Sports and Exercise (vol. 20(2)) found that trolamine salicylate penetrated well into underlying muscle tissue. It slowed the onset of soreness; reduced levels of soreness; and reduced duration of soreness. There is another very good reason to consider the use of trola -mine over oral analgesics. Researchers at the VA Medical Center in Philadelphia applied trolamine salicylate to the knees of dogs. They found that the dogs had 20 times as much salicylate in the underlying muscles as those who were given ASA orally. The oral salicylates resulted in higher blood levels, but dogs given a topical application received much more of the salicylate in their tendons, ligaments, cartilage, and joint cavities, where it would be far more effective in relieving pain and inflammation. In clinical applications, a study published in the Open Ortho-pedics Journal in 2008 found that menthol was effective in the treatment of the muscle pain associated with tempero-mandibular joint (TMJ) disorders. The Journal of Chiropractic Medicine pub -lished a study in 2008 reporting that topical menthol combined with chiropractic adjustment showed significant reduction in low back pain. All of these studies indicate that topical analgesics have an im -portant role to play in the control of pain and a return to health. PraCtiCal ConsiDErations There are also a number of practical benefits to using these products. Chiropractors often recommend applications of cold or heat to help control pain or to affect a response in the injured area. In the home, the patient can do this with ice, freezer packs, heating pads and hot water bottles. But, this is not practical for many occupa -tional situations. For the long-distance trucker or office worker who often can’t follow this recommendation for long periods of time, a topical gel can be ideal. If repeated applications of the selected product can help reduce or eliminate the use of oral analgesics and anti-inflammatories in -cluding non-steroidal anti-inflammatory drugs, the benefits are compounded. This can be vital in situations where oral analgesics are contraindicated such as when treating female patients who are pregnant or nursing. Topical analgesic products have additional practical applica -tions in the clinic as well. The Journal of Athletic Training pub -lished a study in 2001 that found that topical menthol gels com -bined with typical ultrasound gel can be effective as a coupling agent when applying therapeutic ultrasound. Many chiropractors are using kinesio-taping techniques to aid in the treatment of soft-tissue injuries. Spray products, with an al -cohol content of up to 90 per cent, can be effective as skin cleans -ing agents prior to applying the tape. In addition, the menthol included in most sprays helps reduce the discomfort that might accompany the application of the tape. Topical analgesics offer a safe and effective adjunct to chiro -practic treatment. The pain relief they provide can give the patient a good reason to maintain care until the problem is resolved. They can prevent the often harmful side-effects of oral analgesics. They are convenient to use in a number of occupational and recreational situations and they are extremely cost effective. In my experience, the patients who have followed my advice to use a specific topical product have been very thankful and have maintained their health through chiropractic care. • 18 • CANADIAN CHIROpRACTOR | DECEMBER 2011 www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor December 2011: Page 18
