There are a variety of patches, creams and gels available for those with back pain. Do they work?  Have you used any?  Considering which ones might work for you?

Here is an outline of the seven different kinds of topical back pain relief products (six of them available without a prescription), their mode of action, and the likelihood that they could work for you.

1. Counterirritants

Counterirritants are substances such as menthol, camphor, or wintergreen oil that create a stinging, burning, or “icy hot” sensation.  The theory is that the burning sensation overrides the noxious signals going into your brain, thus alleviating pain.

These products are likely to be safe. You may get some skin reddening, though it’s probably just temporary.  Any relief you get is probably temporary, too.

2. Capsaicin

Capsaicin is the active ingredient that makes hot peppers hot. If you rub it on your skin, it will produce a burning sensation.  In some respects, this will work similarly to the counterirritants described above. But there’s more.

Once capsaicin is absorbed into the skin, the theory is that it inhibits the nerve transmitters that your body uses to signal pain. So its effect may be more substantial than the effect of the counterirritants.

Don’t expect pain relief right away; it might take a week or two for the benefits to kick in.

3. Salicylates

Salicylate is the active ingredient in aspirin. Aspirin is a proven anti-inflammatory and pain reliever, but it can chew up your stomach lining. As an alternative, you can find gels or patches containing salicylate so that it’s absorbed directly into your skin.

The advantage of using salicylate-containing cream is that you can get an effective dose in the painful area with a far lower system-wide load. There’s some research that backs up this method.

4. Herbs for Pain

A number of different herbs are claimed to have pain-relieving, muscle-relaxing, or circulation-boosting properties.

One example is comfrey root. Researchers have shown that applying comfrey-root to your low back affords rapid pain relief.

Another herb, ilea, is also used in a number of topical back-pain formulas.

5. Chinese Herbs for Pain

A wide variety of herbs are used topically in traditional Chinese medicine to address back pain.

Chinese herbs are herbs, of course, but I’ve included them in a separate category because the traditional Chinese medical understanding of their mechanism of action is rooted in an entirely different medical worldview.

The choice of herbs to be used depends on a traditional Chinese medical evaluation of the nature and underlying cause of your problem.

Some of the herbs that might be suggested include dipsacus, eucommia, and psoralea.

6. Homeopathic Preparations

The underlying theory of homeopathy, that vanishingly minute amounts of the right ingredients can spur your body toward health, is so scientifically unlikely that I can’t recommend the use of a homeopathic product.

I’m all in favor of the “spur your body toward health” part of the philosophy, but the “vanishingly minute amount” ends up meaning that homeopathically-prepared remedies contain absolutely zero of the supposedly active ingredient. That strains my credulity.

Besides which, I’m not aware of any research evidence that homeopathic treatment is effective for any condition.

7. Prescription Topicals

Allopathic physicians can prescribe pain patches containing lidocaine, a cocaine analog that alleviates pain.

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Comfrey root – apply it to your back