One challenge people have with chronic pain conditions like temporomandibular joint disorders (TMJ or TMD) is finding an effective treatment. If you go to a doctor or pain specialist, they might prescribe you one of many different medications or therapies. One increasingly popular treatment option is compounded pain creams.

However, despite their growing popularity, studies suggest that these creams don’t work for either nerve pain or pain caused by joints, muscles, and other stimuli. Or if they do, the effects are minimal.

Dramatically Increasing Costs

pain cream squeezed out of a tubeThe cost of pain creams has grown dramatically in recent years. For example, Medicare spending on these creams, gels, and ointments rose from $13 million in 2010 to $323 million in 2016, an almost 2400% increase! The increase was fueled by price hikes and an increasing number of prescriptions.

As far as the price of these compounds goes, they seem to be dramatically inflated, with a tube of lidocaine compound costing an average of $751, compared to a tube of non-compounded lidocaine costing only about $455. Diclofenac had an even more significant disparity. The compounded form cost over $1500, while the non-compounded form cost only $128 a tube.

The costs seem to be ripe for corrupt practices. According to a recent report by the Office of the Inspector General for the Department of Health and Human Services, over 500 pharmacies had suspiciously high bills for these treatments.

In one case, a drug company sent representatives to city employees and got them to sign up for a prescription pain cream that would be free to them. However, the city’s insurance paid over $8000 per prescription for the cream. This was not a drug cream but based on a nonprescription herbal supplement, resveratrol. A bottle of resveratrol pills costs about $60–and it might be more effective (more on this later).

But perhaps it doesn’t matter because those payments represent relief for chronic pain sufferers. Not so, according to a study of these topical skin creams.

To learn whether TMJ treatment can address your pain in Columbus, OH, please call (614) 848-5001 today for an appointment with TMJ dentist Dr. Mike Firouzian at Firouzian Dentistry.

No Better Than Placebo

In one 2019 study by Johns Hopkins University, researchers recruited nearly 400 patients with different types of pain. Researchers randomly assigned patients to two groups, either compounded cream or placebo. They were then treated for a month, and at the end of the month, researchers evaluated their pain.

Researchers found that people getting the compounded treatments didn’t get better results than those receiving placebo. Although there were small reductions in pain, they were not statistically significant, nor was the number of people who felt they got a positive result from their treatment.

For $1500 a tube, you would like to believe that these pain treatments could beat a placebo.

At Best, Limited Evidence

Later, a 2020 study compiled all the randomized clinical trials (RCTs) that compared topical pain creams to placebo. RCTs are considered the gold standard of testing the efficacy of medical treatments. After searching all the medical journals, researchers identified only nine RCTs for topical pain creams used on TMJ pain. Notably, the total number of patients is small: only 355 patients in all clinical trials combined.

In reviewing the evidence, researchers found that two creams, NSAID and capsaicin, had no evidence of effectiveness. NSAID (nonsteroidal anti-inflammatory drugs) is the class of medication that includes ibuprofen (Advil) and naproxen (Aleve). Some other topical creams seemed to lead to significant pain relief. Theraflex-TMJ caused considerable pain reduction after ten days, and relief persisted at least five days after the last application. Cannabidiol (CBD) cream did lead to significant pain relief. Ping On ointment, a combination of peppermint oil, menthol camphor, and other natural substances, did lead to substantial pain relief in one study.

In addition, there was a high risk of bias in the studies, so researchers reported the evidence to be of limited value.

About the $8000-a-prescription cream, it’s worth noting that we couldn’t find any studies looking at its effectiveness. Instead, the studies looked at the injection of the active ingredient or other applications. These studies used animals, not humans.

Effective Pain Treatments

Don’t waste money on expensive compounded creams. Also, avoid creams with little to no proven efficacy, such as NSAID and capsaicin cream.

It might be worth trying CBD, Theraflex-TMJ, or Ping On ointment to see if these work for you. The results might be worth it, especially for people with temporary TMJ pain that will resolve on its own with time.

For people with long-term TMJ pain, we can help with chronic muscle pain related to TMJ. Muscle pain is the most common type of discomfort associated with TMJ. This can be related to several causes, but often it comes from the fact that your jaw can’t ever find a good rest position.

Utilizing complex tools to measure the tension in your muscles and track the movement of your jaw, we can help find that ideal rest position and design an oral appliance to help put your jaw in that position. Then you can experience relief not just from jaw or face pain but also from headaches and other TMJ symptoms.