Liver-friendly topical pain relief

I have been on a hunt for some pain relief that will not compromise my liver. I figured I’d start from the outside in. I’ve had enough drama involving insides lately, and wanted to give them a break.

While topical creams can avoid gastric complications, some contain ingredients, which when absorbed through the skin, can have the same side effects as those taken internally. You have to be doubly careful if you are using such a cream while also taking an oral pain reliever with similar ingredients.

Pictured here are three pain relievers. Two are “natural” remedies, one is by prescription.

I’ve said “diclofenac” so frequently in recent posts, you might think I’m getting a dollar every time I type the word. (Forget it — it’s a generic). The cream on the right in the image, however, goes by one of the patented names of the drug, Voltaran. Apart from sounding something like a sci-fi-fantasy overlord, it’s a good pain reliever, like super-strong-aspirin. For me, the gel (cream, actually) works better than the tablets. But it still has the side effect of liver damage, being an NSAID. So, I use it sparingly.I expect the danger is more remote than the pills, but, right now, I’m not taking chances.

Lately, I’m not using it at all.

So, I’m looking for other stuff. Stuff that works, without major side effects.

The other two products in the picture have the distinctive smell of “pain relief”–the pungent, resinous, aggressively minty smell of the tube you probably had in the medicine cabinet growing up. It made your skin feel hot. That smell is also found in some decongestants– it’s in the little blue jar of petroleum rub that blessedly replaced mustard plasters, and percolated away in a hot water vaporizer my childhood bedroom. That stuff also has camphor, which has a similar smell, and warming effect.

So what are we talking about here? Two things: menthol and camphor.

What is menthol? It’s a synthetic organic compound usually made with some sort of mint oil, most often peppermint, to form a waxy solid that melts under slight warmth. Surprisingly, menthol is actually a very minor opiod receptor agonist. (An opiate agonist creates a small opiate effect to relieve pain. Oddly, the LDN I take for MS symptoms and chronic pain is an opiate ANTAGONIST, which blocks opiates, but reduces inflammation in the central nervous system and so also reduces pain.)

My grandmother was a particular fan of something called camphor ointment, which, I think is jellied petroleum infused with as much camphor as anyone else in the room can stand–or perhaps a little more. She did everything with it but eat it, and to tell the truth, I’m not sure of that last statement.

Camphor is made from the wood and bark of a tree. It too is warming, and often used for minor aches and pains. It’s a common ingredient in moth balls.

Both menthol and camphor are usually sold over the counter in pain meds, mixed up in some petroleum base. Both slightly irritate the skin and increase local blood flow, hence, the warming relief for aches.

Nature vs Pharma? Sombra and döTERRA Deep Blue

Sombra Warm Therapy

The product in the middle, Sombra, comes in a warming and cooling formula. This one is the warming type, and contains 3% each of camphor and menthol.

The inert ingredients are: aloe vera extract, capsaicin, carbomer, decyl polyglucose, deinoized water, grapefruit seed extract, green tea extract, orange peel extract, queen of the prairie extract, rose water, sodium hydroxymethylglycinate, vegetable glycerin, witch hazel, yucca extract.

I also sometimes take capsaicin for pain, so I wouldn’t exactly call that ‘inert,’ but I suppose Sombra & Co. have their own reasons for listing it among the also-rans.

WebMD lists the side effects of this rub to be minor skin irritation, or, more rarely, a burn for those sensitive to camphor and/or menthol. Good to try this in a small spot before using, say on the inside of your forearm.

OK. Got that so far?

döTERRA Deep Blue essential oil blend

The small bottle, its deep blue color eponymous for the product inside, I got from my doctor’s office. It’s a high-end aromatherapy blend. It has that same “smell.”

Essential oils are powerful, and should almost never be used  on the body without guidance. They can also be very dangerous at full strength. With a couple of exceptions, all essential oils should be diluted according to directions.

The directions on this bottle, rather unhelpfully said: “To apply topically: dilute with döTERRA Fractionated Coconut Oil.” OK.

I put a couple of drops of this blend into a palm full of carrier lotion and put it on the bits that hurt, back and shoulder. It was warming, and a bit irritating, but did the trick.  So what’s in it? It’s a blend of wintergreen, camphor, peppermint, blue tansy, German chamomile, helichrysum, and osmanthus essential oils.

That all sounds good and safe, right? Wintergreen and camphor instead of menthol and camphor?

However, there is a significant difference between wintergreen oil and menthol. Menthol, you may recall is a synthetic compound that often contains some mint oil.

Wintergreen, despite being a common candy and gum “mint” flavor is NOT a mint, and in those cases, is most certainly artificial. Wintergreen is an evergreen whose Latin name is Gaultheria Procumbens. It contains 98% methyl salicylate in its essential form. If you have a salicylate allergy, for instance, are allergic to aspirin, you probably already know where this is heading. As wintergreen oil is absorbed through your skin, it metabolizes into salicylic acid.

So the unsuspecting can not only incur the danger of liver damage inherent in all NSAIDs by using this product, but there’s something worse at stake. Salicylate toxicity is dangerous, and a common cause for hospitalization. Methyl salicylate can make an allergic person very ill or worse. The much-publicized death of a young track star who repeatedly stopped to apply an over-the-counter pain cream during a race is one example. Her use of the cream was excessive, and she unwittingly used the cream together with a known aspirin allergy.

The commonly available commercial cream she used had methyl salicylate listed as an ingredient.

The essential oil mix (which I might add cost $22 for 5 ml, and, I repeat, was bought from a doctor’s office–I was REALLY in pain that day), lists the common name for Gaultheria Procumbens, ‘wintergreen oil,’ to underscore its “natural” qualities. The sole caution on the bottle mentions skin irritation.

Buyer beware, as one should always keep in mind, but this one completely slipped by my label-reading skills. I’m not allergic to aspirin, but I’m not sure I’m going to use this stuff again.




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