Make Pain a Thing of the Past – topical pain medication – Physician Partners of America

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Doctors have known for years that topical pain medications – those applied to the skin – are effective for some pain patients. Recently, however, they were surprised to learn that those creams, patches and ointments are more helpful than previously thought.

In fact, half of patients taking oral opioids stopped them after trying topicals, a recent study shows. Another 30 percent were able to quit using all types of pain medications and switch to topical analgesics.

The study, published in Clinical Focus: Pain Management Fast Track, surprised even its authors. “As a clinician active in the pain world, I have seen it [discontinuation of opioids] but certainly not at this magnitude,” study leader Jeffrey Grudin, M.D., told Practical Pain Management. Grudin is director of pain management and palliative care at Englewood Hospital and Medical Center in New Jersey.

About the Topical Pain Medications Used

The study followed 121 chronic pain patients. After treatment with topical analgesics, 49 percent of those followed after three months and 56 percent of those followed up at six months said they had stopped using opioids altogether.

Another 31 percent followed up at three months, and 30 percent reporting at six months, said they were not taking any more pain medications. This included nonsteroidal anti-inflammatory drugs (NSAIDS), which target the inflammation   that causes most neck and back pain.

The patients who took part in the study suffered moderate symptoms of neuropathy, arthritis, radiculopathy, myofascial musculoskeletal or tendonitis pain.

The Most Effective Topical Pain Medications

The topical analgesics used in the study included diclofenac, ketoprofen and flubiprofen. Other topical pain medications readily available through pharmacies are also shown to be effective. They include baclofen, ketamine (3-5%) and lidocaine (7-8%).

More Research Needed

It is clear that more research needs to be done. The study was small, and 67 of 121 study participants dropped out before the six month follow-up. Still, the study shows this is one opioid alternative that holds promise for people suffering from chronic pain.

“Topical analgesics are effective for a variety of types of pain,” Dr. Grudin, the study leader told Practical Pain Management. “Our study supports the fact that we can eliminate opioid use in a certain percentage of patients with chronic pain conditions.”


The abdomen is a very busy part of the body. Since there are a lot of organs in the abdomen, one of the first thing that a medical professional is likely to ask you if you’re having abdominal trouble is where the pain is located.

To better understand your abdominal pain, learning more about where your organs live can help clarify what may be causing your pain.

Here are the four quadrants of your abdomen and some of the parts in each of them:

Right Upper Quadrant

Here are some of the organs in the right upper quadrant of your body:

  • Gallbladder
  • Liver
  • Duodenum
  • Upper portion of your right kidney
  • Part of your colon
  • Part of your pancreas

Right Lower Quadrant

In the right lower quadrant of your body, you will find:

  • Appendix
  • Right ureter
  • Part of your colon
  • Lower portion of your right kidney
  • Right ovary (for females)
  • Right fallopian tube (for females)
  • Right spermatic cord (for males)

Left Upper Quadrant

These organs are found in the left upper quadrant of your body:

  • Stomach
  • Pancreas
  • Spleen
  • Part of your liver
  • Upper portion of your left kidney
  • Part of your colon

Left Lower Quadrant

The left lower quadrant of your body is home to organs like:

  • Left ureter
  • Part of your colon
  • Lower portion of your left kidney
  • Part of your colon
  • Left ovary (for females)
  • Left fallopian tube (for females)
  • Left spermatic cord (for males)

Things to Remember About the 4 Quadrants

Looking at the lists above, you may notice that some body parts are in more than one quadrant. The colon, for example, has portions across all four quadrants of your body.

This is why it is important for you to explain to your medical professional not just where your pain is located, but the nature of the pain and any other symptoms that you are experiencing.

Another thing to keep in mind is that sometimes your pain could come from an organ that is not typically located in that quadrant. For example, if your uterus becomes enlarged, it could potentially cause pain in your lower left or right quadrants.

Having an understanding of your body can help you stay informed, but when you need treatment for your abdominal pain, it is time to go to a medical professional.

Next Steps to Treat Abdominal Pain

Even though it is smart to understand the four quadrants of your abdomen, do not take it upon yourself to make a diagnosis. It may be tempting to do some research and figure out the source of the pain yourself, but it rarely helps bring anything but confusion.

When you have abdominal pain, go to a medical professional for diagnosis and treatment options. Use your knowledge of the four quadrants to describe the location and nature of your pain, then let your doctor figure out what it is and how to help.

Make sure to follow the instructions of your medical professional and you’ll be on the path to recovery.


Abdominal Pain “Quick Answers”

A: Abdominal pain its self is a symptom. Other symptoms along with the abdominal pain may include

  • Nausea,
  • Diarrhea
  • Severe pain after eating

A: Some diseases that can be a cause of your abdominal pain include:

  • Gastritis,
  • Appendicitis
  • Kidney stones
  • Gallbladder Pain disease
  • Duodenal and gastric ulcers
  • Infections
  • Pregnancy-associated problems
  • Ruptured blood vessels
  • Heart attacks
  • Liver and pancreas inflammation
  • Kidney stones
  • Problems with the blood circulation to the intestine
  • Diverticulitis
  • Cancers


Some sensations of abdominal pain might not be caused from the abdomen its self:

  • Some heart attacks and pneumonia can cause abdominal pain and even nausea.
  • Diseases of the pelvis or groin can also cause abdominal pain in adults.
  • Testicular problems often can cause lower abdominal pain.
  • Certain skin rashes, such as shingles, can feel like abdominal pain, even though the person has nothing wrong inside their body.
  • Even some poisonings and bites, such as a black widow spider bite, can cause severe abdominal pain.

A: Medical attention should be given when (but not limited to):

  • Abdominal pain that lasts more than six hours or continues to worsen
  • Pain accompanied by vomiting more than three or four times
  • Severe abdominal pain
  • Pain that stops a person from eating
  • Abdominal pain during pregnancy
  • Abdominal pain after eating
  • Pain along with an inability to urinate, move the bowels, or pass gas
  • Pain accompanied by a fever over 101 F (38.3 C)
  • Any other pain that feels different from a simple stomach ache
  • Pain so bad the affected person passes out or almost passes out
  • Pain so bad the affected person cannot move

A: Most doctors determine the cause of abdominal pain by relying on:

  • Characteristics of the pain
  • Physical examination
  • Exams and tests
  • Surgery and endoscopy

A: If the cause of the pain is known, a person should follow the instructions specific for the diagnosis.

For Example:

  • For an ulcer, the person must avoid nicotine, caffeine, and alcohol.
  • For a gallbladder disease, the person should avoid greasy, fatty, and fried foods.

While it is important to pay attention to changes in your health, it is not safe to self-diagnose when pain is severe or chronic.

Right Upper Quadrant:

  • Liver
  • Galbladder
  • Duodenum
  • Head of Pancreas
  • Right Adrenal Gland
  • Upper Lobe of Kidney
  • Hepatic Flexure of Colon
  • Section of Ascending Colon
  • Section of Transverse Colon

Right Lower Quadrant

  • Lower Lobe of Right Kidney
  • Section of Ascending COlon
  • Right Fallopian Tube (female)
  • Right Ovary (female)
  • Par of Uterus (if enlarged)
  • Right Spermatic Cord (male)
  • Cecum
  • Appendix
  • Right Ureter

Left Upper Quadrant

  • Left Lower Part of Liver
  • Upper Lobe of Left Kidney
  • Splenic Flexure of Colon
  • Section fo Transverse Colon
  • Section of Descending COlon
  • Stomach
  • Spleen
  • Pancreas
  • Left Adrenal Gland

Left Lower Quandrant

  • Lower Lobe of Left Kidney
  • Secion of Descending Colon
  • Left Spermatic Cord (male)
  • Part of Uterus (if enlarged)
  • Sigmoid Colon
  • Left Ureter
  • Left Ovary (female)
  • Left Fallopian Tube (female)

A. The appendix is located in the lower right quadrant of the abdomen (right iliac region). This are is approximately 100mm (4 inches) long and about the diameter of a dime.

A: The uterus is located in both parts of the lower right and lower left quadrant of the female human anatomy.

About Physician Partners of America

Headquartered in Tampa, Fla., Physician Partners of America (PPOA) is a fast-growing national healthcare company committed to combatting the opioid crisis through interventional pain management. Founded in 2013 with three employees, it has rapidly grown to more than 500, and manages a wide range of medical practices.