Topical Analgesics for Chronic Pain

Such medications as anticonvulsants, nonsteroidal anti-inflammatory drugs, antidepressants, and opioid analgesics enable effective treatment of a variety of chronic pain conditions, but all have the potential for severe adverse effects. Because few patients with chronic pain respond adequately to monotherapy, drug combinations are common, and the risk of side effects increases accordingly. When chronic pain is experienced in a localized area of the body, applying medications topically may have the desired therapeutic effects while reducing potential morbidity. Several commonly used medications are now known to penetrate the skin in therapeutic concentrations, and topical analgesic preparations are becoming more widely used as valuable additions to medical practice. Here we examine the different classes of topical analgesic used to treat chronic pain and the evidence of their efficacy for specific pain conditions.