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Creams for pain or inflammation - options? #280147
04/02/18 05:51 PM
04/02/18 05:51 PM
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Madison, Wisconsin, USA
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Cake Offline OP
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I think I have seen a couple of posts here mentioning creams people have used for pain and/or inflammation, possibly compounded creams. Many years ago (early 2000's) I had a pain doctor who prescribed a compounded cream but I no longer have any records about the ingredients.

A google search pulled up this list of possible ingredients for compounded creams for pain: https://www.uscompounding.com/pain-management-compounding_5007_ct.aspx

If you have used one can you share the ingredients and how it worked for you?

Re: Creams for pain or inflammation - options? [Re: Cake] #280149
04/02/18 06:34 PM
04/02/18 06:34 PM
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Just Friday I started a compounded cream with the following ingredients:
Ketamine 10%, Gabapentin 6%, Lidocaine 5%, Amitriptyline 2%, Baclofen 2%, bupivacaine 2%, Cyclobenzaprine 2%, Meloxicam 0.1%

I'm using it on my hands and wrists only and so far it seems to help quite a bit. Also at night I use a CPD gel and compression gloves.

I've also used Voltaren gel (an NSAID) on my neck and shoulders and it helps there. I also tried it on my back and hips with no effect.

Re: Creams for pain or inflammation - options? [Re: Cake] #280156
04/03/18 05:15 AM
04/03/18 05:15 AM
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Thanks Martin.... do you have a pain management doctor who is prescribing, or another type of doctor?

Will you report back after you use it a while? that would be helpful info!! What is CPD gel? Good to know about the voltaren gel .... might be a good option for me.

Re: Creams for pain or inflammation - options? [Re: Cake] #280162
04/03/18 05:13 PM
04/03/18 05:13 PM
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I made a typo - its CBD gel made from hemp oil:

https://www.medicalnewstoday.com/articles/317221.php

My primary care doctor prescribed both the voltaren and compounded creams.

I'll be sure to update after a week or so. It seems to be helping already. The compounded cream causes a brief lightheadedness so I've taken to applying it when I can sit for 20 minutes or so. It's not very intense but I prefer to let it pass than try to do something.

Re: Creams for pain or inflammation - options? [Re: Cake] #280168
04/04/18 05:04 PM
04/04/18 05:04 PM
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Ketamine is a hypnotic medication. Absorption through the skin is probably individual but I am surprised to see it in a cream. Typically given to kids mostly in ER via IV route to induce temporary hypnotic and pain reduction to reset limbs after a fall or being pulled out of joint.

Gabapentin 6%, Lidocaine 5%, Amitriptyline 2%, (all reduce peripheral nerve sensation)
Baclofen 2%, (muscle relaxant)
bupivacaine 2%, (anesthetic )
Cyclobenzaprine 2%, Meloxicam 0.1% (muscle relaxants)


Starting at 18 yrs old > Reiter's Syndrome. Diagnosed 2001 Ank Spon.
Started Remicade 2002 - 5mg/kg every 7 weeks.

Right Eye Glaucoma- Trabeculectomy/lens replacement 2006.
Right eye DSEK Cornea Transplant 2009.
Right eye Ahmed Shunt 2016.
Right eye DSEK Cornea Transplant 2016.
Supra Ventricular Tachycardia. 2004. Cured by RF ablation 2008.

ICU RN - Seattle, WA

~Grasp The Challenge and Succeed~
Re: Creams for pain or inflammation - options? [Re: Cake] #280170
04/04/18 08:18 PM
04/04/18 08:18 PM
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To clarify here are the functions of the drugs used in the compounded cream:

Meloxicam is an NSAID.

Amitriptyline is an antidepressant that is also used for neuropathic pain management and IBS

Gabapentin is used to control seizures and is also used for neuropathic pain management

Lidocaine and bupivacaine are topical anesthetics

Baclofen and Cyclobenzaprine are muscle relaxants.

Ketamine is a dissociative anesthetic used in the O.R. and E.R. Here is a good article from the NIH on its neuroprotective, antiinflammatory and antitumor effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258981/

Re: Creams for pain or inflammation - options? [Re: Cake] #280181
04/06/18 09:14 PM
04/06/18 09:14 PM
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Madison, Wisconsin, USA
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Thanks.

While I am waiting to see my doctor, a friend suggested BioFreeze to me and I've been using that. It is mildly helpful- makes the skin feel cold, so distracts your brain from pain signals to cold signals.

Re: Creams for pain or inflammation - options? [Re: Cake] #280182
04/06/18 10:53 PM
04/06/18 10:53 PM
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My rheumy recommended Salon Pas patches, which are the same concept of distraction as the BioFreeze, except they are tingly instead of cold. She also prescribed a Flector patch last year (it's an NSAID), but my insurance wouldn't cover it.

And the ortho who did my wrist injection last fall recommended emu oil for my thumb the next time it flares. I've since bought a bottle, but haven't used it consistently enough to give it a fair trial yet.


Ginny - 57 year old female
Dx with USpA in March 2013; changed to AS in July 2015
Iritis and Scleritis
unicompartmental knee replacements: right-June 2014, left-Aug 2018
MTX, Humira, Cyclobenzaprine, plus Celebrex as needed
Supplements: Folic Acid, Vitamin A, Vitamin D, Calcium, Fish Oil, Culturelle probiotic, Melatonin (as needed)
Re: Creams for pain or inflammation - options? [Re: MartinMMM] #280208
04/17/18 05:57 AM
04/17/18 05:57 AM
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Originally Posted by MartinMMM
Just Friday I started a compounded cream with the following ingredients:
Ketamine 10%, Gabapentin 6%, Lidocaine 5%, Amitriptyline 2%, Baclofen 2%, bupivacaine 2%, Cyclobenzaprine 2%, Meloxicam 0.1%

I'm using it on my hands and wrists only and so far it seems to help quite a bit. Also at night I use a CPD gel and compression gloves.

I've also used Voltaren gel (an NSAID) on my neck and shoulders and it helps there. I also tried it on my back and hips with no effect.


Ditto to all of that except the gloves. It helps a little bit, maybe 1-2/10 reduction, which is worth the effort especially when systemic meds aren't enough (much less expensive than the cream unforunately). But worth trying to see. It doesn't penetrate deeply so it can't get into the hips or deep into a thick back like mine, but on the knees, hands, and feet it does help and so I pay the full price each month as insurance no longer covers compound pain cream for me.


Dx w/ AS in 1985. HLA-B27+. Left total hip replacement in 1998, lost 2" of height due to osteoporosis. Relevant meds include Remicade, Oxycontin, Percocet, Lyrica, Soma. 7 hour spine fusion surgery in April 2014 for cervical spondylotic myelopathy and radiculopathy. Tried for a year to return to work and couldn't make it past a 5 hour day, so was forced to go on disability in 2015 and haven't been able to attempt another day of work since then. Living to help others now.
Re: Creams for pain or inflammation - options? [Re: Cake] #280210
04/17/18 01:04 PM
04/17/18 01:04 PM
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It's been a few weeks now and I want to report on the compounded cream. I use it on my hands which were quite painful all the time and sometimes woke me up at night. The cream helps takes the edge off the pain and helps with the stiffness and definitely decreases swelling. I use it at night and in the morning and occasionally at mid day on the back of my hands and wrists. The cream itself is sticky and somewhat unpleasant and that's why I generally limit to twice a day. It is also mildly psychoactive and makes me a bit drowsy and lightheaded for about 20 minutes. My insurance doesn't cover it.

The voltaren cream is helpful on neck and shoulders, decreasing pain although not dramatically. It doesn't seem to help hips or lower back at all when applied there. My insurance covers it.

I'm trying a new device called Quell - https://www.quellrelief.com/ - to see if it helps. It's my second day so nothing to report yet other than it is easy to use and relatively comfortable. I mention it here because it's also topical in the sense that it's wearable. My insurance doesn't cover it.

I'm avoiding medications that are psychoactive since I'm trying to stay as alert and active as possible. So far I've tried to gabapentin which was very problematic. It made me "spacey" even with a low dose at night. Also cyclobenzaprine with a similar reaction. And I can't take NSAIDS as they give me extreme gastritis. So these topical drugs and hopefully the wearable are my best option. That and exercise and yoga.

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