Purpose of Review

Topical analgesics are a non-opioid option for the treatment of chronic pain conditions including neuropathic pain, musculoskeletal pain, and osteoarthritis. There are many topical medications available; however their efficacy is variable. This article reviews the various topical analgesics, their mechanisms of action, and their efficacy.

Recent Findings

Studies have found topical NSAIDs are useful in treating acute musculoskeletal pain syndromes (strains and sprains) and show some efficacy in treating hand and knee osteoarthritis (Derry et al. Cochrane Database Syst Rev 5:CD008609, 2017). Topical capsaicin 8% has been shown to be efficacious in the treatment of postherpetic neuralgia, painful diabetic peripheral neuropathy, and HIV-neuropathy (Derry et al. Cochrane Database Syst Rev 1:CD007393, 2017). Topical lidocaine has been widely studied and found to reduce pain in patients with postherpetic neuralgia (Knezevic et al. Pain Manag 7:537–58, 2017). Although many other topical analgesics are available, there is limited data to support the efficacy of other agents.

Summary

Topical analgesics are a relatively benign treatment for chronic pain conditions including neuropathic pain, musculoskeletal, and myofascial pain. There is evidence to support the use of topical NSAIDs, high concentration topical capsaicin, and topical lidocaine for various painful conditions.

中文翻译：

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慢性疼痛局部镇痛药综合综述

审查目的

局部镇痛药是一种非阿片类药物，用于治疗慢性疼痛，包括神经性疼痛、肌肉骨骼疼痛和骨关节炎。有许多外用药物可供选择；然而，它们的功效是可变的。本文综述了各种局部镇痛药、它们的作用机制和功效。

最近的发现

研究发现外用 NSAID 可用于治疗急性肌肉骨骼疼痛综合征（拉伤和扭伤），并显示出治疗手膝骨关节炎的一些功效（Derry 等人。Cochrane Database Syst Rev 5：CD008609，2017）。外用辣椒素 8% 已被证明可有效治疗带状疱疹后神经痛、疼痛性糖尿病周围神经病变和 HIV 神经病变（Derry 等人。Cochrane 数据库系统修订版 1：CD007393，2017）。外用利多卡因已被广泛研究并发现可减轻带状疱疹后遗神经痛患者的疼痛（Knezevic 等人，Pain Manag 7:537–58, 2017）。尽管有许多其他局部镇痛药可用，但支持其他药物疗效的数据有限。

概括

局部镇痛药是一种相对良性的慢性疼痛治疗方法，包括神经性疼痛、肌肉骨骼疼痛和肌筋膜疼痛。有证据支持外用非甾体抗炎药、高浓度外用辣椒素和外用利多卡因治疗各种疼痛症状。