A massage client who needs a topical analgesic to help her shoulder pain

Massage therapy is a key component of pain-management plans, and the right topical analgesics can support your hands-on care of clients’ pain.

Out of the 100 million adult Americans experiencing chronic pain, nine million suffer from shoulder pain daily. This pain not only affects their quality of life but also leads to significant professional disruptions. The U.S. Bureau of Labor Statistics reports that shoulder injuries and illnesses result in more missed workdays than any other body part, with an average of 26 workdays missed per year.

To manage shoulder pain, Healthline recommends over-the-counter pain medications, ice, heat, massage therapy, and topical analgesics. Studies show that massage, especially sports massage with hot packs and deep tissue techniques, provides significant short and long-term relief. Using topical analgesics like camphor, menthol, capsaicin, and methyl salicylate during massage can enhance pain relief by reducing inflammation and interrupting pain signals. It’s important to monitor for side effects and follow safety guidelines to ensure effective treatment.

Massage for Shoulder Pain

After taking an in-depth look at 15 different studies involving a total of 635 participants, one 2017 systematic review and meta-analysis published in the Journal of Physical Therapy Science reported that massage therapy has “a significant effect on reducing shoulder pain” both short and long term. Additionally, some massage techniques tended to supply more relief than others.

For instance, analyzation of this data found that study subjects experienced the most shoulder pain relief after engaging in 36 sports massage sessions which included applying a hot pack to the their neck, back, and shoulder areas.

However, long-term pain relief was found to be greatest in studies where participants received a deep tissue massage to the shoulder area for a total of 10 sessions.

Not only is the type of technique used a factor to consider when trying to help clients overcome shoulder-related pain, but the use of the right topical analgesics during the massage session can make a difference as well.

Topical options for shoulder pain relief

Topical analgesics work in different ways depending largely on which ingredients they contain. Some of the most common are:

  • Camphor
  • Capsaicin
  • Menthol
  • Methyl salicylate

Harvard Medical School explains that camphor and menthol work by diverting the body and brain from experiencing pain via the cooling sensation they create whereas capsaicin causes a burning sensation where it is applied, interrupting the pain in that way. Harvard adds that methyl salicylate works by reducing both pain and inflammation.

Most Common Causes of Shoulder Pain

This information can be used to help determine which type of topical would potentially work best based on the root cause of the client’s shoulder pain.

According to the American Academy of Orthopaedic Surgeons, the most common reasons people experience pain in the shoulder area include:

  • Inflammation
    (tendinitis or bursitis)
  • A tear in the tendon
  • Instability
  • Arthritis
  • Bone fracture

Massage therapy combined with topical analgesics can potentially provide relief for many of these. For instance, a 2014 study published in the British Journal of Pharmacology found that methyl salicylate had a positive effect on rheumatoid arthritis in mice, helping to inhibit its progression.

Another study in the Journal of Athletic Training noted that use of menthol treatments is as effective in reducing pain as application of crushed ice, with the combination of the two more effective yet.

Application and Safety

When using topical analgesics in conjunction with soft tissue shoulder massage, there are some things therapists should and should not do to help ensure client safety.

For instance, the Food and Drug Administration (FDA) warns that, although rare, some individuals have suffered adverse reactions to pain-relieving topicals that contain a warming or cooling agent. Among these reactions are a burning pain and the formation of blisters on the skin.

Therefore, it’s important to monitor the client for these potential side effects when using topicals with these ingredients. If either appear or the client begins to have any other type of response, the FDA suggests that they seek immediate medical attention and that the reaction be reported to MedWatch, the FDA’s Safety Information and Adverse Event Reporting Program.

Other topical analgesics safety tips provided by the FDA include not using them in areas where the skin is damaged or irritated, not covering areas where a topical has been used with a bandage, and never applying heat in addition to the topical.

Additionally, after application, the FDA recommends avoiding touching areas sensitive to these ingredients, which includes the eyes, nose, mouth, and genitals, as this can cause irritation.

Choose an effective topical analgesic and your hands-on work with clients will be augmented. These products simply provide an effective means of pain relief.