Topical Pain Relievers: Bengay and Beyond!

Back pain? Aching muscles? Joint pain?

Instead of reaching for acetaminophen or ibuprofen, have you ever tried a topical pain relieving ointment to treat your aches and pains? In this blog post, we’ll review common conventional topical treatments for pain, from Icy Hot to Bengay. The 2nd blog post in this series is about herbal topical pain relievers.

I’m sure you’d recognize the menthol-scent of someone who has slathered Icy Hot all over their shoulders after a long day of raking leaves.  Common over-the-counter topical pain relievers include Bengay, BioFreeze, Icy Hot, and Aspercreme. In my world, these topical pain-relievers composed the scent of the medicine cabinet from my childhood, as well as my great-grandmother’s apartment. The smell immediately opens my sinuses and drops my shoulders a bit (an attribute of the aromatic powers of menthol/camphor).

Topical pain relievers have been around, literally, forever. Let’s take a closer look at how they work.

Counterirritants

Many of the active ingredients in these over-the-counter pain relieving rubs are considered counterirritants, and include menthol, camphor, capsaicin (found in chili peppers), and methyl salicylate (oil of wintergreen).  These ingredients are considered counterirritants because they cause mild, local inflammation in the area of application, and this inflammation stimulates the nerves and creates a new, milder sensation. Essentially, they distract you from the more intense pain that you’re looking to lessen.

Interesting to note that many of the counterirritants are also powerful aromatic herbs – menthol, camphor, and wintergreen – which stimulate awareness and open the senses. When I smell any of the mints, I become more aware of my body and my surroundings, and can better tune into where I am holding tension in order to release it. Just the smell is medicinal!

Counterirritants tend to provide temporary relief, and must be reapplied when their pain-distracting properties begin to wear off.

NOTE OF CAUTION: Never combine these topicals with a heating pad, and understand that though it is very rare, there have been reports of serious skin injuries, ranging from first- to third-degree chemical burns where these products were applied.

Topical NSAIDS and Salicylates

Topical salicylates contain the pain-relieving substance found in aspirin. Examples include Aspercreme and Bengay – both of these are available over-the-counter.

Another common choice to relieve pain are prescription topical non-steroidal anti-inflammatory drugs (NSAIDS),  which typically have significantly less side effects than oral NSAIDS. Here’s a bit from a piece I found on the Harvard Health blog:

We know that oral NSAIDs can ease arthritis pain. A scientific review by the Cochrane Collaboration, an international body of health experts, found that some prescription topical NSAIDs can offer the same pain relief as oral medications with fewer gastrointestinal concerns. Common prescription topical NSAID pain relievers include diclofenac gel (Voltaren) and patches (Flector).

The advantage of using a topical analgesic is that the medication works locally. Targeting pain more precisely using a medication applied to the skin can help skirt the side effects of oral drugs. This can be a boon for people whose stomachs are sensitive to NSAIDs. (Keep in mind that a small amount of the medicine still enters the bloodstream and ends up in the stomach and elsewhere, so a topical analgesic isn’t a guarantee against NSAID-related stomach irritation.)

Other people seek topical NSAIDs because they want to avoid adding another pill to their daily regimen, or have trouble taking pills.

A key warning about using topical analgesics: don’t use them if you are also taking an oral NSAID—either prescription or over-the-counter—without telling your doctor. Taking too much of an NSAID can land you in the hospital with stomach bleeding or an ulcer flare-up. In fact, up to 100,000 Americans are hospitalized every year for NSAID-related gastrointestinal problems.

Quick Rules for Using Topicals Safely

• Do not apply to broken skin or rashes.

• Do not cover or bandage the skin after applying the pain reliever. Just rub it it until you can’t see it anymore.

• Do not apply heating pads to areas where you’ve recently used a topical rub.

• Remove the topical with warm soap and water if the skin becomes uncomfortable or painful.