Have you ever wished that you could rub a painkiller into your skin instead of taking so many blasted pills? If only topical painkillers — ointments or creams that contain pain medication — were a real thing.

Well, they’re starting to be. I’ve recently come into possession of two different kinds, both of them prescriptions. It occurs to me that this presents a unique opportunity. Why not try them both at once and see which works better?

I have constant pain under my shoulder blades, and they’re bothering me quite a bit right now, so I’ve applied one topical painkiller to one side, and the other to the other side.

Let’s meet our contestants!


First up is an ointment called Pennsaid. As I understand it, it’s very new to the market, only recently having been approved by the FDA.

Normally this stuff is obscenely expensive, but my rheumatologist has a deal worked out with a North Carolina pharmacy where either they’ll get your insurance to cover most of it, or they’ll simply charge you $10 for a bottle if your insurance won’t play ball. My case fell into the latter category.

So for ten bucks, I got a 3.8oz (112 gram) bottle with a pump dispenser on top. The active ingredient in Pennsaid is “Diclofenac sodium.” I don’t know about the sodium part, but I know that Diclofenac (in pill form) is commonly prescribed to reduce inflammation.

Pennsaid has an appearance and consistency very similar to baby oil. It’s a clear, runny fluid — thicker than water but much thinner than cream. The instructions that came with the bottle — which were extensive — state that you should pump it twice and then rub it in well to whatever effected area you’re applying it to. Then wash your hands thoroughly after.

Disclaimer: The Pennsaid bottle and instructions say that it is intended for knee pain, and not recommended for other uses. My rheumatologist assured me that, like many other drugs on the market, that is a legal requirement to protect the company that makes it (Horizon Pharma USA, Inc.) and that the ointment can be used for other purposes. He did suggest not applying it anywhere on my head! Not that I was going to.

It does not say how long it will be before you feel the effects, nor how long the effects can be expected to last.

Lidocaine Ointment

This one is a generic, and I don’t know what the brand name version is. To be honest, I’m still a little fuzzy on how I got my hands on it or who helped me get it. I clicked on ad on Facebook that talked about pain management for chronic pain sufferers, filled out a little information — I thought it was for a research study — and then one day I got a phone call about it. I thought they were trying to sell me something, but I dutifully answered their questions. Next thing I know, I’m getting notifications that an order has been placed at a pharmacy I’ve never heard of, my insurance is covering this one (presumably because it’s a generic), and I can expect a package in the next day or two.

And so I received a surprisingly heavy little box that contained not one but two bottles (seen at the top of this page). Or well, a bottle and a jar. This topical painkiller is applied in two parts, apparently. I know this not because there were detailed instructions that came in the package (there weren’t), but because there are “Step 1” and “Step 2” stickers applied to the lids.

The first step is another pump bottle, this one labeled “5% Baclofen” and “5% Diclofenac.” (Hey, that sounds familiar.) This stuff is a white cream, very much like the kind of lotion you’d put on dry skin. Dispense a specific amount of it, rub it in, and wash your hands.

Step 2 is the jar, which is large enough that it could almost be called a tub. Inside is something similar in appearance and consistency to petroleum jelly. This container is labeled “Lidocaine 5% ointment.” You’ve probably heard of Lidocaine; it’s what dentists typically use to numb your gums before working on your teeth. Grab a little of it, slather it over the same spot where you rubbed in the first stuff, and (you guessed it) wash your hands. 

Similar to Pennsaid, no details are provided about when it will take effect or how long those effects will last.

And the Winner Is…

Rather unexpectedly, I seem to be getting better results from Pennsaid. I didn’t see that coming, because both medications have Diclofenac (the inflammation reducer), but the Lidocaine ointment comes with two other painkillers as well. Strange that the one that’s only got Diclofenac produced the superior results.

I should point out that this exercise was hardly scientific. It’s very possible that the pain under one shoulder blade was less than the other before any ointments were applied. It’s also possible that I may have used more or less than the proper amounts of the various ointments.

On the whole, I’m encouraged and excited that powerful, prescription topical painkillers are finally becoming a thing. Products like BenGay and Aspercreme are great and all, but they don’t usually produce sufficient results to make using them regularly worthwhile.

That said, in all honesty, I think I’ve gotten more beneficial results from BioFreeze. But admittedly, I probably haven’t used either of these prescription ointments enough yet to know their full potential.