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This JAMA Patient Page describes the types of topical nonprescription pain medications and tips for using them.
Topical nonprescription pain medications are over-the-counter drugs applied to the skin to treat pain.
Topical pain medications can effectively treat pain caused by several acute and chronic conditions. Because they are applied directly to the skin, topical pain medications are easy to use and less likely to cause side effects or interact with other medications than oral pain medications. Pain relief typically occurs within several days of starting a topical pain medication.
• Children present frequently to primary and emergency care with nonspecific abdominal pain.
• Only a few treatment options exist to manage colicky, undifferentiated pain; however, most children will not present more than once or twice to health services for this problem.
• Undifferentiated abdominal pain is poorly understood but likely multifactorial, arising from a combination of sensitizing medical events, psychosocial events and visceral hyperalgesia.
• Among children who seek health care for this problem, 20%–25% go on to be diagnosed with a disorder of the brain–gut axis, “a functional gastrointestinal disorder,” for which international guidelines exist to guide management.
• At first consultation, it is important to establish a positive therapeutic relationship between the clinician and the child and their parents, focusing on optimizing symptom control over unnecessary investigation and medicines.
