Topical pain medications are applied directly to the skin and come in a variety of forms including creams, gels lotions and patches. The three major categories of topical pain relievers are:
- Topical Analgesics Containing Salicylates
Salicylates (Methyl Salicylates), the same ingredients found in aspirin, are effective pain relievers that also reduce inflammation when absorbed by the skin. These compounds appear to work by inhibiting prostaglandins (substances that contribute to pain and inflammation). These creams are not recommended for use by those who are allergic to aspirin, due to an association between the development of Reye's Syndrome and the use of aspirin (a salicylate compound). Brand name products include Bengay, Aspercreme and Sportscreme.
Also See - Capsaicin Creams
Capsaicin is a compound found chili peppers that causes a hot, burning sensation. Capsaicin applied to the skin depletes a chemical (substance P) in nerve cells that helps send pain signals to the brain. Brand name products include ArthriCare, Capzasin and Zostrix. - Counterirritants
These products contain ingredients such as menthol, wintergreen or eucalyptus oil that makes the skin feel hot or cold. Its thought that this distraction from the sensation of pain is what provides temporary pain relief. Brand name products include Flexall 454, Icy Hot and JointFlex.
Do Topical Pain Relievers Work?
The studies that have been done do show limited evidence that most over-the-counter topical pain medications offer temporary relief from muscle aches and pain.
Are Topical Pain Relievers Safe?
When used moderately, and in accordance with the label directions, these topical medications are relatively safe. They should not be used long term or in excessive quantities. Its also important to realize that many of these medications mask or suppress the natural pain signals of the body, and ignoring pain can increase your risk of further muscle or joint injury. If you do use these medications for temporary pain relief, its important to rest your sore muscles, so try to avoid intense exercise until soreness subsides.
Side effects from these medications often include burning, stinging or irritated skin. Never use these medications on broken or irritated skin. Do not heat or ice your injury if you are using these topical medications and always wash your hands thoroughly after applying creams, lotions or gels. As stated above, creams containing salicylates should not be used by those who are allergic to aspirin.
Topical Pain Relievers and Overdoes
While extremely rare, it is possible to overdose on these topical pain relievers. An overdose occurs when someone accidentally or intentionally uses more than the normal or recommended amount of this product.
Overdoses can be serious, and sometimes fatal. An excessive absorption of the chemical methyl salicylate can lead to toxic levels in the blood and cause the same symptoms as an overdose of aspirin (nausea, vomiting, sweating, rapid breathing, and ringing in the ears) and possibly death. In fact, in 2007 a 17-year-old high school track athlete died after accidentally overdosing on methyl salicylate.
Also See
- Sports Cream Overdose
- Methyl-salicylate Overdose
- Eucalyptus Oil Overdose
- Menthol overdose
- Zinc oxide overdose
- Poisoning from Hand lotions and creams
Sources:
National Institutes of Health, Medline Plus, Sports Cream Overdose.
National Institutes of Health, Medline Plus, Methyl Salicylate Overdose.
McCleane G. Topical application of doxepin hydrochloride, capsaicin and a combination of both produces analgesia in chronic human neuropathic pain: a randomized, double-blind, placebo-controlled study. British Journal of Clinical Pharmacology. 49.6 (2000):574-9.

