Dr. Mandar Shah, co-founder of Prima Innovations
Dr. Mandar Shah, co-founder of Prima Innovations

Muscle pain can be one of the most common reasons people struggle through a workday, skip exercise, or lose a night's sleep. A 2025 study in Frontiers in Public Health found that low back pain now affects 452.8 million working-age people worldwide, an increase of more than 50% since 1990. That means hundreds of millions of people are trying to do their jobs while managing pain. Yet for a problem this widespread, the treatments available today still ask patients to accept a compromise between pain relief and drowsiness.

Most prescription muscle relaxants are in tablet or injection form, where the drug travels through the bloodstream and acts through the brain before it reaches the muscle. This indirect route may be why many patients feel drowsy, dizzy, or foggy after taking them. A 2025 review summarized in American Family Physician found that these side effects affected the patients' overall quality of life. Over-the-counter topical products tend to numb or distract from pain without relaxing the muscles, which is the root cause of pain. Hence, patients could be left choosing between relief and staying alert.

Dr. Mandar Shah, a pharmaceutical scientist and co-founder of Prima Innovations, believes muscle pain can be treated where it starts, without involving the brain at all. He has spent decades developing new drugs and formulations within several different pharmaceutical companies. In his view, the industry often defaults to tablets or injections even when a more direct topical route is possible to develop. "Tight or aching muscles sit right under the skin," Shah says. "Why should we send drugs through the blood and the brain to reach the target muscle area?"

Shah explains that treatment should reach only the part of the body that needs it, wherever that is possible. He adds that topical delivery can limit how much of the body is exposed to a drug, which may reduce side effects. "When the problem is right under the skin, that is where the treatment should go," he shares. "Not every condition may allow this."

Shah's own work on the idea began with a setback, when he was laid off from a facility where he worked that shut down. While he was laid off, he often massaged his wife's neck using mixtures he made himself. Accidentally adding more of a common cosmetic preservative than usual seemed to relax her neck within minutes. He optimized the concentration of the active ingredient later on, filed a relevant patent on the findings, and subsequently filed several additional patents recently.

Shah says some investors have called the idea "too good to be true," and he believes that skepticism is healthy. In his understanding, the effect had gone unnoticed because it only occurs at a concentration no one previously had reason to evaluate. Recently, Shah established the mechanism of action. "Understanding the mechanisms is what moves a finding from phenomenon to pharmacology," he says. "This is why the team has focused on understanding how the compound acts on muscles and pain signals to the benefit of the patients."

The stakes may be the highest for people who cannot afford to feel foggy, such as drivers, shift workers, parents, and older adults, all of whom face heightened risks when treatments induce drowsiness. Shah also notes that military pilots can develop neck and back pain from high-G maneuvers, rotary aircraft, and heavy helmets, and need rest before flying again. For them, the side effects of treatment might matter as much as the pain itself. Shah says, "Relief that sidelines you is only half a solution."

According to Shah, formal clinical trials need to be completed to demonstrate that the approach is safe and effective in people, even though preliminary animal studies and preliminary human evaluations were extremely successful. "The science has to speak for itself," he notes. "Some of the most useful advances may not come from new molecules but from looking critically at the known molecules for newer applications. Sometimes the answer is already on the shelf. We just have not looked at it the right way."

Countless people are living with muscle pain, and many may have accepted that the relief comes with a cost of alertness. "Nobody should have to choose between relief and alertness," Shah says. He believes that it is time to question that trade-off rather than accept it. Shah states, "Since the cost of developing a new molecule for topical treatment will be much higher than repurposing an existing molecule, a small investment can lead to a brand new treatment and an excellent return on investment, not only for the investors themselves, but for patients too."