The present invention is directed to a safe and effective therapy for the treatment of pain associated surgical incisions, wounds, cuts and abrasions. The present invention relates to a pharmaceutical composition comprising a combination of a guanylate cyclase inhibitor and a topical anesthetic or a combination of a redox dye and a topical anesthetic. The compound and treatment may be used to relieve pain resulting from surgical procedures, especially anal surgery.

A modality of twitch obtaining intramuscular stimulation (IMS) pain relief therapy employs an EMG needle (13) having a TEFLON coated shaft, and exposed conductive tip (17) to apply micro-electrical stimulation locally, and focally to muscle motor end plate zones or regions of adjacent motor end plate zones. The electrical stimulation facilitates the elicitation of strong twitch responses from muscle fibers associated with the stimulated motor end plates, generally without requiring physical needle manipulation following the initial pin insertion. Less skill is required to effectively elicit pain relieving twitch responses, thus facilitating training of medical personnel to carry the procedure. Rapid movement between multiple treatment sites is possible allowing treatment of a larger number of afflicted muscles, and muscle areas in a single treatment session. The strength, the number of twitches obtained at the treatment sites can provide substantial relief from regional, and diffuse myo-facial pain of radiculopathic origin. In addition, since physical manipulation of the pin is generally unnecessary, patients experience less pain, less discomfort during the procedure, and the risk of repetitive stress injury to the therapist is reduced

Intramuscular stimulation (IMS) pain relief therapy is facilitated by a hand held tool (1) which once positioned against a patient's skin can be controlled to automatically advance a needle (11) to penetrate the patient's flesh, reciprocate the needle (11) within the patient's flesh a predetermined number of times through a predetermined stroke, and retract the needle (11). A tubular guide member (13) is provided at its distal end with a skin contact member (15) forming a constricted orifice closely matching the diameter of the needle (11). The orifice allows substantially free passage of the needle (11) therethrough, and at the same time prevents bowing of the needle (11) as it is advanced, which is a primary source of patient pain. Automation and control of the needle penetration; reciprocation and retraction sequence reduces the amount of manual, and mental effort required on the part of the treating physician, thereby allowing physicians to perform IMS procedures more consistently effectively and efficiently. This leads to better results (increased pain relief); decreased procedure induced patient pain and tissue trauma; and reduced risk of repetitive strain injury to the treating physician.

Methods and compositions for treating pain at a specific site with an effective concentration of capsaicin or analogues thereof are described. The methods involve providing anesthesia to the site where the capsaicin or analogues thereof is to be administrered, and then administering an effective concentration of capsaicin to the joint. The anesthesia can be provided directly to the site, or at remote site that causes anesthesia at the site where the capsaicin is to be administered. For example, epidural regional anesthesia can be provided to patients to which the capsaicin is to be administered at a site located from the waist down. By pretreating the site with the anesthetic, a significantly higher concentration of capsaicin can be used. Effective concentrations of capsaicin or analogues thereof range from between 0.01 and 10 % by weight, preferably between 1 and 7.5 % by weight, and more preferably, about 5 % by weight. This provides for greater and more prolonged pain relief, for periods of time ranging from one week to several weeks. In some cases the pain relief may be more sustained because the disease that underlies the pain may improve due to a variety of factors including enhancement of physical therapy due to less pain in the soft tissues which may foster enhanced mobilization of soft tissues, tendons, and joints.