Can Topical Cryotherapy Provide A Viable Alternative For Pain Relief?

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By Anthony Leone, Special Projects Editor

People who cannot take traditional pain medication for heel pain, sore arches or other podiatric problems may find comfort with Biofreeze (Performance Health, Inc.). The topical modality is designed to help relieve pain from sprains and sore muscles, among other aliments, according to the company.
Biofreeze is a topical cryotherapy analgesic that generates a cooling remedy that numbs painful areas and helps reduce inflammation, according to the manufacturer. The modality incorporates Ilex, a natural extract of holly, which is formulated in a base for topical application, according to Debra A. Levinthal, DPM, who has used the product for approximately four years.
While Dr. Levinthal initially reserved Biofreeze for patients who preferred more holistic or natural remedies for pain, she now uses it adjunctively with traditional pain relieving therapies in patients who have inflammatory processes such as tendonitis, fasciitis, neuritis and arthritis.

“I do find that it is excellent in initially breaking the pain cycle. Most patients report a significant decrease in pain upon its use in the first week,” emphasizes Dr. Levinthal, an Assistant Professor and Assistant Chairwoman in the Department of Medicine at the William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science in Chicago.
Dr. Levinthal adds that Biofreeze might be useful in treating acute ankle sprains and fifth digit fractures that are generally buddy taped. Lisa M. Schoene, DPM, ATC, FACFAS, says she also applies Biofreeze to patients with tendonitis and ankle sprains. Dr. Schoene even uses it in conjunction with and after applying Kinesio tape to an injured area. One can also combine Biofreeze with ultrasound and massage therapy, according to Dr. Schoene.
“It can be helpful for many injuries, common podiatric conditions or after surgery,” explains Dr. Schoene of the Gurnee Podiatry and Sports Medicine Associates in Gurnee, Ill.

When Oral Drugs Are Not An Option
While oral pain relief agents may have potential risks and side effects, Dr. Schoene has seen minimal or no side effects with the topical Biofreeze in her experience.
Dr. Levinthal echoes those sentiments, noting that Biofreeze provides a pain management alternative for patients who either cannot tolerate oral antisteroidal medications or prefer not to take oral drugs. She has found similar efficacy when it comes to the patients’ perception of pain relief.
“In the majority of cases, I found our outcome of decreasing subjective pain using the Biofreeze was equal to those who I had placed on an oral regimen,” notes Dr. Levinthal.

Evaluating Other Advantages Of This Modality
Dr. Schoene says most of her patients are comfortable with home application of Biofreeze. The company says patients can use the modality up to four times a day. If patients request to wear a wrap over the Biofreeze treated area, the company cautions that patients only employ a breathable cotton wrap when using Biofreeze.
Another bonus is that patients in various age groups have responded significantly well to Biofreeze, claims Dr. Levinthal. She says most patients can have an estimated average success rate of 60 to 70 percent using Biofreeze as a sole therapeutic pain relief agent.
Dr. Schoene says the success rate would vary depending upon the type of injury, condition and patient compliance.
While the two doctors did not note any significant adverse reactions with Biofreeze, Dr. Schoene says Biofreeze may not be strong enough to relieve serious painful conditions but would be helpful in combination with an oral agent. She notes that it may, in fact, reduce the need for the very strongest medication that might be prescribed.
“I typically use (Biofreeze) with a combination of modalities and I feel it has been a very nice complement,” says Dr. Schoene, who is a board-certified sports medicine podiatrist and the podiatrist for the Joffrey Ballet of Chicago.
Performance Health warns that patients should not use Biofreeze on open wounds, sunburns or in combination with heating pads. In addition, the manufacturer says pregnant women and nursing mothers should not use the product.

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