When one ointment is applied to the skin, we feel warmth, and sometimes a burning sensation, while another brings a pleasant coolness. The effect produced is due to the substances that make up the product. In the first case, we get a warming (hyperemic) effect, in the other – a cooling (interferential) one.
Effect of warming ointments on pain
The feeling of warmth that occurs after applying warming ointments is associated with the expansion of the surface vessels and capillaries of the skin. In this zone, microcirculation and metabolism are enhanced, and recovery processes are activated. Ointments with the following irritating components allow to achieve this effect: 1. Chemical nature – extracts of horseradish, mustard, red pepper, turpentine, insect (bee) and snake poisons, methyl salicylic acid, essential oils of some plants, etc .; 2. Mechanical nature – wateryaga or other means containing silica crystals. Due to increased blood flow, inflammatory mediators are washed out of the painful focus, and edema is reduced. That is, when using warming ointments, the pain goes away by reducing the inflammatory reactions in the affected area. A distracting effect also plays a role: a burning sensation at the site of application of an ointment, cream or gel becomes a dominant sensation, replacing, pushing back and masking the pain. Indications for the use of warming ointments Hyperemic drugs should be used in case of chronic pain syndrome: arthrosis, arthritis, osteochondrosis, sciatica, etc., chronic injuries, sprains and bruises after the end of the acute stage. For example, bruises can be smeared with warming ointments for 2-4 days from the moment of injury, which will speed up their “resorption”. The second important indication is damage prevention. It will not hurt for athletes to rub the muscles and joints with a warming ointment an hour or two before exertion: pain, dyspnea, then they do not come. The risk of stretching muscles and ligaments is also reduced.
Contraindications to the use of warming ointments
Do not use irritating agents for pain caused by fresh damage – blow, bruise, sprain. Because this will lead to an increase in the focus of damage, intensify the inflammatory process, which is already initiated by the body.
And common to all external agents: dermatitis, allergy to the components of the ointment, open in the area of pain.
Effect of cooling ointments on pain
Here, the analgesic effect is achieved by numbing the nerve endings due to their “freezing”. A certain role is played by a decrease in microcirculation at the site of application, since less blood enters the focus, and with it – biologically active substances that potentiate inflammation and pain (prostaglandins, interleukins).
To achieve a cooling effect, substances are used that quickly evaporate from the place of application:
• chloroethyl – spray in cans of football doctors;
• menthol;
• alcohols;
• essential oils – eucalyptus, mint.
Evaporating, the components of the ointment take with them heat from the skin, causing it to cool, narrowing of the capillaries, and inhibition of the transmission of pain impulses.
Indications for the use of cooling ointments
They should be used in the acute period, immediately after injury, sprains, bruises. By reducing anti-inflammatory substances at the site of damage, it is possible to reduce the extent of the lesion of soft tissues (muscles, skin, ligaments), and reduce pain.
Contraindications to the use of cooling ointments
Allergy to the components of the product, open skin lesions, dermatitis.
There is no point in relieving chronic pain with cooling ointments: there are hyperemic agents for this.
Combined ointments for pain
Pharmaceutical companies are trying to make their products universal, therefore they produce ointments with a combined composition. For example, they combine menthol and pepper extract, camphor. For such and similar funds, first an anesthetic effect is characteristic, which is then replaced by an irritating, warming effect.
There are also ointments with the addition of anti-inflammatory substances: NSAIDs, paracetmol, Dimexidum. Such remedies are good for local pain, are poorly absorbed and have a weak general effect. But here you need to take into account the features of additional components:
1. Indomethacin, acetylsalicylic acid, piroxicam and phenylbutazone have a destructive effect on cartilage. Ointments with such substances should be used only for pain in the area of soft tissues – muscles, ligaments. It is better not to use them on joints.
2. Diclofenac is characterized by chondroneutral action, which makes it a universal remedy.
3. Ibuprofen, ketoprofen and, to a greater extent, paracetamol – have a chondroprotective effect, restore articular cartilage. Ointments with such substances should be used for joint pain, arthritis and arthrosis.
In the case of fresh soft tissue injury, do not use combined agents. If there is no ointment with a cooling effect at hand, you can relieve pain simply by applying cold to the sore spot: ice, freezing or a bag of water from the freezer. And to provide the damaged place with peace.