Topical Analgesics for Pain

Topical analgesics can be a useful treatment addition for some people living with chronic pain. Here's what you should know about the various types of topical analgesics and their effectiveness at treating chronic pain.

Woman applying topical pain medications.
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Topical analgesics are pain medications that are applied directly to the skin instead of being swallowed or injected. They may come in creams, lotions, gel or patch form. Topical pain medications work in different ways for different conditions, though they are commonly used to treat musculoskeletal pain and some types of neuropathic pain. While some may require a healthcare provider’s prescription, many are available for over-the-counter purchase.


  • Counter-irritants: Topical pain medications that stimulate nerve endings when applied to the skin, and are used to treat musculoskeletal pain. Counter-irritants produce hot, cold or tingling sensations. These new sensations are thought to interfere with the sensation of pain. Capsaicin cream, for example is a topical counter-irritan,t
  • Topical NSAIDs: Topical NSAIDs include salicylates, which are chemically similar to aspirin, and medications like diclofenac. Topical NSAIDs penetrate the tissues beneath the skin with anti-inflammatory medication, reducing swelling at the pain site. They also inhibit pain transmission from sensory nerves. These topical pain medications are used to treat musculoskeletal pain.
  • Local anesthetics: Patch forms of local anesthetics can be applied to the skin, and may be worn for several hours for pain relief. These topical medications can relieve certain types of neuropathic pain.

Side Effects

Because they are designed to act locally where the medication is directly applied, the levels of medicines are very low in the body's circulation. Therefore, topical pain medications rarely produce the same degree of side effects as pill forms of medication. They do, however, carry a risk of skin irritation or swelling. Once they are removed or washed away, the irritation usually goes away within a few hours. Symptoms may be worse if topical pain medications are applied in excess of instructions, or are left on the skin for longer than advised.

Effectiveness for Chronic Pain

While chronic pain sufferers might find temporary relief with topical pain medications, many are not effective on their own for long-term pain management. So why use them? Well, for some people, topical pain medications offer tolerable pain relief with few side effects, something they may not get from other oral pain medications. They are also useful for people who do not tolerate typical painkillers well.

Topical creams like NSAIDs and counterirritants may also be used along with other medications to manage chronic musculoskeletal pain, such as arthritis. Local anesthetics may be used to manage breakthrough pain caused by nerve damage. Talk to your healthcare provider to find out if topical analgesics are right for you and your pain.

Frequently Asked Questions

  • What are different types of topical analgesics?

    Topical analgesics can be counter-irritants, topical NSAIDs, or local anesthetics. 

    Counter-irritants applied to skin produce hot, cold, or tingling sensations that interfere with pain sensations. Common counter-irritants include IcyHot, Biofreeze, and creams that contain capsaicin. 

    Topical NSAIDs are creams and gels that contain non-steroidal anti-inflammatory medications. Diclofenac, the active ingredient in Voltaren, is a topical NSAID. 

    Local anesthetics are used to numb the area. These can be applied as a spray, gel, cream, or patch. Bengay is a typical local anesthetic that contains lidocaine. 

  • Is CBD cream a topical analgesic?

    Yes, research shows topical cannabidiol (CBD) creams can relieve certain types of pain. For instance, a 2020 study found topical CBD effective in relieving neuropathy pain. Other studies show it may also ease arthritis pain.

  • What is analgesic cream used for?

    Topical analgesics are used to relieve pain and inflammation. They are commonly used to treat acute and chronic musculoskeletal pain and neuropathy.

2 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. Xu DH, Cullen BD, Tang M, Fang Y. The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities. Curr Pharm Biotechnol. 2020;21(5):390-402. doi:10.2174/1389201020666191202111534

  2. Hammell DC, Zhang LP, Ma F, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. Eur J Pain. 2016;20(6):936-48. doi:10.1002/ejp.818

Additional Reading
  • American Chronic Pain Association. APCA Medications and Chronic Pain: Supplement 2007.

  • Mason L, Moore RA, Derry S, Edwards JE, McQuay HJ. Systematic Review of Topical Capsaicin for the Treatment of Chronic Pain. British Medical Journal. 2004 Apr 24;328(7446):991.

  • Mason Lorna, Moore R Andrew, Edwards Jayne E, Derry Sheena and McQuay Henry J. Topical NSAIDs for Chronic Musculoskeletal Pain: Systematic Review and Meta-analysis. BMC Musculoskeletal Disorders. 2004; 5:28.

  • Mason Lorna, Moore R Andrew, Edwards Jayne E, McQuay Henry J, Derry Sheena and Wiffen Philip J. Systematic Review of Efficacy of Topical Rubefacients Containing Salicylates for the Treatment of Acute and Chronic Pain. British Medical Journal. 2004 April 24; 328(7446):995.

By Erica Jacques
Erica Jacques, OT, is a board-certified occupational therapist at a level one trauma center.