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2015 ; 4
(1
): 17-32
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Skin Matters: A Review of Topical Treatments for Chronic Pain Part One: Skin
Physiology and Delivery Systems
#MMPMID25627665
Peppin JF
; Albrecht PJ
; Argoff C
; Gustorff B
; Pappagallo M
; Rice FL
; Wallace MS
Pain Ther
2015[Jun]; 4
(1
): 17-32
PMID25627665
show ga
Chronic pain is a complex disorder with multiple etiologies for which the
pathologic mechanisms are still largely unknown, making effective treatment a
difficult clinical task. Achieving pain relief along with improved function and
quality of life is the primary goal of pain clinicians; however, most patients
and healthcare professionals consider 30% pain improvement to be clinically
significant-a success level that would be unacceptable in other areas of
medicine. Furthermore, patients with chronic pain frequently have multiple
comorbidities, including depression and sleep apnea, and most have seen several
physicians prior to being seen by a pain specialist, have more than three
specific pain generators, and are taking multiple medications. The addition of
further oral medications to control pain increases the risk of drug-drug
interactions and side effects. However, topical analgesics have the advantage of
local application with limited systemic levels of drug. Topical therapies benefit
from reduced side effects, lower risk of drug-drug interactions, better patient
acceptability/compliance, and improved tolerability. This two-part paper is a
review of topical analgesics and their potential role in the treatment of chronic
pain.