In a recent thread I reported on the relative merits of Capsaicin/Menthol patches and 3.5% Menthol cream followed by an application of 0.075% Capsaicin cream...

http://neurotalk.psychcentral.com/thread124004.html

While the creams solution is ideal for home use and also the cheapest avenue, it requires 2 separate applications with a 30 to 45 minutes drying time in between and is somewhat messy, since Capsaicin cream must be applied with gloves...

In my Internet research, I have just come across a new product, a single application Lidocaine/Menthol based cream that purport to achieve the same results as the Capsaicin/Menthol combination, while treating inflammation as well...

http://www.tpr20info.com/about-tpr-2...dients-detail/

After reading some positive testimonials on the product, I contacted the company to provide samples to test and I plan to report on its effects on a regular basis...

http://www.tpr20info.com/linda-ys-st...or-4-5-months/

I have another subject of interest in mind that should have a separate thread to do it justice: has Peripheral Neuropathy affected your sex life and what can be done about it...

There is no capsaicin in this cream.

No, the Capsaicin is replaced by Lidocaine and various anti-inflammatory ingredients...

The advantage is that it won't give a burning sensation or require gloves to apply...

I will soon know if it works, as DHL just called to announce it would be delivered this morning...

Topical anesthetics without a cover, don't get absorbed well thru the skin. Lidoderm patches work because there is a cover.

Emla cream, which is used before surgery on the skin or for needle sticks in children is covered with saran wrap to work.

The menthol in this new product is very low. Compare to 3.5% in Biofreeze.

So I am guessing based on other patients here and the properties of the ingredients, that this cream for its very high price is not going to "deliver much". It might work for a while, but wear off quickly. And the suppression of substance P is not there either.

Just my impressions.

I went back and read your first posts. There is substantial evidence that your PN is connected to back problems! In that case what you put on the feet is going to have minimal effectiveness long term.

My Peripheral Neuropathy started within 4 days of a sacrum adjustment by an osteopath some 14 years ago and no doctor has been able to fix the problem ever since...

Because standing up or walking is quite painful, I no longer travel and stay mostly at home working on my computer, trading stocks/options, etc...

I don't expect any topical cream, be it a combined application of Capsaicin/Menthol creams or a single application of Lidocaine/Menthol cream to resolve any of the causes of the PN; only to manage the pain symptoms, so that I can live a near normal life...

To provide the cover you suggest and increase efficacy, I plan to use tight socks and to keep my feet warm...

I have started applying the TPR 20 at 3:00 pm today and plan to apply same 3 times a day, every 8 hours, for one week before reviewing the frequency: so far the pain level is down from around 5 to about 3...

Try wrapping your feet in Saran Wrap, then put on the socks for abut an hour, or so - to increase absorption. The socks alone will wick away much of the cream and be less effective.
I use a high % menthol cream, either 'Biofreeze' or 'Icy Hot' (the Rite Aid generic- 'Cool Heat' is much cheaper than either) every day, sometimes twice a day. I use a latex glove (one glove will last for 2-4 days) for application and massage it into my feet (massage towards the heart) for at least 5 minutes per foot. Then I wear cotton socks (for diabetics - from Foot Smart)

Thanks for the suggestion: I'll try it at the next application...

So far, TPR 20 has worked fairly well with just socks on: the pain level went from 5 to 3 soon after it was applied. About 5 hours later, it started to wear off, just as I went for a 2 hour pre-dinner snooze...

However, upon waking, the pain had gone down to about 2, as the warmth under the covers seems to have reactivated the ingredients...

It certainly is a lot quicker and less messy to apply than the combination 3.5% Menthol followed by a 30/45 minutes drying time, then 0.075% Capsaicin I had tried earlier...

So, I tried the Saran wrap: I cut a 4" wide section off my wife's 'clinging paper' master roll and wrapped it around my feet and ankles in the best possible style, then put on the socks...

For the first time I experienced what it feels like sliding around inside one's own socks when walking, the slippery saran being the only contact interface between the feet and the inside of the socks... a bit like driving on thin ice, right in the tropics...

However, the pain killing effects of the TPR 20 still lasted about the same: 4 to 5 hours...

Since the pain in my feet is most likely referred pain from some nerve damage and/or inflammation in the sacral area - triggered by the fateful sacrum adjustment - I now plan to apply the cream there as well with the hope that the anti-inflammatory ingredients will percolate and end up making a difference to the pain in the feet...

I know it's a long shot, but I'm willing to try anything at this juncture...

The saran wrap caused a lot of sweating and I no longer use it. However, I continue with this experiment, using exclusively TPR 20 applied to my feet and lumbar area twice during day time and once more at night for the lower back...

During the night, I coat my feet with a good quality multivitamins moisturizing cream with Aloe to keep the skin in good shape, which precludes using TPR 20...

Today, my feet felt well enough that I spent 20 minutes brisk walking on the treadmill for 1.2 mile with incline set at 3. Pain increased from 2/3 to 4 during the exercize, which was quite bearable...

After several days of steady usage, it seems that the pain level is now slightly less and the relief lasts a little longer. I now plan to continue the same application regime for at least a month to see if these improvements continue...

I don't believe you need the saran wrap all the time once you apply the cream. An hour or so is enough to drive the product into the skin. If the vehicle base is transdermal in type, it would penetrate faster, but I don't know what they use etc.

The Lidoderm patches have an aqueous adhesive impregnated with lidocaine that releases continuously thru the skin. The cream you use is a one time thing with no reservoir drug to be continually available. When using Emla for before surgery, the wrap is used for about 1 hr prior.

I would think using Lidoderm patches on the sacral area would be the way to go since you believe that is where your compression issues are. You would wear the patch there for 12 continuous hours, with 12 hrs off, and repeat.
It is also possible you have developed some spinal stenosis, and it would be prudent to see if that is happening. An MRI and Xrays would be a good idea so you could understand what is happening. It is always possible to have more than one thing going on and fixating on that "adjustment" in the past only, may be only part of a larger back problem.