Topical Relief for Muscle Pain

Muscle creams, also called muscle rubs, are available over the counter (OTC) and are used to ease muscle and joint pain caused by arthritis or injuries. They contain a wide variety of active ingredients. Some have active medicines that penetrate the skin and enter the body while others contain counterirritants that create a cool or hot sensation as a distraction from pain points. Common OTC muscle creams include BenGay, Icy Hot, Biofreeze, and Tiger Balm.

Arnica

Arnica is an herb, and its flowers are commonly used in medicine. It contains active chemicals that can aid in reducing swelling and decreasing pain and act as an antibiotic.

Arnica is commonly used for pain associated with osteoarthritis, sore throat, and surgery, to name a few. So far, only its use for managing osteoarthritis pain is supported by scientific evidence. One study showed that an arnica gel provided similar pain relief to topical ibuprofen (an NSAID) for osteoarthritis. Even so, topical arnica products have a similar, if not worse, side effect profile compared with topical NSAIDs.

Common products containing Arnica include:

• Boiron Arnicare Gel 2.6 Ounce Topical Pain Relief Gel
• Arnicare Cream
• Arnica-Menthol Organic Magic Balm
• Arnica + K Cream

While Arnica is commonly used in food and homeopathic treatment, there are some concerns related to its safety. Be sure to use only as directed. Eating the Arnica plant, topical creams, or ointments, or the plant extracts or oil can result in serious poisoning. Additionally, don't use Arnica if you're pregnant, breastfeeding, have allergies to ragweed or related plants, on broken skin, have digestive issues, have a high heart rate, or before surgery.

Capsaicin

Capsaicin is a chemical compound derived from chili peppers. It's commonly used to relieve minor pain in muscles and joints caused by arthritis, backaches, muscle strains, bruises, cramps, and sprains. This substance works by affecting nerve cells in the skin that are associated with pain, which results in decreased activity of these nerve cells and a reduced sense of pain.

Capsaicin is potent and is in small doses in muscle rubs. Capsaicin creams, gels, oils, and other products contain between 0.025% and 0.075% of the substance. Capsaicin can also be applied by a healthcare provider at a higher concentration after the application of a topical anesthetic.

Over-the-counter options include:

• Capzasin-P: A capsaicin 0.1% topical analgesic cream
• Zostrix: A capsaicin 0.033% topical analgesic cream
• Zostrix Maximum Strength: A capsaicin 0.075% topical analgesic cream

This chemical can cause burning or stinging pain, and ingestion can lead to nausea, vomiting, abdominal pain, and diarrhea. If the chemical comes in contact with your eyes, it can be extremely painful and even cause conjunctivitis or blepharospasm.

Menthol

Menthol is a common active ingredient in topical pain relief products. It provides a cold sensation once applied. Similar to capsaicin, it desensitizes nerve cells in the skin. The substance can feel nice on the skin, but it cannot alleviate inflammation. Instead, it works to override the pain sensation with a cooling sensation.

Menthol can be paired with other ingredients to add to its cooling power. It's found in the following OTC products:

• BenGay Cold Therapy
• Icy Hot Naturals
• Icy Hot Advanced Relief Patch
• Salonsip Gel Patch
• Aspercreme Heat Pain Relieving Gel
• Aspercreme Max
• BenGay Zero Degrees
• Mentholatum Sports Pain Relief Cold
• Tiger Balm Ultra

Lidocaine

Lidocaine is an anesthetic (numbing medicine) that works by blocking the transmission of nerve signals. It is used to relieve itching as well as pain and discomfort from eczema, minor burns, scrapes, insect bites, hemorrhoids, and other conditions. It is also used to numb areas of the body before a surgery.

Common brands of topical lidocaine include:

• Lidotrex
• Regenecare
• Renuu Patch
• Vexa-D
• Vopac

If lidocaine is ingested, it can cause numbness of the mouth and throat, which can lead to trouble swallowing or choking. If a large amount is ingested, it can also get into the bloodstream, leading to serious symptoms like seizures, coma, or cardiac arrest. Consult a healthcare provider before using lidocaine.

Turmeric

Turmeric might be a familiar name to you. It has a chemical called curcumin, which can help decrease swelling, especially in arthritis. One study found that topical administration of a curcumin 5% ointment significantly reduced knee pain in older adults with knee osteoarthritis.

Muscle cream products that contain turmeric include:

• Jointflex Pain Relief Cream with Turmeric
• Biofreeze Pain Relief Cream
• Everyday Medical Turmeric Pain Relieving Cream

Turmeric is a natural ingredient. Therefore, there are limited concerns about the safety of the substance. Do not take turmeric products if you are allergic to turmeric or any ingredients contained in this drug.

How to Apply Muscle Cream

Before using a muscle cream, speak with your healthcare provider or pharmacist to make sure it's safe for you.

When applying a muscle cream, the first step is washing and drying your hands. Next, read the packaging completely to note the dose recommendation, directions, and warnings.

Apply the cream to the affected area or where you feel pain. Some muscle creams can be applied up to four times per day. Be sure to follow the directions and do not use more than recommended.

Wash your hands after application, and store the cream in a safe and cool place.

Possible Side Effects

The effects of muscle creams vary depending on the ingredients, but generally, there are some particular side effects to keep in mind:

• Redness, warmth, stinging, or burning
• Rare but serious side effects such as blistering, swelling, severe redness, increased or unusual pain, nausea, vomiting, ringing in the ears
• A serious allergic reaction, which is rare but may happen with symptoms like a rash, itching, swelling, dizziness, and trouble breathing

If you have any of the above symptoms, call your healthcare provider right away.