Pain Relief Without a Prescription?

Recently by Cynthia J. Koelker, MD: Horse and Buggy Dentistry

A reader of SurvivalBlog wrote to ask whether dimethyl sulfoxide (DMSO) is safe and effective for use in humans. The chemical is well-known in veterinary circles for its soothing effect on swollen, inflamed equine (horse) muscles. But would it have the same effect on people?

Unrelieved pain is a great fear among survivalists and preppers. Few have access to narcotics or anesthetics. Wouldn’t be great if there were a readily available, safe and effective over-the-counter remedy? That is the primary question with DMSO.

What is DMSO anyway? The chemical dimethyl sulfoxide is a potent solvent, produced as a by-product of the wood pulp industry. It is best known medically for its ability to penetrate the skin, and has been useful as a carrier to aid the absorption of other beneficial medications. Therein lies one of the concerns: if the skin is contaminated or the DMSO formulation is impure, unwanted chemicals may enter the body. Therefore if you are going to use DMSO as a topical preparation, make sure you use medical grade rather than industrial grade DMSO.

Whether DMSO works as a topical pain reliever is controversial. The “party line” of the medical establishment is that it is probably NOT effective. One study (in the journal Pain. 2009; 143(3):238-45) concluded that topical DMSO was no more effective than placebo in relieving symptoms of chronic knee osteoarthritis. However, such a study does not answer the question completely. Did the DMSO penetrate inside the joint capsule, to the actual source of pain? A study on the knee cannot answer the question as to whether DMSO is effective for muscular pain, or perhaps acute joint pain caused by strain or overuse. In 2008 a systematic review of DMSO use in osteoarthritis (Osteoarthritis Cartilage. 2008; 16(11):1277-88) concluded there is insufficient evidence either way to decide whether it is beneficial.

This raises another point: pain is not simply one thing. Joint pain and muscle pain are not the same. Acute pain is different than chronic pain. Traumatic bone pain is different from cancer pain. Neuropathic pain is not the same as primary muscle pain. Bladder pain is different than headache pain.

DMSO has been used effectively for certain types of pain. Currently it is only officially FDA-approved for discomfort or pain associated with interstitial cystitis, a chronic condition of the bladder causing pelvic pain and/or urinary symptoms. A small amount of DMSO is instilled into the bladder via a catheter, where it is left in place for 10-15 minutes, then emptied. This process is repeated every week or two for a few months, and most patients experience some relief of pain. DMSO is thought to work by reducing inflammation and possibly decreasing bladder muscle contractions.

If DMSO can work in the bladder, might it not be effective elsewhere? One of the worst pain syndromes is cancer-related pain. DMSO (plus sodium bicarbonate) has been used as IV therapy for patients with refractory metastatic cancer pain unresponsive to other treatments with encouraging results [J Pain Palliat Care Pharmacother. 2011; 25(1 and 4)].

So where does this leave us? Doctors don’t really know. I’ve had patients who have sworn DMSO is effective. These have been younger patients with acute injuries or inflammation; such patients are prone to conditions akin to the acute injuries active horses might suffer. Treating a young injured race horse is likely to yield better results than treating a worn-out work horse.

Physicians prefer to have strong proof for what we advise, though that is often lacking. Regarding DMSO, the Memorial Sloan-Kettering Cancer Center concludes, “Most of the clinical studies done on DMSO were published in the 1980s and early 1990s. Reliable data to verify its purported uses are limited.”

Regarding safety, the concerns are acute and long-term side-effects. Any use of DMSO is likely to yield either bad breath or a garlic-like taste in the mouth or similar odor on the skin. Rashes and dry skin are common with topical use. Allergic reactions are possible as well. Those using the product long-term may suffer kidney or liver damage and ideally would undergo blood testing every 6 months (a difficult proposition at TEOTWAWKI).

The MSDS sheet lists a multitude of concerns (but no more than other drugs we use every day, including aspirin).

My own conclusions are these:

  1. DMSO probably does work for certain conditions which have not been well-identified, but may be related to acute injury or overwork rather than chronic inflammation.
  2. It is reasonably safe to use medical-grade DMSO topically on an intermittent basis.
  3. Patients who already have liver or kidney damage or who are pregnant or nursing should not use DMSO.
  4. We need more studies to prove which ailments DMSO is best used for. Unfortunately, those studies are unlikely to be performed due to lack of funding.
  5. Using industrial-grade DMSO can be dangerous and result in unwanted poisoning with unidentified products.
  6. DMSO is probably no more effective than OTC NSAIDs (aspirin or willow bark, ibuprofen, naproxen) but may provide an alternative, especially for patients intolerant of these meds.
  7. All users should be warned about the garlic-onion-oyster odor [or taste] they will experience.
  8. Doctors don’t know everything, but we err on the side of caution.

JWR Adds: Readers are further warned to store DMSO only in containers with tight-fitting lids that are vapor tight, and to store their supply of 99.9% pure medical (or veterinary) grade DMSO well away from any toxic substances. The solvent’s amazing carrier properties are well-documented. Keep in mind that if you apply it to a sore muscle using your hands then any contaminants on your hands will be absorbed through the skin and enter your bloodstream. The speed with which this can occur can be astonishing. I once read about a man who washed his hands with a scented soap shortly before using DMSO. Then, less than a minute after applying the DMSO with his hands to his sore knees, he could taste the hand soap on his tongue, almost as if he had licked the bar of soap! Some drug addicts have reportedly used DMSO as a "soft" way to ingest drugs that require only small doses, such as PCP and Fentanyl. And though perhaps exaggerated in the frequency of occurrence in popular fiction, DMSO mixed with a powerful toxin such as saxitoxin has reportedly been used by foreign intelligence agencies for killing some political opponents of unpopular regimes.

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Cynthia J. Koelker, MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education. The author continues to practice medicine in Akron, Ohio where she resides with her family and beloved golden-doodles. She is the author of 101 Ways to Save Money on Health Care: Tips to Help You Spend Smart and Stay Healthy.

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