Although back or neck pain are more common than shoulder pain, this does not diminish the frustration your patients feel when they experience nagging shoulder pain.
Regardless of the cause, shoulder pain can interfere with your patients’ activities of daily living, such as dressing, bathing or showering, or personal grooming activities such as brushing their hair.
pain can also affect your patients’ ability to properly perform their work,
particularly if it requires them to spend most of their time working on a
computer. Even weekend warriors can be sidelined from their favorite athletic
activities as a result of soft tissue shoulder pain. Fortunately, many topical
analgesics are well-suited for treating shoulder pain.
conditions treated with topical analgesics
shoulder issues, such as a dislocated shoulder, cannot be primarily treated
with a topical analgesic. However, pain that results from overuse or overstretching
are the most common causes for patients to come to see you with a chief
complaint of soft tissue shoulder pain.
In most instances, the
culprit is either a repetitive use or an athletic injury. Patients with
arthritis, tendonitis, or bursitis of the shoulder may also benefit from
of topical analgesics
There are several
different types of topical analgesics, each of which works in different ways,
depending upon your patients’ needs.
topical analgesics contain the same ingredients as in aspirin and NSAIDs, although
in much lower amounts. They are particularly good for joints close to the
surface of the skin, such as knees and elbows.
Topical analgesics that produce a cooling sensation fall into this category.
They usually contain menthol, camphor, or eucalyptus oil. These work well right
away, but are usually not recommended for chronic shoulder pain.
category of topical analgesics produces a warming sensation from chili pepper
oil, which can help ease joint pain or nerve damage in the shoulder. Topical
analgesics with capsaicin generally require several applications to have a
long-term effect, so are better suited for chronic shoulder conditions, such as
arthritis or frozen shoulder.
How do topical
actually work by tricking the brain into ignoring pain signals. They stimulate
a particular neuron receptor in the brain to lessen the pain sensation on the
shoulder.1 Although the skin temperature on the shoulder will not
have changed, the patient experiences a sensation that it processes as relief
In fact, a 2012 study in
Journal of Sports Physical Therapy compared a menthol
topical analgesic to ice for athletic injuries and found that the topical
analgesic offered significantly better results.2
Advantages of topicals for soft tissue
The main advantage for
topical analgesics is that they deliver pain relief directly to the shoulder.
In comparison, aspirin or NSAIDs must first be absorbed into the body before they
can begin to relieve pain. Because topical analgesics go directly to the affected
area, your patients should feel results almost instantaneously.1
Topical analgesics also
can be used with far lower risk of side effects. Unlike oral aspirin or NSAIDs,
which may cause gastrointestinal issues for your patients, some topical analgesics
only contain a minute amount of these painkillers, so are far less likely to
This low side effect
profile also makes topical analgesics an excellent option for pediatric or
geriatric patients, as well as those who don’t wish to add more oral
medications to those they are already taking.
analgesics are an excellent way for your patients to enhance their chiropractic
care by using them between regular visits for shoulder joint adjustments. This
is particularly beneficial for those of your patients with chronic shoulder
Combined with the use of
either ice or heat, and self-massage, topical analgesics can help your patients
get their shoulder back into full swing.
1. D. Rub-on pain reliever can ease arthritis discomfort. Harvard Health Blogs. Accessed 12/15/2018. Available at https://www.health.harvard.edu/blog/rub-on-pain-reliever-can-ease-arthritis-discomfort-201301185817
2. Johar P, Grover V, Topp R, Behm DG. A comparison of topical menthol to ice on pain, evoked tetanic and voluntary force during delayed onset muscle soreness. International Journal of Sports Physical Therapy. 2012;7(3):314-322.