Your back is sore – again. You aren’t sure what to do this time, once you’ve tried stretching and a heating pad. You consider using a topical cream – but do they really work?

The answer: it depends. It depends on your type of pain, the cause of your pain, and which pain relieving topical treatment you use.

Topical over-the-counter creams are absorbed by the skin and usually contain one of these main ingredients:

  • Capsaicin – This causes a burning sensation, as capsaicin is found in chili peppers. Capsaicin creates a warming or burning feeling, and it works by depleting nerve cells of a chemical that sends pain messages.
  • Salicylates – Contains the same ingredients as aspirin. Salicylates work best on joints close to the skin.
  • Counterirritants – Contain menthol, camphor or other substances that create a cooling or burning sensation that cover up the pain.


study gave capsaicin to patients with osteoarthritis and rheumatoid arthritis. The study found that 80% of the capsaicin-treated patients experienced a reduction in pain after two weeks of applying the treatment. The burning sensation was too much for some patients, though. The study did conclude that “capsaicin cream is a safe and effective treatment for arthritis.”

Some over-the-counter capsaicin creams are Capzasin and Bengay. Tiger Balm also has capsaicin. It is important not to use capsaicin on broken skin or open wounds.


Salicylates may work best when applied to joints close to the skin such as knee, elbow or fingers. If you are allergic to aspirin or are taking blood thinners, check with your doctor before using topical medications that contain salicylates. An over-the-counter salicylate is Aspercreme.


Counterirritants work to distract you from the pain by alternating cooling and burning sensations. Counterirritants may work best on sore muscles. A study in the Journal of SportsRehabilitation found that people who used counterirritant ointment after doing exercises to tire out their arm experienced “significant pain relief.” The main ingredient is often menthol, as in Biofreeze.

General Tips for over-the-counter topical creams:

  • Follow all package directions.
  • Do not apply to wounds or open skin.
  • Do not use under a tight bandage.
  • Wash your hands well after using any of these topical treatments.
  • Avoid touching your eyes with the product on your hands.
  • Do not use in conjunction with a heating pad.


Until this point, we have solely discussed over-the-counter pain relievers. Prescription topical pain relievers, including patches, are often prescribed for chronic pain or fibromyalgia. They are stronger, and have more potential side effects. If your pain is at a point where over-the-counter treatments are not helping, contact us. Or call our dedicated Medical Concierge at 800-890-1964 to learn about treatment options available to you.