these can be helpful in achieving the goal of a healthier patient but, unfortunately, many people use them as a substitute for proper care. Fortunately, there is another tool that has very few side-effects, is much safer to use than oral analgesics and can be more effective. toPiCal analgEsiCs Topical analgesics have been widely used for many years. In ancient Athens, the paidotribai (athletic therapists) used various oils to supplement massage treat -ments on athletes. Menthol, used in Japan more than 2000 years ago, was isolated from peppermint oil in 1771 by German physician Hieronymus Gaubius. At the turn of the 19th century in America, the first athletic trainers employed the combi -nation of massage and a counterirritant to treat athletes. One of the oldest producers of men -thol and other topical applications, the Mentholatum Company, can trace its roots to Wichita, Kansas, where Albert Alexander Hyde founded the Yucca Com -pany in 1889. After four years of research he introduced his very first Mentholatum Ointment, which is still available today as are other Mentholatum products. When topicals were initially marketed, it was believed that cooling gels (those containing menthol) and the heating ap -plications (those with capsaicin and meth -yl salicylate) mimicked the effects of ice and various heat sources, but the mecha -nism of action was poorly understood. More recent research has provided much better insight into what is happening at a cellular and molecular level. thE sCiEnCE of toPiCals The sensation of pain originates with stimulation of nerve endings. Myelin -ated A-delta fibres transmit pain signals faster and carry sharp pain. The slower, unmyelinated C fibres carry pressure and touch. Both fibres stimulate transmission and inhibition cells at the dorsal horn of the spinal cord. While there is some un -certainty as to how pain is modulated at the cord level, the gate theory, introduced by Melzack and Wall in 1965, is currently favoured. The A-delta fibres impede the inhibitory cells, leaving the gate of pain transmission up to the brain open. The slower C fibres excite the inhibitory cells, thus closing the gate. This is why we rub a sore or injured area. The pressure of the rub closes the gate and inhibits transmis -sion of the pain signal to the thalamus. This also helps explain the function and value of topical analgesics. Among the most common active ingredients found in topical analgesics are menthol, methyl salicylate, capsicum and trolamine salicy -late. The effect of menthol is primarily due to its counterirritant properties. Menthol stimulates the C fibres (type 2) and this triggers stimulation of the inhibitory cells and the release of substance P . Once this substance is depleted, the pain signals are temporarily blocked. Capsicum works in a similar manner. When a pain signal is received within the brain, endorphins are released to the nerve endings. Trolamine salicylates are believed to relieve pain by inhibiting prostaglandins at a local level, much as ASA does systemically. A study published in Medicine and Science in Support your PaTienTs suPPorT your treatment One Size DOeS Not Fit All. Five SizeS DO. Our eASy tO uSe meASuring tOOl enSureS the prOper Fit. Shoulder Length The patented Therapeutica Pillow is ergonomically designed to promote correct spinal alignment, bio-mechanical configuration and to aid in achieving neutral posture for both back and side sleeping. • Wedge Extension Supports the Upper Back • Cervical Contour Supports your Neck • Center Cavity Cradles your Head • Raised Side Sections Help Eliminate Back, Neck, Shoulder Pain • Side Cavities give Jaw Comfort to TMJ sufferers • Our custom blended foam is poured not cut • No stocking — Order as needed • 5 year warranty for shape and resilience 6-10 Years CHILD Shoulder Length Adult PETITE Shoulder Length Adult AVERAGE Shoulder Length Adult LARGE Shoulder Length Adult X-LARGE Sleeping Pillows Pillow Size Measuring System Sleeping Pillows Measure from the base of the neck to the outside tip of the humerus bone. Choose the smaller size if your measurement falls on the black line. FirsT Time buyers Buy 1 Pillow, get a Free Trial Pillow ! (Limit one offer per doctor) Contact us today and see how easy it is to support your patients. 800/348-5729 or www.therapeutica.com 16 • CANADIAN CHIROpRACTOR | DECEMBER 2011 Therapeutica MT fall 111 support.indd 1 www.canadianchiropractor.ca 30/09/11 2:03 PM
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