The business of fighting pain – be it from arthritis, muscular aches, broken bones, or the result of a fistfight or an unexpected fall – is among the city’s fastest growing. Unfortunately for many New Yorkers, “battling pain,” as veteran nurse Marie Pilla of New York Presbyterian Hospital puts it, “is little more than pocketbook pain, because you often pay for a supposed pain reliever that promises the world and delivers zilch. A lot of them,” she said, “simply don’t work.”

We’re besieged by growing numbers of purported pain fighters, each anxious to capture business from the city’s more than 1 million pain sufferers who, in the pursuit of some relief, shell out an estimated $840 million a year for prescriptions and over-the-counter medications. Because America is in a graying era, that figure is expected to swell in the city to about $1 billion within the next three to five years.

One of the latest such products to hit the market, a pain neutralizer out of Canada, is of particular interest, given the public’s growing concern about safety, the big names endorsing it, and the extensive promotional campaign that’s just hitting the city via CVS, one of New York’s largest drugstore chains.

Called 024, the product is a topical analgesic that is applied to the area of pain. A combination of seven different oils, all natural, patented ingredients, it’s said to be the first remedy offered for the treatment of painful fibromyalgia, a disorder characterized by achy pain and stiffness in the muscles and tissues. 024 has the green light from the Food and Drug Administration, is said to be free of side effects, and supposedly works in a matter of minutes.

Given the adverse publicity surrounding the likes of Vioxx, Bextra, and Celebrex, and warnings of the risks of analgesics, such as Advil, one of 024’s pitches is the safety factor.

Is the product effective? Several pain management experts I spoke to had not heard of it (its relative newness could explain that) and were quick to point out that the city is already top-heavy in topical analgesics, among them such well-known names as industry leaders Bengay and Icy Hot.

024 boasts testimonials from such figures as Bill O’Reilly and a former heavyweight champ, Larry Holmes. “I’ve tried this thing and it works,” Mr. O’Reilly said on his radio talk show. A spokesman for Mr. Holmes, Jay Newman, told me the ex-champ “loves it, uses it every week, especially after sparring sessions, and even hands it out to some of his athletic friends.”

Neither Mr. O’Reilly nor Mr. Holmes, I’m told, has a financial interest in the product or in Swiss Medica, a 2-year-old Toronto-based company that holds a patent on the 024 process.

The city’s pain sufferers will be able to judge for themselves the effectiveness of the product because a sampling of CVS’s 428 New York stores, 100 of which are in the city, are in the process of giving away thousands of free applications of 024, which first appeared in the Big Apple in April.

Discussing the promotion, Swiss Medica’s CEO, Raghu Kilambi, said, “We want to make a lot of noise.”

024 will have to butt heads with a crowded field of well-established painkillers that have already made a lot of noise, such as Advil, Aleve, Tylenol, Bengay, and Icy Hot, as well as assorted aspirins, each pursuing a piece of a lucrative $12 billion market that embraces more than 10 million Americans nationally. The biggest area of this market is said to be the arthritis crowd, the 60-plus age group.

Developed by a German chemist who now works for Swiss Medica, O24 has been on the Canadian market since early 2004. It arrived in America in November 2004 and runs $19.99 for either a bottle of spray or a box of 20 towelettes, or $7.49 for a pack of towelettes.

Swiss Medica has set lofty goals for 024, which is sold in such drugstore chains as Walgreen and Rite-Aid. 024 sales in America ran about $200,000 last year, and Mr. Kilambi figures they’ll jump to $8 million this year and to $20 million in 2006.

Whether such buoyant goals will ever be met is open to serious question, given the intense competition among pain fighters. Surely though, the market is there, what with 50% of all adults suffering chronic pain, according to the American Chronic Pain Association. Of these pain sufferers, 76% say they experience daily pain, while 48% say their pain is ever present. Interestingly, half are concerned about side effects and other risks from pain pills.

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