My friend Steve plays acoustical guitar, both 6-string and 12-string. We met over 40 years ago at a church-sponsored retreat and we are still singing together, every Saturday night at our local church. However, now that we’re both in our 60s, our bodies are showing some wear and tear.
Steve’s hands are beginning to bother him, especially in the winter. Last week he asked me what he could do to relieve the stiffness. “Should I try the CBD oil that everyone’s talking about?”
“Well, CBD might help, but it’s pretty expensive compared to other options you could try first. Does a heating pad help?”
“Heat helps, but I need something I can rub on my hands.”
There are several non-prescription products Steve could try. Methyl salicylate, camphor, menthol, eucalyptus, and capsaicin are derived from natural sources and have been used for decades to treat aching muscles and stiff joints. Counterirritants and capsaicin work locally instead of affecting your entire system, making them useful to add to other pain medications like Tylenol®, ibuprofen or naproxen without risking toxicity or overdose.
Methyl salicylate, camphor, menthol, and eucalyptus work as counterirritants. Instead of calming or blocking nerves to relieve pain, counterirritants give you relief by triggering the sensory nerves located in your skin, giving you a sensation of intense warmth or soothing coolness while also keeping your nerves too busy to recognize any painful sensations.
Counterirritants also create redness and warmth from increased blood flow to the area caused by inflammation, similar to applying a heating pad. Mustard plasters of the past worked by doing this. Applying a mustard slurry to your chest for 15-20 minutes creates redness, warmth and increased blood flow for up to 48 hours after removal. You must remove a mustard plaster promptly, however, because it will cause blistering and serious burns if left on for more than 20 minutes.
Most non-prescription topical analgesic products contain one or more counterirritants which work in similar ways, including methyl salicylate, also called wintergreen oil, its odorless cousin, trolamine salicylate, menthol, which is extracted from peppermint oil, and camphor.
Popular topical pain relievers that contain counterirritants include Mineral Ice® with just menthol, Tiger Balm® Arthritis Rub with menthol and camphor, and Ben-Gay® Ultra Strength Pain Relieving Cream, containing methyl salicylate, menthol and camphor. If Steve wanted to avoid smelling like a breath mint he could try the odorless Aspercreme® formula instead, which contains trolamine salicylate.
Steve has other choices besides products containing one or more counterirritants. Capsaicin is derived from hot chili peppers and works by triggering the release of a nerve messenger called Substance P in the skin where you apply it. Substance P’s job is to transmit messages to your brain that there’s pain. Applying capsaicin to your knee flushes out all the Substance P in the tissue it touches, keeping your nerves from sending messages to your brain about your painful knee until your body can build it back up.
When applied for the first time, capsaicin causes a moderately intense burning and tingling sensation from the release of Substance P, followed by diminished pain sensation for several hours, giving you up to 8-10 hours of pain relief. As your body builds back its Substance P, you’ll eventually start feeling tingling and burning. If you reapply capsaicin at that point, you’ll enjoy another stretch of pain relief.
Capsaicin is extracted from pepper, so make sure to wash your hands after applying it. Believe me, if you rub your eye with capsaicin on, you’ll know it! I recommend using the roll-on applicator of capsaicin, so you can avoid touching it completely.
5 Tips for Using Topical Non-Prescription Pain Relievers:
- They are best suited for small areas that are easy to reach.
Small areas that you can reach easily are good choices to add a counterirritant for relief of occasional discomfort or breakthrough pain.
- Avoid broken skin and cover loosely, if at all.
Counterirritants work by causing irritation, and can burning or blisters to sensitive or broken skin.
- Camphor can create either a warming or cooling sensation.
Camphor causes both a cooling sensation when gently applied and warmth when rubbed into your skin.
- Apply capsaicin with a roll-on stick.
Applying capsaicin with a roll-on stick keeps the pepper-based extract from chili peppers from ending up on your fingers or inadvertently in your eyes. Ow!
- Reapply capsaicin when you first notice tingling or burning.
Reapplying capsaicin promptly keeps Substance P from building up, and you much more comfortable.
