are just beginning a training program. Treating such injuries quickly with ice and anti-inflammatory medications (as directed by a doctor) can provide significant relief, and advertisements for over-the-counter analgesic creams claim that the products also produce significant relief from muscle and joint soreness. Can something that you rub on your skin really help your muscles and joints?

Although these rub-on creams often smell and feel good to athletes, cream critics claim that not enough of a cream's active ingredient (usually trolamine salicylate) can actually work its way through the skin to reach deeper areas. However, research carried out with the creams has actually been fairly positive.

A little over a decade ago, researchers at the Veterans Administration Medical Center in Philadelphia smeared trolamine salicylate cream on to the knees of both dogs and humans. In the canine case, dogs with trolamine rubbed into their knees had 20 times as much salicylate in the underlying muscles, compared to those who were taking aspirin orally (salicylate is the active ingredient in aspirin). The research documented one very important fact: even though pill-popping pooches had higher BLOOD levels of salicylate, animals using cream had much more of the drug in their tendons, ligaments, cartilage, and joint cavities, where it really mattered, and where the chemical could actually relieve pain and inflammation.

In the Philadelphia research, results with humans were similar, with ample amount of salicylate building up in joint cavities. Actual pain relief was just as good with the salicylate cream, compared to ingesting aspirin orally. Plus, the researchers noted one special cream advantage: the ointment rapidly penetrated the skin and then lingered in the underlying muscles and connective tissues for long periods of time, only slowly drifting into the blood stream to be carried away. Overall, the cream was quite good at relieving local muscle and connective-tissue discomfort and of course produced none of the gastrointestinal upsets which are so common with aspirin and ibuprofen, two popular anti-inflammatory drugs which are taken orally.

In a more recent test of trolamine salicylate, packaged in a commercial product called Aspercreme, scientists at the Mount Sinai Medical Center in Miami asked 22 males and 12 females to perform three sets of 20 repetitions of biceps curls each day for five consecutive days in order to induce significant muscle soreness. Four times each day, the study subjects rubbed one-half ounce of cream onto the skin directly over the biceps muscles. Half of the subjects rubbed in Aspercreme, the other half employed a placebo cream. Unaware of which cream they were actually using, subjects rated biceps soreness on a O to 10 scale several times a day.

As it turned out, the Aspercreme provided three main benefits: (1) Muscle soreness appeared within 12 hours after initial exercise for the placebo users but took 24 hours to appear for Aspercreme appliers. (2) The amount of pain experienced was significantly lower for Aspercreme users. (3) Pain persisted for one day less with Aspercreme.

In other words, salicylate-containing creams delay pain, reduce the magnitude of soreness, and hasten pain's exit. And, unlike drugs taken orally, analgesic creams don't cause stomach upsets. To make matters even pleasanter, very few people experience skin irritation when they use analgesic creams.

So, analgesic creams containing 10 per cent trolamine salicylate really do work and are sometimes more effective than oral medication at relieving post- exercise soreness. There's also the intriguing possibility that a bit of cream rubbed on one of your body's 'hot spots' BEFORE a workout may actually reduce the amount of inflammation and pain which may be experienced after the session is over. As always, however, don't try to train through pain; when a body part hurts, you should discontinue training until it has recovered. ('Effect of a Topical 10% Trolamine Salicylate Cream on Delayed Onset Muscular Soreness, '