Letter to the Editor Regarding Efficacy and Safety of Diclofenac and Capsaicin Gel in Patients with Acute Back/Neck Pain
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LETTER
Letter to the Editor Regarding Efficacy and Safety of Diclofenac and Capsaicin Gel in Patients with Acute Back/Neck Pain: A Multicenter Randomized Controlled Study Ruben Schwartz
. Ivan Urits . Omar Viswanath
Received: April 25, 2020 Ó The Author(s) 2020
Key Summary Points The most commonly used topical anesthetic that pain physicians prescribe is diclofenac gel, but it may not be that effective. This is a response article where we agree with the usage of capsaicin gel alongside diclofenac for maximal patient satisfaction. Topical anesthetics are safer options for patients with numerous comorbidities, which is common in the chronic pain population.
Dear Editor, We read the study by Predel et al. ‘‘Efficacy and Safety of Diclofenac ? Capsaicin Gel in Patients with Acute Back/Neck Pain: A Multicenter Randomized Controlled Study’’ with great interest [1]. We agree with the study’s emphasis on the importance of topical analgesics. In the treatment of patients with chronic pain, utilizing a truly multimodal analgesic regimen is of the utmost importance, of which topical analgesics represent a vital spoke on the treatment wheel. In addition, these patients oftentimes have numerous comorbidities that limit the amount of oral analgesics physicians can prescribe to alleviate their patients’ symptomatology [2]. Or, they have overused antiinflammatory medications to treat their chronic pain to the point that their liver and kidney function has been negatively impacted. Topical
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12505694. R. Schwartz (&) Department of Anesthesiology, Mount Sinai Medical Center of Florida, Miami, FL, USA e-mail: [email protected]
O. Viswanath Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
I. Urits Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
O. Viswanath Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
O. Viswanath Valley Anesthesiology and Pain Consultants, Envision Physician Services, Phoenix, AZ, USA
Pain Ther
analgesics have been proven to be effective at treating pain, but more importantly are safer than oral analgesics owing to less systemic absorption [3, 4]. With the tremendous reliance on opioid medications throughout the patient population, there has been a push to move to different modalities for treating chronic pain. Topical analgesics offer a safer option that patients of all ages and comorbidities can utilize. Typically, the non-steroidal anti-inflammatory drugs (NSAIDs) like diclofenac are the first-line therapy for many ailments [5]. There has been some controversy within the pain community of the efficacy of diclofenac. Although it has been shown to be a potent anti-inflammatory, its ability to control a patient’s pain is questionable. Capsaicin gel is a proven option for patients suffering from arthritis, chronic pain, gastr
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