Whether it’s a cream, patch, gel, or spray, there are many options for applying something to your skin to relieve pain. Topical pain relievers can take up an entire aisle in the grocery store or pharmacy.

How do you choose one? How are they different? This guide will help you sort out your options so you can decide what’s right for you.

See Topical Pain Relief for Arthritis

Choosing the right topical treatment to relieve your pain is easier when you understand your options.
Topical Pain Relief for Arthritis

There are 4 general categories that over-the-counter topical pain relievers fall into: counterirritants, salicylates, capsaicin, and lidocaine.

Read more: Over-the-Counter Topical Arthritis Pain Relief



Brand names: Icy Hot, Tiger Balm, Flexall, Gold Bond

What is it?

Counterirritants disrupt pain signals by creating a temporary hot or cold sensation, distracting the brain from pain. Examples of counterirritant active ingredients include menthol, eucalyptus, camphor, and wintergreen.

See How to Understand Chronic Pain vs. Acute Pain


The natural ingredients in counterirritants are mostly safe and cause only minor side effects, like skin irritation.


Counterirritants can produce a strong odor.


Brand names: Aspercreme, Sportscreme, Myoflex

What is it?

Salicylates relieve pain by delivering a small dose of anti-inflammatory medication that’s chemically similar to aspirin.

Read more: Pain Medications for Arthritis Pain Relief

Some topical options, like Bengay or Thera-gesic, are a combination of salicylates and counterirritants.


Salicylates can temporarily reduce acute pain and are odor-free.


Salicylates can cause drug interactions with medications such as blood-thinners. If you are sensitive to aspirin or take a medication that may interact with aspirin, talk with your doctor before using a salicylate.


Brand names: Capzasin, Zostrix

What is it?

Developed from chili peppers, capsaicin creates a burning sensation and also reduces levels of “substance P,” an action which some experts think can interrupt pain signals.


Capsaicin can be effective even on deeper joints below the skin, such as back, hips, and shoulders. It also has low side effect risks.


The burning sensation may be too intense for some people, so you should try it on a small area first. It needs to be applied while wearing gloves, and hands should be washed afterward. Avoid contact with eyes or mouth.

Also, capsaicin can lose its effectiveness over time due to damage to the nerve tissues.


Brand names: Lidoderm, Lidocaine Viscous, Xylocaine

What is it?

Lidocaine is a numbing and desensitizing agent, which “mutes” pain signals.


Lidocaine is an effective anesthetic for arthritis and musculoskeletal pain and is available in both over-the-counter and prescription strengths.


Overuse can lead to serious side effects such as irregular heartbeat, so it’s important to follow manufacturer’s instructions.

Also, lidocaine should not be used in combination with heat packs or cold compresses. The numbing action of lidocaine diminishes your sense of hot and cold, which can result in accidental burns or damaged skin.

In addition to these over-the-counter options, there are topical pain medications available with a prescription, including topical NSAIDs and prescription-strength lidocaine patches.

See Prescription Topical Arthritis Pain Relief

Overall, topical pain relievers are a great option for those who experience intermittent pain in their joints because of conditions such as osteoarthritis, rheumatoid arthritis, gout, and others. But it’s important to follow manufacturer’s instructions to use them safely and effectively.

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