Practitioner Blog

Compounding for Chronic Pain

The Advantages of Compounding for Chronic Pain

Dr. Sheldon Bjorgaard, BSC., ND  

Chances are, if you are a human being, you have experienced physical pain at some point during your life. Pain, though uncomfortable, and sometimes unbearable, is useful to healthcare providers as it tells us what is going on inside the body and gives us clues as to which structures are affected. That being said, severe pain, chronic pain, and pain that significantly interferes with our activities of daily living needs to be managed before it causes other health problems.

Current guidelines for patients presenting with acute or chronic pain often includes one or more oral pain medications depending on the nature and severity of the pain. These include: Non-Steroidal anti-inflammatories (ibuprofen, naproxen, diclofenac), Muscle relaxants (baclofen, cyclobenzaprine, Anticonvulsants (gabapentin, pregabalin), Antidepressants (amytriptyline, nortriptyline, duloxetine), and Opioids (codeine, oxycodone). Unfortunately, especially when used long term, many oral pain-relieving medications have unfavorable side effects. These include gastrointestinal ulcers, cardiovascular disease, liver toxicity, dizziness, drowsiness, constipation, and dry mouth. Furthermore, taking two or more different medications daily often becomes cumbersome and difficult for patients to remember the correct dosing, all of which further interferes with quality of life, which is what we are trying to improve in the first place!

All of these factors beg the need for more options when it comes to pain prescribing. One of these options is compounded topical pain medication, which is the use of pain medication topically in a cream or lotion, and delivered directly to the affected area(s). There are several major advantages of using medications this way.

  • Customizeable and Individualized
    • We can combine multiple medications in the same topical formula to address your particular type or types of pain.
  • Application directly to the site of pain/injured tissue
    • The medication is applied directly to the affected area(s) and is absorbed through the skin.
  • Less systemic absorption
    • Because the medication is applied topically, a far smaller amount is absorbed into the bloodstream. This leads to fewer systemic side effects and organ involvement.
  • Convenience in dosing
    • Topical medication is easy to apply, and leads to less oral medication use. It also helps reduce the chance of harmful drug interactions or mistakes in dosing.
  • Minimization/elimination of addiction or abuse potential
    • Because there is minimal systemic absorption, the abuse potential of topical medications is extremely low compared to oral medication.

If you or a loved one are dealing with chronic pain, have experienced side effects from oral pain medications, or would like to discuss more options when it comes to pain management, talk to your doctor or naturopathic doctor about topical compounded pain medication customized for your individual case.


Pain Management Therapy: The Benefits of Compounded Transdermal Pain Medication Andrea Branvold and Maria Carvalho. J Gen Practice 2014, 2:6.