At WisdomAndHealth, we carry a wide assortment of topical analgesics for the treatment of pain. But buying a product to treat pain can be confusing. Which is the best product for your particular pain type and location? Which ingredient should be used?
This short article attempts to address some of these questions, with a focus on pain relievers that are applied to the skin. We will not discuss products taken orally, such as aspirin, acetaminophen, or ibuprofen. Please seek guidance from a pharmacist or other medical professional if you are considering taking these oral medicines. And, as always, if the pain persists and does not respond to these products, please consult with a doctor or other medical professional for advice.
What is pain?
According to the International Association for the Study of Pain (IASP), pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Basically, it is the unpleasant sensation associated with an injury, such as a bruise, sprain, muscle spasm, and so forth. In its simplest sense, pain is our body’s way of telling us that something is quite wrong, and that action is needed.
The IASP has an extensive system for classifying pain based on the area on the body that is affected, the duration of the pain, pain intensity, and so forth. For more detail, please visit the Association’s page on Wikipedia .
For our purposes, there are a few types of pain worth noting:
First, nociceptive pain is caused by extreme temperature (heat or cold), mechanical causes (such as bruising), or chemical causes, such as chili powder in the eyes. This type of pain can be mild, and can resolve itself quickly. However, nociceptive pain caused by sprains, ligament damage, or other exercise-related causes can persist. Fortunately, nociceptive pain can be treated effectively with topical (on skin) pain relievers.
Incident pain is caused when a body part is moved. For example, the pain associated with the movement of an arthritic joint would be classified as incident pain. A chronic condition such as arthritis is typically treated with oral medications. However, topical pain relievers can supplement other medications, especially when used in between doses of oral medications. When applied to the skin, these products may provide extra pain relief when needed.
Lastly, psychogenic pain is pain caused by mental, emotional, or behavioral factors. Back pain is sometimes diagnosed as being psychogenic. While the name psychogenic may suggest that it’s all “in the mind,” it nevertheless a very real type of pain that can respond to topical treatments.
Next, we look at the various types of ingredients applied to the skin to treat pain, especially nociceptive pain, incident pain, and psychogenic pain.
Menthol is currently made synthetically, but was originally derived from peppermint and related plants. It is widely used to treat minor pain, such as throat pain. The mechanism by which menthol works is well understood. Menthol is widely available in topical creams, lotions, and sprays. However, the challenge with menthol is that the product should have other ingredients to help drive the menthol deep into the skin for best pain relief.
Camphor is another substance originally derived from plants, such as certain evergreens, rosemary, and other plants. Camphor, like menthol, has a cooling effect on the skin. But again, products which can drive camphor deeper into the skin can be more effective than simpler products. Camphor and menthol are sometimes combined in a single product, but some folks find the odor objectionable.
Methyl salicylate, or oil of wintergreen, is chemically related to acetylsalicylic acid, the active ingredient in aspirin. As such, it is an excellent pain reliever. However, folks who are sensitive to aspirin should not use products containing methyl salicylate without consulting a healthcare professional.
Capsaicin is the active component in chili peppers (also known as capsicum), and can be quite irritating. However, when used as a cream or patch, capsaicin may provide deep, warm pain relief. Capsaicin patches are an excellent way to treat lower back pain, since they can remain in place for many hours. In creams, capsaicin can be combined with menthol to provide both warm and cool pain relief. Just don’t get capsaicin into your eyes!
What to use when
For noceptive pain caused by exercise or injuries, or even pain associated with carpal tunnel syndrome, menthol-containing products such as BioFreeze are a good option. BioFreeze also contains an herbal extract, called Ilex, which helps drive menthol deeper into the skin for better efficacy. One nice option with BioFreeze is that it comes in a roll on form. The roll on allows you to apply directly to the affected area, with minimal waste. For those of you with arthritis in the hands, or with carpal tunnel syndrome, both the roll on or the hands-free applicator are good options.
If a menthol-only product like BioFreeze is ineffective, combination products such as Sombra are a good alternative. Sombra contains menthol and camphor. In addition, Sombra has a small amount of capsaicin for additional relief. The Sombra roll on is a good product to self-apply directly to the lower back.
Another alternative is Salonpas Gel . This product contains methyl salicylate and menthol. The combination is quite strong. However, people with known allergies to aspirin should not use Salonpas gel without checking with their medial professional.
Lower back pain is a bit more complicated, as there can be many causes. In fact, back pain can have elements of nociceptive pain, incident pain, and psychogenic pain. For this type of pain, Salonpas patches were developed. Please note that Salonpas patches contain blends of camphor, menthol, and/or methyl salicylate, or capsaicin (known as Salonpas Hot ). The Salonpas Hot patches are perfect for the lower back due to their size and their ability to stretch as you move.
Today’s topical analgesics are much more powerful and sophisticated than those sold previously. While some of the ingredients have not changed, the delivery systems have, making these ingredients more effective, with less odor than some of the older products sold in supermarkets. Devices such as the roll on and patches may result in lower product use, thus saving you money in the long run.