Lidocaine is a local anesthetic that temporarily prevents your nerves from sending pain signals. 

Topical lidocaine products are often used for pain in a specific area. There’s evidence that they can help with some types of peripheral neuropathic pain, although research specifically on MS pain is limited. 

Lidocaine may help ease localized burning, tingling, or pain from light touch. Patches tend to cause few side effects, and only a small amount of the medication is absorbed into the bloodstream.

Several OTC topicals contain lidocaine, including brand names like:

• Aspercreme With Lidocaine
• Gold Bond Medicated Maximum Strength Pain & Itch Relief 
• Icy Hot Max With Lidocaine 

Some MyMSTeam members have shared their experiences using lidocaine topicals: 

• “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.”

Lidocaine Safety Considerations

Mild side effects of lidocaine may include skin discoloration, irritation, or itching where you apply it. Hives, swelling, or rash may indicate an allergic reaction and require medical attention. 

Do not apply lidocaine to broken skin. Be sure to avoid heating pads or other external heat sources over treated areas because heat can increase lidocaine absorption and raise the risk of toxicity.

Capsaicin is the substance found in chili peppers that gives them their spicy kick. Capsaicin is also used in topical pain relievers and works by gradually reducing the activity of pain-sensing nerves.

Higher-concentration capsaicin patches have stronger evidence for treating some types of peripheral neuropathic pain.

Capsaicin may help relieve symptoms of some forms of peripheral neuropathic pain. However, research on capsaicin for MS-related pain is still limited. There also isn’t enough evidence to support using topical capsaicin for trigeminal neuralgia related to MS.

Capsaicin is available under brand names like: 

• Capsagesic-HP Arthritis Relief
• Capsin
• Icy Hot Arthritis Therapy
• Zoztrix

Prescription-strength capsaicin products are also available.

MyMSTeam members have shared their experiences with capsaicin topicals:

• “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. 

Capsaicin Safety Considerations

Make sure to avoid applying a capsaicin topical to injured skin. You’ll also want to start 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 capsaicin, and avoid rubbing your eyes. Avoid applying heat over capsaicin-treated areas because doing so may increase irritation or even lead to superficial burns.

Menthol, which comes from peppermint, and camphor, which is found in the camphor tree, are known as counterirritants. They create warm and cool sensations on the skin to interfere with how your nerves process pain signals. 

Products that contain menthol or camphor may be used to provide temporary relief of localized minor muscle and joint aches and pains.

Topicals with a combination of menthol and camphor include:

• Icy Hot
• Arctic Relief
• Camphotrol
• Tiger Balm 

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

Menthol and Camphor Safety Considerations

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. 

Make sure to wash your hands thoroughly after applying these products. Also, avoid using heat on treated areas.

Cannabidiol (CBD) is a compound found in the cannabis plant that doesn’t cause the “high” associated with THC. Researchers have studied CBD for a variety of symptoms, including pain.  

While most studies of CBD for MS have focused on CBD taken by mouth, some research has looked at topical CBD for pain. One small study found that topical CBD oil helped improve pain and other symptoms of peripheral neuropathy. However, more research is needed on topical CBD and 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. 

CBD Safety Considerations

Use caution when considering topical CBD products for MS-related pain. No cannabis-based medications are U.S. Food and Drug Administration (FDA)-approved to treat MS symptoms. Talk with your doctor or neurologist before trying CBD for pain relief, as they can help you understand the potential risks and benefits.

Topical NSAIDs have good evidence for relieving acute musculoskeletal pain, such as pain from sprains and strains. Some topical NSAIDs can also help with chronic pain from osteoarthritis.

Topical amitriptyline, gabapentin, ketamine, and combination creams have been studied for nerve pain, although evidence for how well they work is limited and mixed. One case report involving a person with MS found that topical amitriptyline helped relieve MS-related nerve pain.