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DEAR DR. ROACH: For several years, I’ve been dealing with lower back pain (lumbar facet arthritis, disc degeneration and spinal stenosis, as well as right-sided lumbar radiculopathy) and feet pain (plantar fasciitis in both feet). In addition to physical therapy, I’ve received cortisone shots in my feet and epidurals in my back that have helped, although I’m going back every five to six months to repeat the shots since the pain always returns.
I’ve come across articles about a DMSO (dimethyl sulfoxide) cream self-treatment that, in some cases, has completely removed the individual’s pain. For others, it’s provided temporary relief (similar to the injections). There are different percentages of the cream that are used (50%, 70%, 100%) in the cases I’ve read about. I’d like to hear your opinion regarding DMSO and whether you recommend me trying this over another round of injections. — J.M.
ANSWER: DMSO is sometimes used in medication because it goes straight through the skin into the blood and can bring other chemicals along with it (which can be desirable or not). If you touch DMSO, you’ll be able to taste it within a few minutes.
I couldn’t find any high-quality evidence showing that DMSO is effective for lumbar facet arthritis, disc degeneration, spinal stenosis, or lumbar radiculopathy. DMSO does have some anti-inflammatory actions, but the conditions that you have all involve anatomic issues with cartilage loss, as well as impingement of the nerves by the bones and other hard tissues. So, anti-inflammatory treatments, even if they’re effective, wouldn’t be expected to bring you long-lasting relief.
I did find a trial of plant terpenes (camphor, menthol, eugenol, eucalyptol, vanillin) that were used topically for plantar fasciitis, with DMSO 15% used to enhance the absorption of these chemicals. This trial did show improvement in pain, but critically, the plant terpenes were thought to be of benefit — not the DMSO, which only allowed the plant terpenes to be absorbed.
I understand your frustration at not getting long-lasting relief from these conditions. While I don’t have anything better than injections (or possibly surgery) to offer you, there’s no good evidence to support DMSO, and its pharmacology makes significant relief unlikely. I warn you against choosing treatments based on testimonials, as it’s never clear whether they’re real or whether it was the treatment that led to someone getting improvement.
DEAR DR. ROACH: There was once a concern about taking Tylenol when getting a COVID vaccine, but I like to take it when getting vaccinated, as this was the standard advice that was given to me 40 years ago with other vaccines. Is there any risk in taking Tylenol with vaccines? -- K.K.
ANSWER: There was, indeed, a theoretical concern that taking acetaminophen (Tylenol) would decrease the effectiveness of the COVID vaccine. Pediatric data from other vaccines showed that the antibody response wasn’t as good when acetaminophen was given at the same time as the primary vaccine (not a booster or a subsequent dose).
Using Tylenol to treat mild side effects when they occur has never presented a theoretical concern. No studies have shown a decreased effectiveness of the COVID or flu vaccines when they’re administered with acetaminophen, but it isn’t necessary for most people. If you’re going to get muscle aches or a fever after a vaccine, it’s usually 6-12 hours after vaccination, so it’s better to take Tylenol when the symptoms begin.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.
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