People from all walks of life and all age groups use over-the-counter (OTC) topical medications to treat and alleviate muscle pains and aches. Although a lot of these pain relievers provide temporary relief, it is important to understand not only the different types of topical pain relievers that are available but also cautions and warnings that are associated with these medications.

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A topical medication is simply a medication that is applied directly to the epidermis (skin). Topical medications are available in several forms including:






So, how do you choose the best one for your specific pain? How are they similar and how do they differ? The following guide will provide you with all of the information you need to know about these medications so you will be able to make an informed decision when choosing a topical pain relieving medication.


Also known by their brand names, Zostrix and Capzasin, this is a topical agent that is derived from chili peppers. Capsaicin not only produces a burning sensation once it comes into contact with the skin, but it also reduces ‘substance P’ levels in the nervous system. This level reduction is thought by medical experts to create an interruption in pain signals.

As with any type of medication, whether it is applied topically, taken orally, or injected, there are pros and cons to using this topical agent. The pros are that capsaicin is able to penetrate the deeper layers of the skin and provide relief to joints in the back, shoulders, and hips. There are also very low side effects associated with this medication.

Unfortunately, there are also cons to using capsaicin for pain relief. The burning sensation on the skin may be too intense for a lot of people to handle, and this is one reason why it is advised to always wear gloves when applying it to the skin. Capsaicin should never be applied to skin that is broken or irritated.

It can also irritate the eyes, so you may want to consider wearing protective eyewear as well. Always wash your hands after applying capsaicin.

Another important factor is that the medication can become less effective over time because damage can occur to the nerves in the affected area.


Known also as Methyl Salicylates, Salicylates are topical analgesics that are commonly found in aspirin. This type of topical agent not only helps to relieve pain, but it also helps to decrease inflammation. However, medical experts and researchers have discovered that this medication does not help reduce muscle pain when it is applied as a cream to the skin. Athletes are one group of people that disagree with these findings.

While Aspercreme, Myoflex, and Sportscreme contain a large percentage of salicylates, other brands such as Bengay and Thera-gesic contain a mixture of salicylates and counterirritants.

There are also several advantages and disadvantages to using this type of topical medication. The advantages include the quick temporary relief of acute pain and its odor free properties.

On the other hand, extreme caution should be taken if the user is taking blood thinners. Salicylates can cause an adverse reaction when it interacts with certain medications, and this is due to the aspirin. It is important to speak with your primary care provider before taking any over-the-counter medications that contain salicylates.

Counterirritants –Some of the medications in this group include:

Gold Bond

Icy Hot

Tiger Balm

Flexall 454

Counterirritants are topical medications that create hot or cold sensations. These sensations are temporary, and they disrupt the pain signals in the brain. This disruption helps to keep the brain from focusing on the pain. The most common active ingredient in this medication is wintergreen, menthol, camphor, and eucalyptus.

There are not many cons to using this type of medication for pain relief. In fact, the most common complaint is that these types of medicines have strong odors. They do offer some benefits as well. These are considered the safest topical medications for pain, but some can cause minor skin irritation.


If you have ever used Xylocaine, Lidoderm or Lidocaine Viscous, you were using the brand name for a generic medication known as Lidocaine. Lidocaine works by ‘numbing’ and desensitizing the painful area. This works to ‘mute’ the pain signals.

Out of all the pain relievers available over-the-counter, this one is the most effective for musculoskeletal pain and arthritis. This pain reliever is also available in prescription strength.

It is also important to be aware that this medication can cause an irregular heartbeat if it is overused. Always follow the manufacturer’s warnings, and consult your physician if the condition worsens.

Keep in mind that lidocaine should never be used in conjunction with cold compresses or hot compresses. As previously stated, this medicine causes a numbing sensation when applied. This can cause a user to have a diminished sense of feeling cold and hot, and this can result in frostbite, burns and other damage to the skin and nerves.

So, are over-the-counter topical medications safe? When they are used in moderation, and in compliance with the manufacturer’s instructions, these types of medications are considered very safe. However, they should never be included in a long-term pain relief treatment plan. They should also not be used in excessive quantities.

Users should also understand that the main job of these medications is to mask the pain, not remove it. This means that by ignoring the pain, or the sensation, you may inadvertently cause further damage to the area causing injury to the joints or muscles. For those who use topical medications for temporary relief from pain with patches, it is important to also rest the muscles and avoid strenuous exercise until the area heals.

Topical medication overdoses are rare, but they do occur. These overdoses are serious, and in some cases, they can also be fatal. Excessive amounts of these medications absorbed into the bloodstream can cause toxic levels in the blood and can cause symptoms like nausea, vomiting and rapid breathing. However, by referring to this guide, you will be able to make the best decision when choosing a topical agent for pain relief.