November 2013 | A Better You | Ointment Options

ABetterYou

Before aches appear, research which pain-relieving salve is right for you

Which pain-relieving gel, cream, or lotion is in your dance bag? Dancers and teachers who are suffering from day-to-day aches and pains can look to a plethora of available medical and quasi-medical ointments for relief. Let’s give those salves a look and see which ones to toss and which you might add to your bag.

Topical pain relievers can be categorized into cooling or heating types. All are meant to soothe soreness in, primarily, the superficial musculoskeletal tissues.

As a physical therapist for both dancers and non-dancers, I’ve accumulated quite a few types of topical ointments. My organic chemistry background has helped me understand how the “natural” ingredients in most of the aids work, in comparison to the more processed ointments.

 

 General types

Topical pain relievers can be categorized into cooling or heating types. All are meant to soothe soreness in, primarily, the superficial musculoskeletal tissues.

The usual liniment salves tend to be the heating type. Some feel warm upon absorption and remain warm, like Tiger Balm, while others, like Icy Hot, rub in warm and then begin to have a cooling effect. My warming rub of choice is Flexall, maximum strength. All three, and many others, contain menthol, which has a warming, pain-relieving effect on soft tissues.

 

Chinese and Japanese products

Other liniment types can also be found at Chinese herbal medicine stores and some health food stores. These mixtures usually contain ingredients such as peppermint or wintergreen, both of which break down chemically into salicylic acid, the main component of aspirin.

These herbal medications use a pulverized or distilled form of the plants, while other over-the-counter salves use menthol distillations, which may be produced in a more industrial setting. Though strict quality controls ensure that these are safe to use, I prefer the more natural, plant-based ointments and balms.

One of my favorite brands is White Flower Analgesic Balm, which I consider industrial strength. These mixtures are best used sparingly in a targeted manner. A tiny amount applied to the temples can help headaches and a bit touched inside the ear can help ear pain. But be especially careful applying any of them close to the eyes, nose, mouth, or private parts, since contact with these areas can cause a burning sensation and the oil can be difficult to remove.

The bright green Eagle Brand Medicated Oil is not quite as strong. Try a few drops on your bunions, or a bony area. It won’t warm up your feet the way exercises do, but the oil creates the sensation of heat in a chilly studio and can relieve the ache of arthritic feet.

Ping On Ointment is an even milder heating and calming salve. It’s good to have options.

For a large area such as the low back, try a plaster such as Wu Yang Brand, whose formula was developed to treat injuries incurred during martial-arts training. Wear the plaster all night. Put a towel between you and the bed sheets, and don’t wear your best pajamas.

The Wu Yang Brand patch has a very potent medicinal odor. If you or those around you find a strong mentholated smell unpleasant, try Salonpas Hot, which contains capsaicin, the odorless active heat-sensation–inducing component of chili peppers. Other varieties of Japanese-made Salonpas may contain additional ingredients, such as menthol, that do give off an odor.

 

Arnica-based products

Arnica is also very effective in alleviating pain. Unlike other ointments, salves whose main active ingredient is arnica don’t provide a cool or warm sensation.

I have used a product called Traumeel with great success. Traumeel contains plant and mineral extracts, including arnica, that perform a wide variety of healing functions, including reducing inflammation, decreasing pain, and accelerating wound healing. Traumeel and other arnica-containing creams can be found online or at health-food stores.

Another product that contains arnica is Biofreeze. It works well on bony areas such as knees, ankles, wrists, and feet. It comes in a gel and also as a spray or roll-on for easy application. It must be purchased through a health-care provider.

Arnica is very safe if it is applied on unbroken skin and kept away from the eyes. It is a fairly slow acting but very effective healing agent. It’s particularly good for bruises and tendon injuries.

 

Safety

Most of the ointments on the market are safe, but not all are appropriate for everyone. Anyone with an aspirin or other non-steroidal anti-inflammatory drug allergy should carefully read the list of ingredients, or better yet, get a recommendation from a physician or pharmacist for a product that will be safe for them. Many pain-relieving ointments, including Bengay and Icy Hot, contain methyl salicylate, which is similar to aspirin.

People who have known allergies to irritants such as insect venom may react adversely to ointments that heat an area with ingredients like red pepper, and should test a small amount of a salve on an area of soft skin like a forearm before applying it to larger areas.

Severe reactions include closing of the throat and difficulty breathing, similar to an allergic reaction to bee stings, or foods such as nuts or shellfish. Call 911 if breathing is acutely impeded. Those with allergies that require a prescription for EpiPen should use it as indicated.

A milder allergic reaction to a salve can include general puffiness or localized swelling, redness, hives, or burning pain. If such a reaction occurs, wash the area with soapy warm water, and rinse with cool water. If there is distinct redness, apply an ice pack for about 15 minutes. Be sure to cover the skin with a paper towel to keep the ice from burning. Over-the-counter Benadryl also works well to reduce minor allergic reactions.

Overuse of some topical pain relievers can, on rare occasions, be poisonous or lethal. In 2007, a medical examiner determined that a young track star died after overdosing on methyl salicylate. This occurred after the 17-year-old repeatedly applied a topical pain reliever over a short period of time. Although poisoning or death are rare, in an article in The New York Times, Edward Arsura, chairman of medicine at Richmond University Medical Center, warned that repeated use of methyl salicylate is more harmful than one-time use, and that exercise and heat can accentuate absorption.

You have options. Assemble your medical kit and use the appropriate ointment for the appropriate use.

I have faith in you.