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February, 2010

What's Important When Looking at Topical Analgesics?

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher

Our recent survey1 discovered that topical analgesics are used by 91 percent of those in chiropractic practice in the United States. This places the use of topical analgesics just under nutritional supplements (employed by 94 percent) as one of the most used products in chiropractic practice in the United States.

The results below provide insight as to how DCs across the country and their patients are effectively utilizing topical analgesics.


The results show that almost half (49 percent) of those DCs surveyed purchase "two or more" topical analgesics for their patients. Purchasing multiple products is a trend that has been noted before and applies to other types of products purchased by DCs.

Only four of the topical analgesic companies presented were familiar to more than half of those responding to the survey. This suggests that choice is important, even if those choices are perceived to be limited.

Quality and Price

Eighty percent of those surveyed were totally confident in the quality of the topical analgesics products they used and offered to their patients. However, they did not agree with the prices. Less than half totally agreed that the prices were affordable (47 percent) or a great value for the money (41 percent). Again, this is consistent with the responses for other products DCs have purchased.

Unlike other products, price was the primary determining factor when switching from one brand of topical to another. Poor quality was the second reason for discontinuing the use of a topical, but this reason was cited only about half as often as price.

Use With Adjustments

Approximately 5 percent of DCs use topical analgesics before they adjust "almost all" of their patients, with another 5 percent using them after they adjust "almost all" of their patients. Of those only one-third use topical before and after they adjust. Of those that used topical analgesics on 50 percent or more of their patients, twice as many (26 percent) used them after they adjusted, compared to only 13 percent who used them before they adjusted

Only 3 percent of respondents report that "almost all" of their patients buy topical analgesics from them. However, the percentage differs based upon whether chiropractors use the topical before or after they adjust. Interestingly enough, a doctor who uses topical analgesics on "almost all" of their patients after they adjust is three times more likely to see "almost all" of their patients purchase topical analgesics from them, than a doctor who uses topicals on "almost all" of their patients before they adjust.

Other Uses

Of those who sell topical analgesics to their patients, approximately 90 percent of doctors report that their patients purchase them for musculoskeletal pain. However, a surprising 27 percent of DCs reported that they have patients who buy topical analgesics from them for non-musculoskeletal pain such as mosquito bites, poison ivy, etc.


Choice continues to be an important factor for products that are sold or used on patients. Topical analgesics are included in this trend. While quality is important, price is even more so. These two factors may suggest that topical analgesics are perceived to be somewhat generic in nature. Additional research should be conducted to verify this.

The use of topical analgesics on patients appears to be correlated to their purchase by the patient. Patients are much more likely to purchase topicals if the doctor uses the topical after care is provided. Patients are also interested in topical analgesics for non-musculoskeletal purposes. This could expand the role of DCs as a broader provider in the eyes of the patient.


  1. Chiropractic Topical Analgesic Survey. MPA Media, completed Nov. 3, 2009.

Click here for more information about Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher.

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