Specially compounded topical pain creams can be expensive but perform no better than placebo.
Premises of compounded topical pain cream:
(1) different drugs for different types of pain (neuropathic, nocioceptive, mixed)
(2) can be individualized for the patient
A topical pain cream is effective if both of the following are present:
(1) a reduction in the pain score
(2) moderate to high patient satisfaction
Results:
(1) many of the drugs included in the creams are not absorbed across the skin
(2) compounded creams can be expensive
(3) placebo provided comparable pain relief
(4) commercial creams with lidocaine, capsaicin or other agent are a cheaper alternative than a compounded cream
(5) a person in chronic pain may be vulnerable
