Topical Pain Relief: How it Works and the Most Effective Application

Many of us have grown accustomed to taking over-the-counter pain relievers, like aspirin or ibuprofen, to alleviate minor and/or sporadic aches and pains. But for those who live with chronic pain or suffer frequent sprains, strains or other injuries, oral pain relievers might not be the best option. Often, pills can cause issues such as stomach sensitivity, and a host of other side effects.

Topical pain relievers, however, can present an effective solution for prolonged or frequent pain. A topical gel or cream is absorbed directly into your skin, dramatically reducing the amount of active ingredient that enters the bloodstream. The medication works locally and often more quickly than a pain pill.

Where to Apply Topical Pain Relief Cream

Because of their quick absorption into the skin, topical pain relievers are typically most effective on joints or muscles situated close to the skin – and, of course, you’ll want to concentrate on areas that are easy to reach. Overall, you want to use topical pain relief medications on areas where the active ingredient is most likely to be effective. Some good places to start include the following:

  • Wrists
  • Neck
  • Biceps and triceps
  • Deltoids
  • Lower back
  • Knees
  • Ankles
  • Feet
  • Elbows
  • Hands

Topical Pain Relief Benefits

Using a topical cream or pain relief gel instead an oral pain relief product exposes you to fewer side effects because it doesn’t require gastrointestinal absorption and the circulation of an active ingredient through your bloodstream. It may also be more effective, since oral medication affects pain sensitivity in the whole body, while a topical pain relief product can help provide relief right whereyou need it most.

Some patients just have a tough time swallowing pills in general, and others may have undergone previous surgeries or procedures that impede drug absorption. In addition, if you’re just starting to experiment with pain management, a topical pain relief cream is a good first step. It follows the generally recommended practice of beginning with the most non-invasive options available.

To help you get started, let’s look more closely at how topical pain relief works.

How Topical Pain Relief Creams Work

The best creams on the market will provide powerful and quick pain relief. A specific product’s mechanism of action depends largely on its active ingredient. To some extent, researchers are still working to define the specific mechanism of action and articulate exactly how topical pain relief products work. But they do work; in fact, they all provide localized relief, almost immediately. A few common active ingredients and how they generally work are outlined below.

Benzocaine’s numbing action reduces itching, burning, and pain on the surface of the skin by blocking the body’s nerve signals. Typically used to treat sunburn and other minor skin irritations, benzocaine is not a common solution for arthritis or other, deeper muscle or joint pain.

The cooling action associated with menthol makes it a popular active ingredient to treat minor muscle pain and joint pain. The cooling effect can distract from aching and discomfort deeper within muscles and joints. Because of its efficacy, you’ll find menthol in a variety of products and in a variety of concentrations. You’ll want to experiment a bit to find out which formulation gives you the highest level of relief with the lowest sensitivity. Products like Arthritis Wonder and Recover Wonder use menthol as an ingredient and can be good products to start with to test your body’s response to menthol.

Wintergreen (Methyl Salicylate)

This organic compound is also known as wintergreen. It is frequently found in topical pain relievers, but it has certain disadvantages. Instead of providing a cooling effect as menthol does, Wintergreen provides a warming effect which is not as effective for treating arthritis pain. Wintergreen can also trigger allergic reactions, such as hives and difficulty breathing. For these reasons, effective pain relief creams like Arthritis Wonder do not contain methyl salicylate.

Camphor employs a cooling action to reduce itching, burning and skin pain, as well as joint and muscle aches. Camphor increases local blood flow, and as a counterirritant, causes irritation that ultimately relieves pain and swelling.

Hydrocortisone is part of the steroid class of topical pain relief creams, which prevent the production of inflammation-causing chemicals in the body. They are more commonly used for skin-level irritations and do come with side effects. Luckily, they are most often accessed as a prescription product rather than being available over the counter, so they are typically used under a physician’s supervision.

Best known as the active ingredient in many over-the-counter allergy medications, diphenhydramine reduces itching and redness on skin when applied topically. It is part of the antihistamine class of drugs that suppress the natural substance, histamine, which causes itching. It is best used for superficial skin irritations like bug bites, sunburn, rashes, etc.

Made from the compound found in chili peppers, capsaicin creates a feeling of heat and has consistently shown itself as one of the most effective topical pain relievers – especially for joint pain, but also for diabetic nerve pain. In fact, capsaicin is one of the most common active ingredients in OTC pain relief creams. However, remember to take care: you should not use products containing capsaicin if you have an allergy to chili peppers. Make sure to talk to your physician.

Lidocaine serves as a local anesthetic that blocks the body’s nerve signals. Lidocaine is commonly used to treat skin conditions and irritations like sunburn, poison ivy or oak and even minor scratches or burns.

Much like lidocaine, the numbing action in pramoxine can relieve burning, itching, and pain by suppressing pain signals.

What Are Counterirritants?

Many of these active ingredients are classified as counterirritants, which means they actually inflame the affected area, stimulating nerves and creating a distracting, milder sensation. Some products contain only one isolated counterirritant, while others may combine multiple versions.

It’s important to note that topical counterirritants don’t actually treat the root cause of your pain – instead, they’re changing the way your brain perceives that pain. The temporary hot or cold sensation the product elicits can interrupt pain signals. Basically, the product serves to distract your brain from the more intense pain you’re seeking relief from. This can be tremendously helpful, because it helps keep you comfortable while your body heals from injury, or it lessens the effects of a chronic condition.

What is the Best Topical Pain Relief?

Ultimately, that decision has to rest with you as the end user. Depending on the type, level, and duration of your pain, you may have to experiment with a few different topical pain relief products before you find the one that’s most effective for you.

For example, while menthol creates a cooling sensation, active ingredients like methyl salicylate and capsaicin result in a warming, tingling sensation. Many patients prefer the cooling effect, but much of that boils down to personal preference.

Keep in mind that topical pain relief creams are less effective against pain that affects a large area and/or affects multiple parts of the body, so concentrate on specific, localized areas of pain – like those related to arthritis, injury or post-workout sore muscles.

Here’s how to get started on finding which product is best for you.

Application Instructions and Best Practices
While topical pain relief products carry significantly fewer side effects than their oral counterparts, they can still cause you trouble if not used correctly. Follow the instructions outlined below for the best results.


  • First, always read the package insert of any pain relief cream or other topical pain reliever. You may also want to save it so you can refer to it later if needed.
  • If you’re pregnant or breastfeeding, or if you have especially sensitive skin, you may want to check in with your doctor before you start using any OTC topical pain relief cream.
  • Check the treatment area to make sure you have no open wounds or broken skin before applying.
  • Wash your hands before and after applying. Some people even prefer to wear gloves. Be sure to keep hands away from eyes, mucous membranes or genitals – don’t touch at all while there’s product on your hands.


  • Use no more than a quarter-sized amount at a time.
  • Let your skin dry completely before you get dressed – this can help you avoid stains, depending on the composition of the product you’re using. A good rule of thumb is that creams are usually less greasy than ointments, less likely to leave a stain and easier to wash off your hands once finished.
  • Avoid using a heating pad after applying your pain relief cream – using the two together has been known to lead to chemical burns.
  • Also, avoid covering the treated area with a tight bandage for the same reason.
  • Avoid using your topical pain relief product more than four times per day – unless your package insert or your physician indicates otherwise.

Active Ingredient Considerations

  • If you’re allergic to aspirin, check with your physician before using a product with salicylates as its active ingredient. Do the same if you’re currently taking blood thinners.
  • In general, avoid using salicylate creams other than occasionally – unless you get different instructions from your physician.
  • Try not to use topical pain relief products containing methyl salicylate before exercising – this could cause you to absorb too much of the active ingredient as your circulation increases during physical activity.
  • Avoid using a topical pain relief cream if you’re also taking an oral non-steroidal anti-inflammatory drug, no matter whether it’s OTC or prescription-strength. Your body absorbing too much NSAID can lead to severe stomach issues, including flare-ups of stomach ulcers.

General Best Practices

  • Please remember that topical pain relief products are just that – topical. Avoid ingesting them, and call 911 if you do so inadvertently.
  • Overall, avoid using topical pain relief creams too often or leaving them on too long – this can lead to irritation or even encourage allergic reactions. If the product you’re trying isn’t working, don’t be tempted to just try more, thinking that it might be more effective. If you find yourself using more than a tube (4 oz.) per week, that’s likely too much.
  • Be very careful using topical pain relief products on children – most should not be used on children under age 2, and your packaging may also detail special instructions for use with children under 12. Some products even stipulate that you need a physician’s advice before using on a child. Make sure you read carefully and follow instructions appropriately.
  • If a topical product causes irritation or your skin shows any sensitivity, stop using it immediately – even if you’ve used the same product with no problems in the past.

You can usually apply a topical pain relief cream every three to four hours as needed, without worrying about side effects or any drug interactions. For the most part, topical pain relief products are unlikely to interact with other medications you use. But just to be safe, tell your physician about all medicines you’re taking – including prescription, OTC, vitamins, herbal and homeopathic options.

Possible Side Effects

Side effects generally associated with topical pain relief products are uncommon and typically very mild. To be safe, though, you should stop using the product immediately and check in with your physician if you experience any of the following:

  • Redness
  • Itching
  • Burning
  • Stinging
  • Hypersensitivity
  • Other observable skin irritation

Where to Apply Topical Pain Relief Cream

It’s important to apply a topical pain relief cream right where you need it in order to get the best results. Let’s look a little more closely at the areas in which topical pain relief can be most effective.

Whether the source of pain is arthritis, carpal tunnel, injury or other, pain in the wrists can make even life’s smallest chores a source of frustration. Topical joint pain relief is especially effective for wrists because the source of pain is generally very close to the skin, allowing the product to absorb directly where pain relief is most needed. This is an especially good option for anyone looking for topical arthritis pain relief.

Neck pain is one of the most common ailments patients report – from sports-related injuries, tension, poor sleeping position or even bad posture. Using a topical cream to treat neck pain allows active ingredients to penetrate the skin and get right to the aching muscles, lessening discomfort almost immediately. Especially for those with temporary injuries or ailments, topical muscle pain relief offers an effective remedy with few side effects.

Biceps and Triceps
These arm muscles can become strained, inflamed or injured from repetitive motion, overuse, tendonitis or tears. Whatever the source of pain, a topical pain relief cream can offer near instantaneous relief – because these muscles sit close to the skin, the active ingredient can penetrate directly into sore muscle fibers to bring relief.

The large deltoid muscle gives the shoulder its full range of motion and allows you to lift your arm. The deltoid sits in the upper part of your arm and is connected to the shoulder and collarbone via a complicated system of tendons. Muscle pain, soreness, tenderness, swelling and inflammation of the deltoids can come from a variety of sources, including sports injury, overuse or other trauma. It’s fairly easy to feel where the deltoid muscle sits beneath the skin, making it a prime area to target with a topical pain relief product.

Lower Back
Irritation of the lower back muscles can lead to stiffness, inflammation, tenderness, swelling, and pain that make even the simplest day-to-day tasks a challenge. Treating the area with a topical pain relief cream can loosen sore muscles and allow you to move throughout the day with more ease. But be careful with expectations – because topical back pain relief creams are best suited for targeting muscles that sit close to the skin, it’s very difficult for them to penetrate deep enough to address inflammation and pain associated with the deepest muscles and joints of the lower back.

Because it is a joint very close to the skin’s surface, the knee is a prime candidate for topical pain relief. Knee issues are extremely common – caused by sports injury, repetitive motion, excessive strain or overexertion, and having a topical knee pain relief option to help relieve stiffness, swelling and discomfort can keep you in motion while dealing with an injury or even chronic pain.

Ankles are complex mobile joints that serve as the foundation of your body’s kinetic chain. As with most joints, they can be irritated by a variety of injuries, and also by either over-pronation or –supination – causing your foot to jam either the outside or inside of the joint. Luckily, the ankle joint sits close to the skin, so topical pain relief creams can be tremendously effective here.

Pain in your feet can be debilitating. Some people suffer edema, or swelling, painful inflammation and/or soreness and tenderness in the toes, soles, and heels. Because the skin of the feet is typically thin and the sore muscles beneath sit close to the skin’s surface, a topical pain relief remedy can be particularly effective.

Elbow joint pain is an aggravation whose most typical culprit is the condition known as “tennis elbow,” an injury that includes minor tears and inflammation in the tendons at the elbow end of the extensor carpi radialis brevis muscle. The resulting irritation can put stress on the rest of the arm, making it difficult to lift things, and it is relatively common – in fact, approximately 30 percent of the population suffers from this condition. Using a topical cream on the outside of the elbow where pain may be most concentrated gives many users temporary relief while sore muscles and tendons heal.

Pain in the hands is most likely a result of osteoarthritis, and if not treated, can make life’s routine tasks frustrating challenges. Swollen joints from arthritis are not only painful but also can limit your ability to use your hands effectively. Because topical creams for arthritis pain relief can directly target those painful joints, they are often used as a first-line defense against arthritis pain.

Pain Management
Living with pain, whether from a temporary, short-term injury or a chronic condition, isn’t easy. In fact, chronic, unrelenting pain can take a heavy toll, even linked to an increased likelihood of depression. The stronger your pain-management arsenal, the better your overall quality of life.

Anyone managing pain on a day-to-day basis will want as many pain relief options as possible, with as few side effects as possible. Thankfully, a whole host of topical pain relief products exists – especially if you can’t, or just don’t want to, take pills to control pain. But keep in mind that what works for one patient may not work for another, so it’s worth the time and effort to try several different topical pain relief creams to identify what works best for your particular type of pain.

Ultimately, topical pain relief creams can be a key part of your pain-management regimen and offer an effective option for managing muscle and joint pain. They are easy and low-risk, without the side effects commonly associated with oral pain medications.

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