Learn about the various types of topical pain medications available for pain relief. Can they ease your arthritis pain?

By Mayo Clinic Staff

After an especially active weekend of hiking or work around the yard, your joints might continue to hurt even though you take your usual arthritis pain medication. Reluctant to pop another pill, you might wonder whether using a joint cream could dull the pain.

How do these products work? Can they relieve arthritis pain?

Topical pain medications are absorbed through your skin. The most common varieties are creams or gels that you rub onto the skin over your painful joints. Some come in a spray or a patch that sticks to your skin.

Because the ingredients are absorbed through the skin, most topical pain medications are best used on joints that are close to the skin's surface, such as the joints in your hands and knees.

Active ingredients in over-the-counter topical pain medications can include:

  • Capsaicin. Capsaicin (kap-SAY-ih-sin) causes the burning sensation you associate with chili peppers. Capsaicin creams deplete your nerve cells of a chemical that's important for sending pain messages. Examples include Capzasin and Zostrix. Capsaicin is most effective if used several times a day. It might take up to two weeks to feel relief.
  • Salicylates. Salicylates (suh-LIS-uh-lates) contain the pain-relieving substance found in aspirin. Examples include Aspercreme and Bengay.
  • Counterirritants. Substances such as menthol and camphor produce a sensation of hot or cold that may temporarily override your ability to feel your arthritis pain. Examples include Icy Hot and Biofreeze.

Opinions differ on the effectiveness of over-the-counter topical pain medications. While many people say these products help relieve their arthritis pain, scientific research reveals only modest benefits.

Some products work only slightly or no better than a placebo in relieving arthritis pain. Capsaicin might be more effective when used with other treatments, such as pills containing nonsteroidal anti-inflammatory drugs (NSAIDs).

Application of capsaicin creams can make your skin burn or sting, but this discomfort generally lessens within a few weeks of daily use. Wash your hands thoroughly after each application and avoid touching your eyes and mucous membranes. You may need to wear latex gloves when applying the cream.

If you are allergic to aspirin or are taking blood thinners, check with your doctor before using topical medications that contain salicylates. Also, using too much can be toxic.

Don't use topical pain relievers on broken or irritated skin or with a heating pad or bandage.

Oral NSAIDs are a common treatment for osteoarthritis, but they can irritate the stomach. Topical NSAIDs, however, have a lower risk of stomach irritation.

In the United States, the Food and Drug Administration has approved several topical products (Voltaren, Solaraze, others) that contain the prescription NSAID diclofenac for the treatment of osteoarthritis in joints close to the skin's surface, such as the hands and knees.

Some studies indicate that many NSAID creams and gels work as well as their oral counterparts. For older people or those who can't tolerate oral NSAIDs, topical NSAIDs might be used instead.

June 09, 2016