* "The topical application of natural products has been used for pain relief in traditional medicine. In China and other countries in eastern Asia, topical interventions are typically multi-ingredient formulations that are composed of natural products of diverse origin, which have been prepared and processed for medical use. These are listed in major pharmacopeia. Systematic reviews of traditional medicines for various types of cancer pain suggested that combining traditional medicines with conventional therapies may improve pain outcomes. A systematic review of externally applied Chinese herbal medicines (CHMs) combined with the 3-step analgesic ladder reported improved pain relief and reduced adverse reactions to conventional analgesics. A book chapter that included randomized controlled trials (RCTs) of topical CHMs for cancer pain found improvements in pain and other outcomes. A meta-analysis of 23 RCTs reported that topical application of CHMs at painful locations combined with 3-step analgesia improved cancer pain and quality of life and reduced the rate of some adverse reactions. For bone cancer pain, a meta-analysis of the results of 6 RCTs reported that combining topically applied CHMs with conventional management resulted in improved pain relief. In a recent clinical study of a traditional herbal topical analgesic conducted in the United States, participants reported effectiveness and convenience of use.