Arthritis: How to replace your pills with a single cream

June 26, 2019

Arthritis Osteoarthritis pain relief

The problem with popping a pain pill

When a pill or capsule is taken to treat pain at a distal site on the body, the drug must first disperse through the entire body.  As a result only a very dilute portion will reach the site of pain where it is needed the most. Furthermore, the effects of the drug for better or worse, will be present throughout the entire body. This is a reason why people tend to suffer side effects from oral medications.

Wouldn’t it be wise then, to apply my medication directly on the site where it is needed rather than have it effect places it’s not? The answer is absolutely!

Swapping pills for a cream

Scientists and Pharmacists have known for a long time that many drugs can pass through the skin. It is also not hard to visualise that a drug applied to a specific area will exert a majority of its effects in that area – it doesn’t have to be diluted first.

Why isn't there a commercial product?

There are a few commercial pain relief products available for arthritis. However, everyone’s skin, arthritic pain and sensitivity is different. It is therefore difficult to make one cream that works for everyone and unfortunately it wouldn’t be a wise commercial move to manufacture such a product in bulk.

A compounding pharmacist can add multiple active ingredients into the one cream and adjust the strength based on your personal response. It is not uncommon to have multiple active ingredients in the one cream, all at varying strengths. These ingredients may include the medicines you are already taking by mouth which means less pills – and less side effects! 

Is this cream the same as moisturiser?

Absolutely not! The compounding pharmacists at Border Compounding Pharmacy use what is known as a Transdermal Cream for arthritic pain. These creams are a specially designed emulsion, designed to push the pain medicine through the skin rapidly.

What kinds of medicines are put in the Transdermal Cream to help with arthritis pain?

There are a number of different ingredients that are commonly used in Border Compounding Pharmacies pain creams. Normally these ingredients can be added together in once cream.  You may recognise some of the list below as medicines you are taking currently as a pill for the pain. This list is by no means exhaustive of what a Border Compounding Pharmacist can prepare in a customised cream for you.


In one German study, there was a 50% reduction in joint pain after 3 weeks of using a capsaicin based cream. Capsaicin is the chemical in chilli's that makes them hot. The reason it is used in pain conditions, is it essentially makes nerves wear out and they can no longer sense any pain. However, there still may be slight burning when first applied. Whilst there are commercially available products, your compounding pharmacist will be able to customise your dosage and build you up slowly on this ingredient to minimise irritation but deliver all the benefits


Ketoprofen belongs to a class of drugs called non-steroidal anti-inflammatories. It is in the same class of drugs as Nurofen, Naprosyn and aspirin.  One problem taking these medications by mouth is that they can have profoundly damaging effects on the stomach. They are all acidic and increase the acid secretions of the stomach and can cause reflux and lead to ulceration. By applying Ketoprofen directly to the site, you are not only getting a much larger anti-inflammatory dose to the site that needs it, you are also avoiding doing damage to your stomach.


Amitriptyline is an antidepressant medication which is sold under the common name of Endep. It has been known to be effective in treating nerve pain or neuropathic pain that often occurs with both rheumatoid and osteo-arthritis.  However, when taken orally it can also have a number of different side effects such as drowsiness and clouding of thought.  By applying amitriptyline directly to the area of pain a larger dose can be given to the site that needs it and side effects are extremely rare. It is very effective in treating various types of arthritis – especially in the hands and knees. This is a prescription only medication and your pharmacist would need to have a discussion with your doctor about putting this in your pain cream.


Magnesium is not a drug but a mineral – it just has a few drug like qualities! Magnesium seems to work in a very similar way to the anaesthetic drug called Ketamine.  However, there is much less risk of overdose or side effects. Baths of Epsom salts have been used for a very long time to reduce aches and pains in the body. Magnesium has been shown to be effective and safe for a very long time!


PEA is a naturally occurring fatty acid that seems to moderate pain in a similar way to cannabis. However, there are no hallucinogenic or risks of psychedelic contaminants with PEA. Because of the lack of side effects, our pharmacists at Border Compounding Pharmacy may suggest this as an oral capsule, but they can most certainly add this to your arthritis cream if necessary.


Menthol, believe it or not, seems to act on a type of nerve receptor known as an opioid receptor. Opioid receptors are where drugs like opium, morphine, codeine and heroin act on and are obviously all very powerful pain killers.  However, these drugs act on a wide variety of different opioid receptors, which is why they are responsible for addiction. Menthol on the other hand only works on one type known as a kappa opioid receptor and thus does not pose any of these risks.  

If you suffer arthritis and would like to know more about an effective alternative to taking oral pain relievers, contact our pharmacy and one of our highly skilled pharmacists will develop a treatment protocol for you.

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