There are a vari­ety of patches, creams and gels avail­able for those with back pain.

Do they work?  Have you used any?  Con­sid­er­ing which ones might work for you?

Here is an out­line of the seven dif­fer­ent kinds of top­i­cal back pain relief prod­ucts avail­able with­out a pre­scrip­tion, their mode of action, and the like­li­hood that they could work for you.

1. Coun­terir­ri­tants

   Coun­terir­ri­tants are sub­stances such as men­thol, cam­phor, or win­ter­green oil that cre­ate a sting­ing, burn­ing, or “icy hot” sen­sa­tion.  The the­ory is that the burn­ing sen­sa­tion over­rides the nox­ious sig­nals going into your brain, thus alle­vi­at­ing pain.

   These prod­ucts are likely to be safe. (Though the FDA has recently issued a warn­ing that some users have expe­ri­enced sig­nif­i­cant skin burns.  So if you use these prod­ucts – fol­low the label directions!)

   You may get some skin red­den­ing, though it’s prob­a­bly just tem­po­rary.  Any relief you get is prob­a­bly tem­po­rary, too.

2. Cap­saicin

   Cap­saicin is the active ingre­di­ent that makes hot pep­pers hot.  If you rub it on your skin, it will pro­duce a burn­ing sen­sa­tion.  In some respects, this will work sim­i­larly to the coun­terir­ri­tants described above.  But there’s more.

   Once cap­saicin is absorbed into the skin, the the­ory is that it inhibits the nerve trans­mit­ters that your body uses to sig­nal pain.  So its effect may be more sub­stan­tial than the effect of the counterirritants.

   Don’t expect pain relief right away; it might take a week or two for the ben­e­fits to kick in.

3. Sal­i­cy­lates

   Sal­i­cy­late is the active ingre­di­ent in aspirin.  Aspirin is a proven anti-inflammatory and pain reliever, but it can chew up your stom­ach lin­ing.  As an alter­na­tive, you can find gels or patches con­tain­ing sal­i­cy­late so that it’s absorbed directly into your skin.

   The advan­tage of using salicylate-containing cream is that you can get an effec­tive dose in the painful area with a far lower system-wide load.  There’s some research that backs up this method.

4. Herbs for Pain

   A num­ber of dif­fer­ent herbs are claimed to have pain-relieving, muscle-relaxing, or circulation-boosting properties.

   One exam­ple is com­frey root.  Researchers have shown that apply­ing comfrey-root to your low back affords rapid pain relief.

   Another herb, ilea, is also used in a num­ber of top­i­cal back-pain formulas.

5. Chi­nese Herbs for Pain

   A wide vari­ety of herbs are used top­i­cally in tra­di­tional Chi­nese med­i­cine to address back pain.

   Chi­nese herbs are herbs, of course, but I’ve included them in a sep­a­rate cat­e­gory because the tra­di­tional Chi­nese med­ical under­stand­ing of their mech­a­nism of action is rooted in an entirely dif­fer­ent med­ical worldview.

   The choice of herbs to be used depends on a tra­di­tional Chi­nese med­ical eval­u­a­tion of the nature of your problem.

   Some of the herbs that might be sug­gested include dip­sacus, eucom­mia, and psoralea.

6. Home­o­pathic Preparations

   The under­ly­ing the­ory of home­opa­thy, that van­ish­ingly minute amounts of the right ingre­di­ents can spur your body toward health, is so sci­en­tif­i­cally unlikely that I can’t rec­om­mend the use of a home­o­pathic product.

   I’m all in favor of the “spur your body toward health” part of the phi­los­o­phy, but the “van­ish­ingly minute amount” ends up mean­ing that homeopathically-prepared reme­dies con­tain absolutely zero of the sup­pos­edly active ingre­di­ent.  That strains my credulity.

   Besides which, there is zero research evi­dence that home­o­pathic treat­ment is effec­tive for any condition.

7. Pre­scrip­tion Topicals

   Allo­pathic physi­cians can pre­scribe pain patches con­tain­ing lido­caine, a cocaine ana­log that alle­vi­ates pain.

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Com­frey root — apply it to your back