Topical Pain Relievers: How Do They Work?

Topical pain relievers have been around for quite a long time, providing much-needed relief for nearly everything from bug bites to arthritis. They also make for a nice alternative for individuals and pets who struggle with taking oral medications.

Arguably, it’s the convenience that makes topical pain relievers such a consistent household item, as they work much quicker than over-the-counter NSAIDS like Advil and Motrin. Directly applying them to the area that’s experiencing pain makes them even more efficient.

But how exactly do they work to provide that relief, and how do you know which type is most suitable for your aches and pains?

Read on to learn more.

Topical Vs. Transdermal

When we talk about products that can be applied topically for pain relief, we’re talking about lotions, oils, balms, salves, and so on. In the health and wellness world, a topical application can be either transdermal or non-transdermal. Although, medically speaking, when something is not designed to be transdermal, it’s simply referred to as topical, which can create a bit of confusion.

Transdermal products deliver a certain type of medicine through the skin. In other words, when the medicated product is placed on top of the skin, whether it be a cream, gel, or a patch, it penetrates through the skin barrier and gets absorbed into the bloodstream to do its work from the inside out.

Transdermal products serve many purposes besides pain relief. They’re used for many medical applications, from nicotine patches to birth control, and they often require a prescription. However, certain topical pain relief products work transdermally for the sole purpose of extending pain relief and relieving inflammation internally.

It’s also important to note that transdermal pain relief products are specifically labeled as such, so you won’t have to waste any time guessing.

Different Types of Topical Pain Relievers and How They Work

Unlike most transdermal pain relievers, topical products provide localized relief when applied directly to the area experiencing aches and pains. They work quickly and effectively, although, for more chronic pain, they need to be applied frequently throughout the day.

Topical pain relievers are broken down into several categories. Each type works better for different types of aches and pains, and they typically have different mechanisms for delivering relief.

Here are some categories and relief providing mechanisms:


Counter-irritants offer either a warming or cooling sensation designed to soothe the area and distract you from the pain. Some of the most commonly known counter-irritants include Icy Hot, Tiger Balm, and Bio Freeze.

The active ingredients you’ll find in counter-irritants are referred to as topical analgesics, which essentially means that they’re pain relieving. Those active ingredients typically include one or more of the following:

  • Menthol
  • Eucalyptus oil
  • Oil of evergreen
  • Camphor
  • Methyl salicylate

The unique thing about these analgesics is that their mechanism for delivering pain relief revolves around the Gate Control Theory, which has to do with how we experience pain via the signals that pass through our “nerve gates” as they make their way up through our nervous system to our brain and back again. These nerve gates decide which signals get to pass through and how.

Menthol, for example, causes a cooling sensation that works by tricking the mind into believing that the body’s temperature is dropping. In turn, this slightly decreases arterial blood flow, which desensitizes the nerve endings—much like how an ice pack works on an injury. Essentially, this analgesic tricks the nerve gates to cut off the pain signals.

The effects of counter-irritants usually come on pretty strong and fast. They best suit achy and sore muscles and joints, especially after strenuous exercise or from arthritis. They also work wonders for mosquito bites. However, the short-lived effects mean they’ll need to be reapplied frequently.


Capsaicin, found in chili peppers, gives them their hot and spicy effect to varying degrees. However, the compound also works in topical pain relievers similar to how menthol and other analgesics work. Essentially, capsaicin products reduce the body’s perception of pain by creating a warm, tingling sensation that stimulates and then decreases the intensity of transmitting pain signals.

Capsaicins work well for joint pain and diabetic nerve pain, but they tend to require multiple applications before providing relief. Expect slower relief for your aches and pains when using only capsaicins.


Cannabidiol (CBD) has taken the health and wellness market by storm—and for good reason. CBD is especially popular for chronic pain and inflammation, among a laundry list of other ailments.

CBD is a naturally occurring phytocannabinoid that comes from the hemp variety of the cannabis plant. CBD works directly with our body’s endocannabinoid system (ECS). The ECS forms a biochemical communication system that regulates our bodies to maintain important balance. The ECS sends out our natural endogenous cannabinoids (endocannabinoids). When CBD is thrown into the mix, the ECS synthesizes it, allowing it to bind with and activate certain cell receptors throughout our bodies. This mitigates any systems that are thrown out of whack by a deficiency of naturally occurring endocannabinoids in our body—which is precisely how it provides pain relief.

You’ll find a variety of topical CBD products on the market, including creams, balms, salves, patches, and more. These products usually have additional analgesic ingredients to aid in pain relief, but these products do not interact with the ECS. There are, however, plenty of transdermal CBD products on the market if you’re looking for something with a bit more oomph.

Homeopathic and Herbal Creams

Most topical homeopathic and herbal pain relievers contain a diluted substance from nature believed to be medicinally effective. They have certain active compounds similar to analgesics. The most popular homeopathic topicals you’ll find contain Arnica Montana—arnica for short—which is a flowering perennial from the sunflower family.

Traditionally used for aches, pains, and bruising, arnica has several anti-inflammatory properties. Topically, it works by stimulating circulation in the area it’s applied to. This allows the body’s healing system to react and encourage relief by reducing inflammation and pain.

Will Topical Pain Relievers Work For Me?

Topical pain relievers work for most people experiencing aches, pains, soreness, and joint stiffness to some extent. The type that works best for you depends entirely on the level of pain you’re experiencing as well as your preferences. Of course, if you’re dealing with serious chronic pain and inflammation, you’ll want to consult with your doctor to figure out an appropriate pain management regimen.

I use REAL TIME Pain Relief products in my massage practice. RTPR products combine counter-irritant ingredients, capsaicins, and other herbal ingredients. Their topical pain relief products work amazingly well, and smell great, too.

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