How Menthol Eases Arthritis Pain

Menthol creams and lotions can provide temporary relief from minor arthritis pain and pain from strains, bruises, and sprains. Generally considered safe, these pain-relieving products still need to be applied according to the packaging instructions or the advice of your healthcare provider.

a man rubbing cream on his elbow

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How Menthol Works

Menthol comes from peppermint oil extracted from plants. It can be both naturally extracted from plants and produced from chemicals. Menthol creates a pleasant diversion with its cooling sensation from pain and other irritations. It can therefore only provide relief for minor pain, and is not really a treatment for pain or inflammation.

One small study compared the ability to complete functional tasks and knee pain while completing functional tasks among patients with knee osteoarthritis (OA) after topical application of either 3.5% menthol gel or an inert placebo gel. Participants who used the menthol gel had significantly reduced pain during exercises and while climbing stairs compared with those who used the placebo gel. However, there were no differences detected in functional tasks or pain following the placebo and menthol conditions.

What Is a Counterirritant?

Counterirritants are used to produce surface irritation of the skin to counteract underlying pain or discomfort. Examples of counterirritants include menthol, camphor, capsaicin, and methyl salicylate.

Topical Menthol Treatments

Topical menthol treatments contain menthol and sometimes other active ingredients as well:

  • Absorbine Jr. contains menthol.
  • Activene Arnica Gel Cream contains menthol and other ingredients.
  • Bengay sometimes contains menthol as an active ingredient, but also contains camphor and methyl salicylate in other types.
  • BioFreeze contains menthol.
  • Dr. Bronner’s Arnica-Menthol Organic Magic Balm contains a blend of arnica, camphor, menthol, and peppermint oils.
  • Flexall contains menthol, camphor, and methyl salicylate.
  • Icy Hot contains menthol and sometimes methyl salicylate, depending on the strength of the product.
  • Mentholatum contains menthol and camphor.
  • Mineral Ice Menthol Pain Relieving Gel contains menthol.
  • Sombra Warm Therapy Natural Pain Relieving Gel contains menthol and camphor.
  • Stopain topical pain reliever contains menthol.
  • Tiger Balm contains a combination of menthol and camphor.
  • Vicks VapoRub contains menthol, camphor, and eucalyptus oil.

Before Using

Menthol can cause eye and skin irritation. A high-percentage menthol product can cause irritation and even chemical burns. A few reports exist of people having severe skin reactions to even small amounts of menthol.

It is possible for menthol products to cause organ failure if swallowed or inhaled in concentrated amounts. Serious effects include seizures, coma, and death. Also, menthol pain relievers should be kept out of reach of children and not applied to a child under 12 years old.

Here are some important rules to follow when using menthol lotions:

  • Don’t apply menthol products to damaged or irritated skin.
  • Don’t put bandages on the area where you’ve applied the lotion.
  • Don’t apply heat to the area using heating pads, hot water bottles, or lamps. Doing so increases the risk of serious burns.
  • Don’t allow these products to come in contact with eyes and mucous membranes (such as the skin inside your nose, mouth, or genitals).

It is normal for these products to produce a warming or cooling sensation where you’ve applied them, but if you feel actual pain after applying them, look for signs of blistering or a burn. Most topical pain relievers should not be used for more than seven days because it could result in a rash or chemical burn on your skin. If you see any of these signs, stop using the product and seek medical attention.

If you experience pain, swelling, or blistering of the skin where an over-the-counter (OTC) menthol lotion was applied, stop using the product and seek medical attention immediately. These products should produce a warm or cool sensation, not pain or skin damage. 

How to Use Topical Menthol Treatments

When using any menthol lotion, apply it to a small area of skin first to see how your skin reacts. If you experience a burning sensation, wash the skin with soap and water, and call your healthcare provider.

A menthol patch typically works well on an area where it can be applied to a flat surface, so it might be best to get a menthol patch if you have back or neck pain. If you have pain in an area that moves a lot or is in a joint that bends, a cream or gel may be best so that you can still move that joint.

For menthol creams or gels:

  • Wash your hands with soap and water.
  • Clean the skin of all other lotions, creams, or ointments.
  • Dry your hands.
  • Apply a thin layer to the affected area.
  • Rub the cream or gel gently into the painful area until it is thoroughly absorbed into the skin.
  • Do not reapply more than three or four times per day, allowing a minimum of two to three hours between applications.
  • After applying, wash your hands with soap and water again.

For a menthol roll-on:

  • Rub a thin film over the affected areas, not more than four times daily.
  • Do not massage the liquid into your skin.

For menthol patches:

  • Peel off the protective backing and apply the sticky side to the affected area.
  • Carefully remove the backing from the patch.
  • Use for up to eight hours.
  • Use no more than three times a day.
  • Consult your healthcare provider if you want to use them on children under 12 years old.

Possible Side Effects

Side effects that can occur with menthol product use include:

  • Skin redness
  • Skin irritation
  • Eye irritation
  • Chemical burns (with higher-percentage menthol products)

In severe cases, side effects may include:

  • Rapid breathing
  • Shallow breathing
  • Eye irritation
  • Vision loss
  • Ringing in the ears
  • Thirst
  • Throat swelling
  • Agitation
  • Dizziness
  • Drowsiness
  • Fever
  • Hallucinations
  • Loss of appetite
  • Nausea and vomiting

Products that contain menthol are flammable. In 2000, the Food and Drug Administration (FDA) added a warning against putting products with menthol near flame, in hot water, or in a microwave.

A Word From Verywell

While it is convenient and generally safe to use OTC topical pain relievers, it is possible to have a severe reaction or apply too much of these products.

If your pain lasts more than seven days, treating the area with a pain-relieving topical product may be masking a more serious problem. See your healthcare provider if your pain keeps coming back, or if the topical cream, gel, lotion, or patch is causing skin irritations, burns, or making you feel sick.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Capital Poison Control Center. Can menthol have harmful effects?

  2. Harvard Health Publishing. Rubbing it in.

  3. Topp R, Brosky JA Jr, Pieschel D. The effect of either topical menthol or a placebo on functioning and knee pain among patients with knee OA. J Geriatr Phys Ther. 2013;36(2):92-99. doi:10.1519/JPT.0b013e318268dde1

  4. Cleveland Clinic. Topical pain relief: what is it + how does it work?

  5. U.S. Food and Drug Administration. FDA drug safety communication: rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.

  6. Anicare Pharmaceuticals Pvt. Ltd. Pain Relieving Analgesic—menthol gel.

  7. U.S. National Library of Medicine. Biofreeze Roll-On—menthol gel.

  8. Zhejiang Dingtai Pharmaceutical Co., Ltd. Cold and Hot Medicated Patch—menthol patch.

  9. Mount Sinai. Sports cream overdose

By Mali Schantz-Feld
Mali Schantz-Feld is a medical journalist with over 25 years of experience covering a wide range of health, medicine, and dental topics.