Answer:
Menthol, a compound in peppermint that gives peppermint its distinct flavor and cooling sensation, is commonly used in topical creams and gels for pain relief from muscle tenderness and soreness, osteoarthritis, carpal tunnel syndrome, and painful diabetic neuropathy. When applied to the skin as a cream or gel, such as Biofreeze, Dermacool, Tiger Balm, or Vicks VapoRub, menthol creates a cooling effect by activating and then desensitizing receptors in the skin that sense cold, which is believed to temporarily distract a person from underlying pain (Pergolizzi Jr., J Clin Pharm Ther 2018). However, most placebo-controlled studies have cast doubt on benefits found in smaller studies.
Sign in as a member for details about the effectiveness and possible side effects of topical menthol products, as well as those that include capsaicin.
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The following sources are referenced in this article:
- Anand, Br J Anaesth 2011
- Antonelli, J Pharm Pharmacognosy Res 2020
- Bishop, TRAC 2009
- Brid, J Pain Symptom Manage 2015
- ClinicalTrials.gov, NCT02728687
- Derry, Cochrane Database Syst Rev 2012
- Ellis, J Orthop Sports Phys Ther 2005
- FDA Drug Safety Communication, 9-13-2012
- Fallon, Support Care Cancer 2015
- Johar, Int J Sports Phys Ther 2012
- Kotaka, Biol Pharm Bull 2014
- Paolo, Acta Biomed 2019
- Peel, Eur J Sport Sci 2023
- Pergolizzi Jr., J Clin Pharm Ther 2018
- Price, Neurology 2022
- Qutenza Prescribing Information
- Schattner, Aust Fam Physician 1996
- Sundstrup, Rehabil Res Pract 2014
- Topp, J Geriatr Phys Ther 2013
- Vicks VapoRub Drug Facts
- Yaman, Eur Oral Res 2021
Gene20208
July 26, 2024Back in 1960 I was diagnosed with spondylolisthesis, later verified by army docs. In college, I played basketball and to counter a bit of lower back pain in that spot I used a smelly product called Mentholatum Deep Heat rub everyday before practice and games. It worked for me. The same lower back pain does reoccur very occasionally, with the modern version of the product still working. OTOH, I find Biofreeze ineffective and Icy/Hot hit and miss, depending on the ailment.
Capsaicin: I developed chronic ITB pain around my left knee during hiking in 1994. In addition to eventually finding a stretch, different than the standard ones, that at least delayed pain on hikes, I started using capsaicin cream, now the rub-on .015 liquid, and rarely have had even a minor problem since. In the latter cases, it’s been on the downhills coming back during long mountain hikes, where I needed a reapplication and forgot to do so at lunch. I keep a canister in my pack and even a bit beyond its use-by date, it works.
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Jeffsan
June 21, 2023I have used numerous menthol products like BioFreeze, Tiger Balm, Australian Dream and others. None have worked well and most only temporarily disguise the pain until the wear off.
marianne20214
July 26, 2024i have used point relief and it almost instantly mitigates my lower back pain ... it does not, of course, last forever but it does last for hours for me. we have a medical supply company and i have tried most menthol products.
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Winifred18170
June 20, 2023I have found Topricin to be very effective for both muscle pain and leg cramps at night (I also take magnesium every day to prevent leg cramps as well as 3 to 6 mile hikes most days and stretching). Have you covered Topricin? I have no financial interest in Topricin. I discovered it through my physical therapist when I had a knee problem many years ago.
We have not reviewed Topricin products, specifically. However, Topricin creams contain homeopathic amounts of arnica and other ingredients. You can find information about topical arnica for pain in the following section of our article about arnica: https://www.consumerlab.com/answers/arnica-gel-cream-for-bruises-pain-swelling/arnica-gel/#topical-arnica
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Wendi18168
June 14, 2023I'm curious to know more about capsaicin salves and/or capsules. I'm a massage therapist who works with severe pain (have even been involved in a study for pain reduction using alternative treatments {chiropractic, yoga, acupuncture, Feldenkrais, and massage} to reduce opioid doses in long-term pain management), for almost 20 years. I began using a salve of wintergreen oil, cayenne pepper, and menthol crystals mixed in olive oil and beeswax. The Cayenne pepper rub had very positive results - close to 7 out of 10 clients would say it was helpful for their discomfort. I often applied it after massage - vs the others who wanted Biofreeze. Many even began purchasing it on their own for home treatments (not by me. I am not a seller of the product.) For my personal pain, however - especially arthritis in my neck/thoracic spine, I also find capsaicin to be more effective than Biofreeze.
We've added some information about topical capsaicin to the following section of our article: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#capsaicin
Linda20221
July 27, 2024I am using a mixture of arnica and capsaicin from iHerb. It helps my neuropathy/arthritis pain in my toes more than anything else I have tried. I always apply it with a disposable glove on so I won’t get it in places where I don’t want it.
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Mary18166
June 13, 2023I didn't see the warning about menthol use. I recently had used some menthol containing gel for knee pain, as well as 2-4 cough drops to treat aa cough caused by a blood pressure medicine. Within @ 3 weeks, I began to shake, difficulty walking, nausea, extreme fatigue. I had developed Menthol poisoning. I may be extra sensitive, but it took @ 5 days of lots of water, and loss of activity to get back to normal. Check out Menthol poisoning on Medlineplus.gov.
Menthol toxicity seems to be most commonly caused by excessive consumption of menthol. We are not aware of reports of menthol toxicity due to topical use.
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Daniel18163
June 09, 2023Any thoughts about the benefits of products such as Tiger Balm for musculoskeletal aches and pains?
We are not aware of published clinical studies evaluating Tiger Balm for musculoskeletal pain, but we've added information about Tiger Balm for tension headaches to the following section of our article: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#headache
Be aware that Tiger Balm can cause allergic reactions in some people: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#tiger-balm-side-effect
We are not aware of published clinical studies evaluating Tiger Balm for musculoskeletal pain, but we've added information about Tiger Balm for tension headaches to the following section of our article: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#headache
Be aware that Tiger Balm can cause allergic reactions in some people: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#tiger-balm-side-effect
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TXBirdy
May 28, 2023Voltaren gel has provided excellent results for me when Biofeeeze did nothing.I have no financial interest in any products.
Kenneth18162
June 20, 2023The active ingredient in Voltaren is diclofenac, a strong non steroidal anti inflammatory (NSAID). The gel can cause allergic reactions just like oral diclofenac (to people like me).
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Kim18158
May 21, 2023I love Biofreeze. I have used it for about 15 yrs. I have found it very effective for knee pain prior to my knee replacements, back pain and tension headaches. I have recommended to others, some like me get great relief from it and others say it didn’t help. Menthol products that “heat up” like icy hot, have no effect on me.
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steve18155
May 17, 2023One usage not mentioned here is for diabetic peripheral neuropathy. The gel when used on the feet at night (covered with appropriate socks) will increase the blood flow to the feet and thus relieve some of the numbness and pain. It also alleviates athletes foot fungus at the same time. Everyone I have mentioned this to has offered me a wealth of gratitude because it is so easy and improved their quality of life. Increasing the blood flow to the effected area is the key.
Please see the following section of our article for information about the use of menthol products for painful diabetic neuropathy: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#painful-diabetic-neuropathy
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Richard18153
May 17, 2023For shoulder pain (rotator cuff tendinitis?) I found that what worked for me was simple Vicks (or generic versions) massaged into the shoulder. All the stronger rubs...shoulder "pads"...etc...didn't.
Thanks for sharing your experience. Interestingly, although Vicks VapoRub is considered a topical pain reliever, there do not appear to be any studies supporting its use for muscle and joint pain, as we note in the following section of our article above: https://www.consumerlab.com/answers/topical-menthol-for-pain-relief/menthol-for-pain/#vicks
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Gretchen18152
May 16, 2023I find Biofreeze very helpful for pain from scar tissue adhesions that sometimes wakes me up at night. After a few minutes I can get back to sleep.
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Robert18149
May 16, 2023As a practicing Chiropractor. I agree there is likely little actual pain modification with these menthol creams. I carry a few and one with CBD. I do get comments that they work quite well for most. However, I do think there is a placebo effect with most of these gels/creams as it is something they can do for themselves which gives the illusion of benefit at times. Also, the "tingling" sensation of menthol can distract from the pain intensity.
Trebor18150
August 08, 2023Pain for the purposes of one suffering from it is entirely subjective. Biofreeze has modest but real benefits for me.
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TexasGal
May 16, 2023I get bouts of restless legs when trying to sleep. My knees develop an odd sensation that wakes me up with the urge to move my legs trying to stop the feeling. Applying Biofreeze over the areas is the only thing that can get me back to sleep. The cooling sensation replaces the other feeling. And yes, I also take magnesium at bedtime and have researched this condition. I also have to avoid bananas. They seem to be a trigger. The Biofreeze is a lifesaver when I get flares.
You may be interested to know other members have also noted this, in the comments on our article about supplements for muscle pain and cramps -- see https://www.consumerlab.com/answers/do-magnesium-creams-sprays-and-oils-really-work/magnesium-oil/#comment-25082
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Pratibha18144
May 16, 2023Could you compare Arnica to some of the cooling agents for pain relief.
also which are the best Omega 3 products
Thanks you
Information about arnica's use for pain relief can be found in our article about arnica pills and gels: https://www.consumerlab.com/answers/arnica-gel-cream-for-bruises-pain-swelling/arnica-gel/
Also, our Top Picks for fish oil and other omega-3 products can be found in our Fish oil Supplements Review: https://www.consumerlab.com/reviews/fish-oil-supplements-review/omega3/#toppicks
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