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Topical Treatments To Relieve MS Pain: What Works?

Medically reviewed by Kelsey Stalvey, PharmD
Written by Emily Wagner, M.S.
Posted on June 5, 2023

Peppermint and chili peppers add flavor to your favorite foods, but did you know that they’re also used in popular topicals to treat aches and pains? These plants contain pain-relieving substances that may offer quick relief from multiple sclerosis (MS) symptoms when applied topically (to your skin).

MyMSTeam members often ask about what treatments others prefer. “I’m wondering what over-the-counter (OTC) products help you with pain/spasms/light tingling and burning sensations?” wrote one member.

Others have shared their favorite remedies for relieving their MS pain — including topicals containing plant-based substances and numbing agents like lidocaine.

In this article, we’ll break down the different types of topical analgesics (pain relievers) and how they can help treat your symptoms and improve your quality of life living with MS.

Types of MS Pain

MS is an autoimmune disease that causes your immune system to attack the fatty coating surrounding your nerve cells, known as myelin. When this coating becomes damaged, it can interfere with communication in your brain and spinal cord (central nervous system), causing symptoms including pain and muscle spasms.

According to the National Multiple Sclerosis Society, many people with MS experience:

  • Neuropathic (nerve) pain — Sharp burning or shooting pain in your nerves
  • Lhermitte’s sign — An electrical shock-like sensation that travels from your neck into your spine when you bend forward that may also be painful
  • Trigeminal neuralgia — Shooting or stabbing pain along your jaw or face
  • MS hug — Squeezing, tight pain around your chest or ribs
  • Pelvic or back pain — Aching pain that can extend into your legs or groin
  • Plantar fasciitis — Inflammation of the muscle along the bottoms of your feet, causing heel pain
  • Elbow pain — Aches or pains that can extend from your elbow into your hand or shoulder

Treatments for MS Pain

If you’re experiencing MS pain, your neurologist may prescribe you medication to help. Commonly used treatment options for nerve pain include antidepressants with analgesic properties like duloxetine (Cymbalta) and venlafaxine (Effexor). Anticonvulsants (antiseizure medications) like gabapentin (Neurontin), pregabalin (Lyrica), and carbamazepine (Tegretol) are also used to relieve nerve pain.

In addition, your neurologist may suggest taking over-the-counter pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) to treat achy muscles and joints.

Topical Treatments for MS Pain

If you’re looking for quick relief in a certain area of your body, a topical treatment might fit the bill. They’re also commonly used to help with arthritis-related musculoskeletal pain, sports injuries, and general muscle aches. You can find many different options in your grocery store or pharmacy, including creams, sprays, patches, and gels.

Topical treatments use different active ingredients to block pain signals in your nerves or create a warming or cooling sensation that helps with pain management. Below are some types of topicals that can help treat your MS pain and what MyMSTeam members have to say about them.

Lidocaine Topicals

Lidocaine is an anesthetic or a numbing agent that temporarily prevents your nerves from sending pain signals. According to the Multiple Sclerosis Association of America, lidocaine may also help treat nerve tingling and burning.

Several OTC topicals contain lidocaine, including brand names like Aspercreme Pain Relief Cream With Lidocaine and Blue-Emu Lidocaine Pain Relief. You can also buy patches with lidocaine to wear on your skin, such as those made by Salonpas Lidocaine Pain Relieving Gel-Patch or Icy Hot Max Lidocaine Patch.

Many MyMSTeam members recommend using lidocaine to help treat MS pain. They’ve shared the following:

  • “For my MS hug, I use Aspercreme with lidocaine.”
  • “Try any sunburn relief cooling gel with lidocaine to ease pains and aches of MS across your body.”
  • “I’ve found Aspercreme works to help with neck pain.”
  • “Leg pain kills me a lot of the time. I use Lidopro cream with lidocaine in it, which helps a lot.”

Side effects of lidocaine topicals can include allergic reactions that cause hives, skin rashes, headaches, an irregular heartbeat, and vision changes. Be sure not to put lidocaine creams, gels, sprays, or patches on open cuts or wounds. Heat can also cause your skin to absorb lidocaine faster than normal — this puts you at risk of developing unwanted side effects. Mayo Clinic recommends avoiding using heating pads on areas where you’ve recently applied lidocaine.

Since lidocaine numbs your skin, it’s also important to check the areas you’ve applied it to regularly to make sure you haven’t injured yourself or developed an infection.

Capsaicin Topicals

Capsaicin is the substance found in chili peppers that gives them their spicy kick. Interestingly, it can also be used in topical pain relievers. Capsaicin is known to help treat burning, shooting nerve pain, and muscle aches. It works by taking away chemicals your nerves need to sense pain.

You can find brand names like Capzasin-HP, Salonpas Hot, and Zostrix HP that are available as patches, creams, and lotions. Importantly, many OTC topicals are sold under similar brand names but contain different ingredients. Read the product label carefully to make sure you’re getting the active ingredients you want. Your neurologist may also give you a prescription-strength topical, if needed.

MyMSTeam members have shared their experiences with capsaicin topicals for their MS pain. One wrote, “I get pain in my upper leg and thigh, usually in the morning. I use the capsaicin cream prescribed by my neurologist, which helps.” “I rub a gel with capsaicin on my feet, and it helps with the tingling and my walking,” shared another.

Make sure to avoid applying a capsaicin topical to injured skin. You’ll also want to start out with a small amount, as many people experience skin burning when they first begin treatment. Make sure to thoroughly wash your hands with soap after applying these topicals, and avoid rubbing your eyes.

Additionally, to avoid severe irritation or even superficial burns, don’t apply heat — such as a heating pad or hot water bottle — anywhere you’ve applied a capsaicin topical. Avoid applying these topicals to parts of your body that are prone to getting hot, such as your armpits.

Menthol and Camphor Topicals

Other plant-based substances like menthol (from peppermint) and camphor (from the camphor tree) are used to treat nerve and muscle pain. They’re known as counterirritants, and they create warm and cool sensations on the skin to interfere with how your nerves process pain signals.

Topicals with a combination of menthol and camphor include Icy Hot Pro, AleveX Pain Relieving Lotion, and Tiger Balm Extra. Some — like Ultra Strength Bengay Cream — also include methyl salicylate, a compound similar to aspirin that also helps relieve muscle and nerve pain. These products are available as creams, balms, and patches.

“I have muscle spasms and I use Tiger Balm,” shared one MyMSTeam member. “I use Icy Hot for my muscle issues,” wrote another.

It’s important to note that treatments that work for one person may not work for you — try out different ones to see which provides the most relief.

Like other topical pain relievers, it’s not recommended to apply menthol and/or camphor to injured skin. Mild side effects can include dryness, discoloration, and irritation. Be sure to wash your hands thoroughly after applying these topicals. As with capsaicin topicals, avoid applying heat to areas on which you’ve applied these types of topicals.

CBD Topicals

Cannabidiol (CBD) is a compound found in the cannabis plant that has attracted attention as a treatment for MS pain. Unlike the psychoactive ingredient THC, CBD doesn’t cause a “high.” Instead, it’s been studied for its effects on inflammation and the immune system.

While most studies focus on CBD taken by mouth for MS, some reports show that applying it to your skin can also help treat muscle and joint pain. One small study found that topical CBD oil helped improve peripheral neuropathy symptoms, or nerve pain in the legs. However, the exact effects of topical formulations have yet to be thoroughly studied in people with MS.

Some MyMSTeam members have tried topical CBD for their symptoms. “I have CBD in cream form that I bought online, and it works great on pain areas,” one explained.

Be sure to use caution when searching for topical CBD treatments. They aren’t regulated by the U.S. Food and Drug Administration (FDA), so the exact formulations may vary.

Before trying CBD or any other topical treatment for MS pain, talk to your doctor or neurologist. They can help evaluate whether it will interact with your other treatments and can advise you on which might work best for your specific situation.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 199,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Have you tried topicals to relieve your MS pain? Which has worked best for you? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Arthritis Pain: Treatments Absorbed Through Your Skin — Mayo Clinic
  2. Pain — Multiple Sclerosis Association of America
  3. Multiple Sclerosis — Mayo Clinic
  4. MS Signs & Symptoms — National Multiple Sclerosis Society
  5. Pain & Itching — National Multiple Sclerosis Society
  6. Pain in Multiple Sclerosis — Cleveland Clinic
  7. Lidocaine Skin Cream or Ointment — Cleveland Clinic
  8. Lidocaine (Topical Application Route) — Mayo Clinic
  9. Aspercreme Pain Relief Cream With Lidocaine — Aspercreme
  10. Blue-Emu Lidocaine Pain Relief Cream for Numbing Relief, 2.7 Oz — Blue-Emu
  11. Salonpas Lidocaine Pain Relieving Gel-Patch — Hisamitsu America
  12. Icy Hot Max Lidocaine Patch — Icy Hot
  13. Capsaicin (Topical Route) — Mayo Clinic
  14. Capzasin-HP — Drugs.com
  15. Label: Zostrix HP — Capsaicin Cream — DailyMed
  16. Menthol — Britannica
  17. Camphor — A Fumigant During the Black Death and a Coveted Fragrant Wood in Ancient Egypt and Babylon — A Review — Molecules
  18. Camphor; Menthol Cream, Gel, or Lotion — Cleveland Clinic
  19. Tiger Balm Extra — Tiger Balm
  20. Icy Hot Pro — Icy Hot
  21. AleveX Pain Relieving Lotion — Aleve
  22. Salonpas Hot — Hisamitsu America
  23. Ultra Strength Bengay Cream — Bengay
  24. Methyl Salicylate Topical — Penn Medicine Lancaster General Health
  25. Cannabidiol (CBD): What We Know and What We Don’t — Harvard Health Publishing
  26. Antioxidative and Anti-Inflammatory Properties of Cannabidiol — Antioxidants
  27. Cannabinoids for Treatment of MS Symptoms: State of the Evidence — Current Neurology and Neuroscience Reports
  28. The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities — Current Pharmaceutical Biotechnology
  29. How To Shop for CBD — Consumer Reports
    Posted on June 5, 2023
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    Kelsey Stalvey, PharmD received her Doctor of Pharmacy from Pacific University School of Pharmacy in Portland, Oregon, and went on to complete a one-year postgraduate residency at Sarasota Memorial Hospital in Sarasota, Florida. Learn more about her here.
    Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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