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DMSO for Pain

Can dimethyl sulfoxide “solvent” your pain problems? This complex industrial solvent is a little too biologically “interesting” for comfort

Paul Ingraham • 15m read
Clear glass vial filled with a transparent liquid, placed on a dark, flat surface.

Not much to see, is there? Pure DMSO looks like water & doesn’t even stink … but you’ll smell like garlic when it gets into you.

I grew up in Prince George, British Columbia, a small northern Canadian city, and a smelly one thanks to all the pulp mills. The Kraft process dissolves wood into pulp for paper-making, and — in addition to the stench — it pumps out the organosulfar compound dimethyl sulfoxide, a powerful industrial and laboratory solvent best known by its acronym: DMSO.

And DMSO is supposedly medicinal! Little did I know, growing up in odiferous PG, that my nose was filled with a nostrum that I would eventually write about as a health science journalist. Was it the smell of snake oil?

DMSO has reputation as a pain-killer, despite the fact that it has never been approved for use as such anywhere in the world. It is popular with more serious athletes and military personnel for injuries. There’s a bit of a macho vibe to its history. It has also been touted and debunked as a cancer cure — most of a century ago — so there’s also a quackery vibe.

The science is quite sketchy, and only one thing is certain: it is a biologically interesting chemical, mainly because it passes through cell membranes like they aren’t even there. What could possibly go wrong? Or right? When you touch DMSO, it doesn’t just “soak in” where you put it on — it gets everywhere, fast. To organic solvents, you’re just a bag of water. You can “taste” DMSO within minutes of touching it.

DMSO may work for pain. No one really knows. But it is probably also a little too interesting to be predictable, reliable, or safe.

What is DMSO? An explosive acid by any other name would smell as garlicky

DMSO is a colourless, slightly oily fluid, and odourless when pure despite its stinky origins — but it will give you garlic mouth and B.O. after it gets into you, thanks to the sulfur component, and/or some funky neurology (triggering a taste receptor). Garlic stank without garlic flavour is practically a deal-breaker for me, but I’d consider it if works. (Note that MSM, methyl sulfonyl methane (MSM), is extremely similar to DMSO but doesn’t do the garlic thing.)

It has a handful of legit medical uses. For instance, it’s FDA-approved as a treatment for bladder inflammation — and that's it.1 Other medical uses are more speculative. Otherwise, it’s mostly related to medical science and laboratory work. Many labs would be unable to function without DMSO.

DMSO and MSM are not supplements,2 even though they are found in every supplement shop in the land, diluted for use as a gel or spray, and sometimes in pills for oral usage. DMSO has no normal role in biology, so it cannot “supplement” anything. It is a quintessential chemical, something our biology is never normally exposed to, the by-product of an industrial process, with many other other industrial and laboratory applications, and thoroughly toxic at high concentrations.

It’s a legitimately a potent acid!3 So it is obviously seems a bit bonkers that something that can burn you badly is also used topically for pain relief (reminds me of the Miracle Mineral Solution debacle, the actual, real-world, not-a-joke practice of drinking bleach to cure what ails you). And while it is very diluted when when used as medicine, skin irritation is nevertheless the most common side effect of smearing DMSO on yourself.

Unsurprisingly, there’s more …

DMSO side effects and safety

Used in moderation, diluted DMSO clearly isn't doing any obvious significant harm. The side effects are mostly associated with higher concentrations/dosages, and proportionate to them. But DMSO's ability to flow through cells makes it a biological wildcard in a way that most chemicals can only dream of, and so subtler or long-term harm is absolutely conceivable. DMSO always gets everywhere, so any effect it can have, it can have on practically any tissue in the body.

DMSO safety has not been well studied, because it’s complicated and there's not a lot of cause to do so. This list is followed by some rather ominous research clues.

Skin side effects:

Systemic side effects:

In animals (DMSO is fairly widely used in veterinary medicine):

As with all supplements (unregulated by nature), contamination and adulteration are also disturbingly possible.

Cellular self-destruct from surprisingly low DMSO dosages

How's it doing all that stuff to people who go overboard? Murdering cells is one sinister possibility. DMSO concentrations under 10% are unlikely to cause serious or obvious harm, and the lower the concentration, the less likely you are to have trouble. However, the chemistry and biochemistry is very complex, and there is plenty we do not know.

For instance, a 2016 study showed "unexpected low-dose toxicity" — concentrations as low as 2-4% caused nerve cells to self-destruct.4

So there's that.

And now darker: DMSO can induce “genome-wide changes”

Remember, this stuff doesn't just soak through the skin: it will soak right into your cells. In fact, that property makes it a great cellular anti-freeze, so it has long been a vital ingredient in cryogenic preservation of stem cells, embryos, and eggs. But what's it doing in there?

A 2019 study reported startlingly powerful effects of DMSO on … genetics? It caused "disruption of DNA methylation mechanisms leading to genome-wide changes. The extreme changes in microRNAs and alterations in the epigenetic landscape indicate that DMSO is not inert."5

Yes, they are actually warning that DMSO may well cause mutations (in spirit, if not quite literally). The "biological effects of DMSO have been forgotten or considered negligible," but they showed that DMSO is actually doing something quite dramatic and poorly understood. What are the odds it’s all good news? Verheijen et al.: "

Use of DMSO should be avoided where possible. However, for the time being, DMSO is indispensable within biotechnological applications. In these cases, the effects that DMSO may have should be considered and the concentration should be kept as low as possible, because even at low concentrations DMSO is not inert.

A large screenshot of Google Image search results for DMSO, showing mostly jars and bottles of DMSO liquids and gels, a couple book covers, etc.

Google image search results for DMSO. If you tap to embiggen, you can see a lot of hope & hype in the details: “healing with DMSO,” “nature’s healer,” “doctor’s choice,” “the wonder drug.”

How can a solvent solve your pain problems?

We don’t actually know if it can, or how it would. It’s just a chemical that is readily absorbed and reputedly kills some pain. DMSO appears to — anecdotally — have some analgesic effects, along with a handful of other quite specific medical uses we know about (it’s weirdly good for burns).

I’ve been familiar with the DMSO thing in broad strokes for years, and I cynically expected the worst when I dug into the topic. I assumed it has a long history of weak and pseudoscientific support, probably much of it funded and conducted for the wrong reasons.

What I didn’t expect was that I’d find … almost nothing at all. There is exactly no meaningful scientific confirmation of DMSO’s reputation for analgesia. There was were a couple positive trials in Germany in the 1990s.67 (But the Germans also produced a lot of positive trials of homeopathy in that period, so I’m certainly not just going to take their two DMSO studies at face value.)

There was a 2015 trial of DMSO at the University of British Columbia (in my back yard, almost literally, I walk there regularly). It was ostensibly positive, but … one study, done on blood in test tubes, and mice, that no one has even tried to reproduce.8

And that’s about it.

And you know how reliable word-of-mouth pain treatments are. I’m not going to say it doesn’t work, because I don’t know. But I feel like it’s a bit late in history for us to be missing an important topical analgesia that’s been right under our noses for well over a century. And in your nose, if you live near a pulp mill.

That said, I don’t outright “disbelieve” that DMSO has some kind of pain-killing effect. We just don’t know what it is, how it works, how strong it is, what kind of pain it might be best for.

DMSO as a delivery mechanism

Some compounds, when dissolved in DMSO, get a free ride wherever the DMSO goes. And so DMSO is also considered a "delivery mechanism" for other medicines, and so sometimes it is packaged with other medicines, anything from the most alternative to the most mainstream. That is, it is used as a "carrier" for other drugs, to facilitate absorption.

And if DMSO can indeed drag other medications deeper into the body, more quickly …

Obviously this strategy shares all the limitations and hazards of existing pain-killers. And does DMSO play nicely with the medication? It could be different in every case. Some products, unsurprisingly, pair DMSO with other substances of highly speculative value.

Still, delivery mechanism can make a huge difference in how well a drug works. For instance, there are big practical differences in the efficacy and safety of oral versus topical diclofenac (Voltaren), a member of the same family as aspirin and ibuprofen. But it entirely depends on the details, and there are a lot of variables in the equation: pain type, body part, DMSO concentration and preparation, the drug that's being delivered, dosage, etc.

All of this means that in theory some combination might be delightful. How many of those combinations have been rigorously tested? And if one or a few of those was promising … wouldn’t a drug company have exploited that by now?

Or did they perhaps decide that using a universal solvent wasn’t the best way to get drugs into the body? Fun fact: DMSO has been tested to see if it delivers diclofenac through the skin better than not using it … and it failed.9 Despite this, there is a mainstream diclofenac+DMSO product, PENNSAID (“penetrating NSAIDs” , I think), which undoubtedly works at least as well as Voltaren… but probably no better (based on the trial I just cited). If there’s ever been a proper head-to-head comparison of Voltaren with PENNSAID, I can’t find it.

So maybe just use Voltaren? Which has been rigorously tested for a few things (mainly arthritis). It’s literally the same idea — soak up a pain-killer where it counts. But you don’t have to roll the dice with DMSO.

DMSO2 (Dimethyl sulfone)

DMSO2 is basically a somewhat declawed version of DMSO, a less potent potent/volatile solvent. For instance, DMSO explodes when heated, and DMSO2 does not. Using it is probably a lot like just using less DMSO.

It is more supplement-like insofar as DMSO2 is actually occurs naturally in small quantities, so — unlike with DMSO — using it medicinally is adding. But don’t overestimate the importance of this. There is an awful lot of chemistry in our diet that we don’t need or want to boost.

Despite being a less "dramatic" substance, with fewer and milder obvious minor side effects like skin irritation, DMSO2 is still mostly the same deal: it gets everywhere just as fast, and so there are about a kajillion unknown possible interactions with biology, 99% of them unstudied. It’s alleged ability to kill pain isn't based on anything but wild speculation and storytelling.

DMSO: a wildcard most patients can do without

I have more than my fair share of body pains, and I would love to solve them with DMSO, or anything at all, and I am willing to take some risks for that chance. But I don’t love the fact that we just have no real idea at all how it relieves pain, and it’s uncanny ability to cross any membrane gives me the heebie jeebies, because of the potential for many unpredictable biological consequences — and then there’s recent evidence that some of those consequences could absolutely be subtle yet serious.

Many very harmful things are weirdly non-obvious. Lead poisoning is one of the best examples: very serious, but extremely hard to detect below a certain threshold. Remember, many health and wellness are in fact dangerous despite their popularity.10

On the one hand, people with stubborn and serious pain are desperate. On the other hand, the last thing we need is serious, subtle side effects!

About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of ScienceBasedMedicine.org for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter., or subscribe:

What’s new in this article?

Jun 29, 2024 — Added a section about DMSO2.

June — Numerous improvements, individually minor, collectively significant. Great example of a “day after” update! Twenty-four hours ago I felt done and I was out of ideas, but I just spent 90 minutes improving it

June — Publication.

Notes

  1. Bear in mind that plenty of mainstream medical practice is not actually evidence-based, but that’s not a can of worms I’ll open here. Yet. But would we be shocked to discover that the evidence-based for using DMSO on interstitial cystitis is somewhat lacking? No we would not.
  2. Some people might use DMSO in a manner similar to supplements, and it is sold with them, and it is often packaged in a way that makes it look like them. Some marketing for DMSO makes it seem like it’s a “natural” product, or even herbal! It’s often associated with supplements for arthritis like glucosamine, but the only similarity is that they are both supposedly good for the same thing — but in completely different ways.
  3. Hold your horses, chemistry pedant! Yes, DMSO actually a *base*, not an acid, but if you write “a strong base” in a popular article, people think you mean that’s got a good beat or something. A strong base is *like* a strong acid, and everyone knows what acid is like. It’s basically xenomorph blood, okay? At least one reader be like, “Oooh, why didn’t you just lead with *that* then?”
  4. Galvao J, Davis B, Tilley M, et al. Unexpected low-dose toxicity of the universal solvent DMSO. FASEB J. 2014 Mar;28(3):1317–30. PubMed 24327606 ❐ This study showed that DMSO can harm retinal cells in rats even at concentrations generally considered safe for medicinal use. It caused cell death by triggering a process that leads to apoptosis (a type of programmed cell death). These findings were supported by various tests and measurements in lab-grown cells. The researchers suggest caution when using DMSO in scientific experiments, especially at concentrations above 1%. They recommend using alternative solvents when possible.
  5. Verheijen M, Lienhard M, Schrooders Y, et al. DMSO induces drastic changes in human cellular processes and epigenetic landscape in vitro. Sci Rep. 2019 Mar;9(1):4641. PubMed 30874586 ❐ PainSci Bibliography 51487 ❐

    The safety of DMSO is uncertain despite decades of routine use in laboratories and industrial processes. The experiment tested the effect of DMSO on cells using new technologies that can cast a wide net for signs of changes in genetic expression, with troubling results: “extreme changes in microRNAs and alterations in the epigenetic landscape indicate that DMSO is not inert. Its use should be reconsidered, especially for cryopreservation of embryos and oocytes, since it may impact embryonic development.” Although highly technical, “DMSO may cause mutations” is not an unreasonable simplified explanation.

  6. Kneer W, Kühnau S, Bias P, Haag RF. [Dimethylsulfoxide (DMSO) gel in treatment of acute tendopathies. A multicenter, placebo-controlled, randomized study]. Fortschr Med. 1994 Apr;112(10):142–6. PubMed 8194818 ❐
  7. Eberhardt R, Zwingers T, Hofmann R. [DMSO in patients with active gonarthrosis. A double-blind placebo controlled phase III study]. Fortschr Med. 1995 Nov;113(31):446–50. PubMed 8529985 ❐
  8. Elisia I, Nakamura H, Lam V, et al. DMSO Represses Inflammatory Cytokine Production from Human Blood Cells and Reduces Autoimmune Arthritis. PLoS One. 2016;11(3):e0152538. PubMed 27031833 ❐ PainSci Bibliography 51458 ❐

    This study reports that DMSO can reduce inflammatory markers in human blood induced by E. coli and herpes virus, and in mice with “serum-induced arthritis,” at concentrations of 0.5%-2% However, it also started to hurt white blood cells at the high end of the tested concentrations. “More study needed,” indeed! They also tested the effect of DMSO on cancer, and found nothing.

  9. Simon LS, Grierson LM, Naseer Z, Bookman AAM, Shainhouse ZJ. Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo, DMSO vehicle and oral diclofenac for knee osteoarthritis. Pain. 2009 Jun;143(3):238–245. PubMed 19380203 ❐
  10. The colorful history of medicine and quackery is overflowing with people who “swore by” treatments that were bizarre and perilous. Even the worst had fans. People believe what they want to believe. For more information, see Popular but Weird & Dangerous Cures: The most dangerous, strange, and yet popular snake oils and “treatments” in history (and why anecdotes and testimonials cannot be trusted).

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