The Top 3 Topical Pain Relief Treatments

Is anything more soothing for sore muscles and tender joints than heat and massage?  That's the attraction for most topical pain relief creams, but do any of them really work? With so many on the market, what's the best one to buy?

Topical pain relief creams are also called topical analgesics (pain relievers), sports creams and deep heating rubs. They fall into three basic categories based on their active ingredients and are sold as creams, lotions, gels or patches, usually over the counter. 

1. Capsaicin. Capsaicin creams and gels are made from chili peppers.  They cause a mild to moderate burning sensation thought to alter nerves' ability to interpret pain by lowering the presence of a neurotransmitter called Substance P. Brand names including Capzasin and Zostrix are marketed for arthritis, backache, and other joint and muscle pains.  These creams aren't generally associated with any adverse side effects though some patients may feel the heat more intensely than others.

Many athletes and arthritis patients swear capsaicin creams reduce their pain and they love the deep warming sensation they provide. This heat may be associated with relaxation, which reduces their pain response. Researchers have concluded that capsaicin creams may reduce nerve and osteoarthritis pain in some patients (when compared to placebo), but they aren't very effective in reducing muscle pain.  Best results are achieved in joints that are close to the skin, like those in the hands or knee.

2. Salicylate. Salicylate creams contain the same pain-relieving substance found in aspirin. Ben-Gay and Aspercreme's (among others) many fans in the sports world say that when rubbed into the skin, the aspirin in these creams reduces pain in their muscles, especially after a tough workout. 

3. Menthol, Eucalyptus and Mint Oils. Pain relieving creams containing either one or a combination of menthol, camphor, eucalyptus, spearmint, wintergreen or peppermint are thought to work by "confusing" nerve signals into feeling heat and cold sensations instead of pain.  Popular brands include Mentholatum Deep Heating Rub® and Icy Hot® (which may contain methyl salicylate too).  While many pain sufferers say these products work, its' relief is temporary at best.  These pain relief creams have to be reapplied frequently and tend to have strong fragrances.

Before using any topical pain relief cream or sports cream, check with your doctor to be sure it's a safe choice.  Never touch your eyes, open wounds or your genitals after using these products and wash your hands thoroughly after application.


British Medical Journal

BMJ. 2004 April 24; 328(7446): 991.

doi: 10.1136/bmj.38042.506748.EE.

Systematic review of topical capsaicin for the treatment of chronic pain

Lorna Mason, research associate,1 R Andrew Moore, director of research,1 Sheena Derry, senior researcher,1 Jayne E Edwards, senior researcher,1 and Henry J McQuay, professor of pain relief1