Topical agents can safely relieve muscle aches, pains


Like oral medications, topical analgesics can offer patients well-controlled pain relief, but they do so without adverse systemic effects.

Although oral medications such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are appropriate for the treatment of acute and chronic pain, these medications can produce adverse systemic effects. Oral opioids have been associated with adverse events, including fatal respiratory depression, addiction, itching, nausea, and constipation. Patients who have taken oral NSAIDs may also be at risk of adverse effects, such as gastrointestinal bleeding, hypertension, increased risk of myocardial infarction, and renal dysfunction, according to a 2013 report on topical analgesics for the treatment of acute and chronic pain, published by Mayo Clinic Proceedings.

Like oral medications, topical analgesics can offer patients well-controlled pain relief, but they do so without the accompanying adverse systemic effects. Individuals who want proven topical agents for alleviation of muscle aches and pains can consider drugstore products that contain capscaicin, menthol, and/or methyl salicylate.


Mild-to-moderate aches, pains

Salonpas Gel Patch Hot (Hisamitsu America Inc.) provides temporary relief for mild to moderate aches and pains of muscles with two powerful pain-fighting ingredients. Menthol 1.25% provides a cooling and soothing sensation, and capscaicin 0.25% offers long-lasting heat; the combination supplies pain relief lasting up to eight hours. Adults 18 years of age and older can apply the patch to a clean and dry affected area. The patch can be left in place for eight to 12 hours. The manufacturer noted that a second pain patch can be applied to the same area if the pain continues for longer than 12 hours. However, only two patches can be used daily for three consecutive days. 

The product should not be used on the face or broken skin, with a heating pad, when sweating during exercise, or before or following heart surgery, and it should be avoided by individuals allergic to aspirin or other NSAIDs. The gel patch may cause gastrointestinal bleeding, although the risk is small. The risk of stomach bleeding problems is higher for individuals who are 60 or older, have stomach ulcers, take a steroid or anticoagulant, or take NSAIDs. 


For individuals who need pain relief for sore muscles, backache, muscle strains, sprains, stiff neck, or joint discomfort, Salonpas Deep Relieving Gel offers effective relief for up to eight hours. This 2.75-oz tube has three pain-relieving ingredients: camphor (3.1%), menthol (10%), and methyl salicylate (15%) that offer immediate pain relief for adults and children ages 12 and older. It can be used three to four times daily. Upon application, the gel melts quickly and penetrates deeply into muscles and joints. The product should not be used on wounds or damaged skin, with a heating pad, or by patients who are allergic to any of its ingredients. ( (Photo courtesy of Hisamitsu America, Inc.)





Bengay Cold Therapy from Johnson & Johnson is a menthol 5% topical analgesic that can be used by adults and children 12 years of age and older. For fast-acting pain relief, this gel provides a blast of cold to numb the strains and sprains of muscles and joints, and to help with simple backache, arthritis, and bruises. It is available in a 4-oz tube and can be applied to the affected area three to four times daily. Bengay Cold Therapy should not be used on broken skin or wounds, with a heating pad, or by children younger than 12 with arthritis-like conditions. Patients should consult a physician if the pain persists or gets worse after a week of use, if the skin becomes irritated, or symptoms are alleviated but then return after a few days. ( (Image courtesy of Johnson & Johnson)



Doctor Hoy’s Natural Pain Relief Gel is indicated for the relief of muscle pain, arthritis pain, gout pain, bruising, and general pain. The gel can be used before and after physical activity to help with muscle relaxation.Doctor Hoy’s gel consists of Arnica Montana tincture (1%), a natural anti-inflammatory agent; menthol USP natural crystals (5%); and camphor USP natural crystals (5%). The menthol is encapsulated in a time-release formula to provide several hours of pain relief. With the Arnica Montana, Doctor Hoy’s gel is able to reduce swelling and can be used for localized swelling from insect bites. Doctor Hoy’s gel is registered with the FDA, according to the manufacturer. (


Homeopathic products

Leg cramps can happen anytime - during exercise or at rest. For quick relief with a homeopathic approach, Hyland’s Leg Cramps Ointment helps to soothe and warm the affected area in legs and calves. It contains Aconitum Napellus 3X Homeopathic Pharmacopoeia of the United States (HPUS) for shooting pain, Arnica Montana 3X HPUS for pain that moves up the leg, Ledum Palustre 3X HPUS for cramp-like tension in the leg and heels, Magnesia Phosphorica 10X HPUS for leg cramps, Rhus Toxicodendron 6X HPUS for leg pain, and Viscum Album 3X HPUS for shooting pain. This product has not been reviewed by the FDA.

Hyland’s Leg Cramps caplets are also available for the relief of stiffness and pains in legs, joints, and limbs, as well as cramps in calves, legs, and feet. The caplets contain Cinchona Officinalis 3X HPUS for pains in limbs and  joints
, Aconitum Napellus 6X HPUS for joint and leg pains, 
Gnaphalium Polycephalum 3X HPUS for cramps in calves and feet
, Ledum Palustre 6X HPUS for leg pain and leg cramps, 
Magnesia Phosphorica 6X HPUS for cramps in calves, 
Rhus Toxicodendron 6X HPUS for pain and stiffness, and 
Viscum Album 3X HPUS for joint pains. Hyland’s Leg Cramps caplets can be used by adults and children 12 and older every four hours or as needed. If pain symptoms last longer than a week or get worse, patients should consult their healthcare provider. The product has no known drug interactions and is not habit-forming, according to Hyland’s. (

Natural Care NerveFix (Nutraceutical Corp.), another homeopathic product, is formulated to relieve minor nerve-related symptoms such as tingling, burning, numbness, pins and needles, and peripheral neuropathy, according to the manufacturer. It is recommended for use with other non-drug therapies, such as exercise, massage therapy, physical therapy, relaxation training, and chiropractic care. Natural Care NerveFix contains the following active ingredients: Aconitum napellus 6X, 12X, 30X; Belladonna 3X, 6X, 12X, 30X; Cantharis vesicatoria 6X, 12X, 30X;  Cantharis vesicatoria 6X, 12 X, 30X; Ferrum Phosphoricum 6X, 12X; Hypericum perforatum 3X, 6X; Kali Phosphoricum 6X, 12X; Magnesium Phosphoricum 8X, 12X; Phosphorus 6X, 12X 30X; and Spigelia anthelmia 3X, 6X, 12X, 30X. Adults and children 12 and older can take two capsules twice daily until the symptoms are reduced and then one capsule twice daily. This product has not been evaluated by the FDA. (


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