Topical Pain Management: An Updated Review of Current Evidence and Emerging Strategies

Area of Science:

• Pharmacology and Pain Management
• Topical Drug Delivery Systems

Background:

• Chronic pain is a global health issue requiring effective treatment strategies.
• Distinguishing between nociceptive, neuropathic, and nociplastic pain is crucial for optimal therapeutic selection.
• Topical analgesics are gaining prominence due to localized action and reduced systemic exposure, benefiting vulnerable populations.

Purpose of the Study:

• To review the current knowledge on the pharmacology, efficacy, and safety of topical analgesic drugs.
• To highlight established therapies like topical NSAIDs, lidocaine, and capsaicin, and emerging options for neuropathic pain.
• To emphasize the role of topical analgesia in multimodal pain management.

Main Methods:

• A narrative review of existing literature.
• Literature search conducted across major scientific databases (PubMed/MEDLINE, Scopus, Web of Science, Google Scholar).
• Focus on studies evaluating the efficacy and safety of various topical analgesic agents.

Main Results:

• Topical NSAIDs are recommended as a first-line treatment for localized musculoskeletal pain and osteoarthritis.
• Lidocaine and high-concentration capsaicin patches demonstrate efficacy in focal neuropathic pain.
• Topical analgesia offers a favorable safety profile compared to systemic treatments, supporting its role in multimodal pain management.

Conclusions:

• Topical analgesics are valuable components of multimodal pain management, offering efficacy with improved safety.
• Further research is warranted for novel topical drug combinations, especially for challenging conditions like neuropathic pain.
• Developing effective and safe topical treatments remains a clinical challenge, necessitating continued investigation and clinical trials.