The best muscle pain relief cream, with advice from doctors and physical therapists

Over-the-counter muscle rubs and pain-relieving creams can be highly effective for managing mild to moderate muscle soreness, as well as localized pain and inflammation, says Lisa Chase, PT, OMPT, orthopedic and sports physical therapist in St. Petersburg, FL. They work by penetrating the skin to reduce inflammation, block pain signals, or provide a physical warming/cooling sensation to control blood flow and distract from pain, she adds.

Muscle rubs work best on muscles close to the skin where they can really penetrate, but sometimes can be effective on carpal tunnel or joint soreness in the right place, adds Derek Ochiai, MD, sports medicine doctor and orthopedic surgeon at Nirschl Orthopaedic Center in Arlington, Virginia.

Penetrex offers fast-acting and effective topical pain relief for a variety of conditions, including arthritis, carpal tunnel, tennis elbow, and general muscle aches. Its active ingredient, arnica, has been used for decades to reduce inflammation from certain conditions like osteoarthritis and surgery and help with trauma, bruises, or tissue injuries.

While there haven't been any peer-reviewed studies looking at the topical benefits of the plant in the last decade, a 2017 study analysis in Nutrients reports that arnica may have some anti-arthritic properties and could be a comparable pain reliever to ibuprofen. Dr. Ochiai adds that arnica does have anti-inflammatory properties that can help with pain, but that topicals are typically only helpful for joints close to the skin, like fingers, wrist, elbow, ankle, and sometimes the knee.

When testing Penetrex, I found it provided pain relief within minutes and lasted for hours. Plus, it wasn't greasy and easily massaged into my skin in about 20 seconds.

Other ingredients in Penetrex include sunflower seed oil, glucosamine, Methylsulfonylmethane (MSM), Vitamin E, Vitamin B6, glycerin, and shea butter. Its scent is a mix of Frankincense oil, peppermint oil, camphor, and JeaTree leaf oil, but it's not overpowering and quickly fades. 

Penetrex is paraben-free, which makes it less likely to cause skin irritation. It's non-staining and is formulated and filled in an FDA-certified laboratory. If you're looking for a go-to product for relatively fast relief, this one's for you.

My chiropractor first introduced me to Biofreeze and it's quickly become my go-to muscle rub for daily use (and it's no surprise it's one of our favorite products for lower back pain relief). B

iofreeze's Pain Relief Gel Roll-On offers soothing, cooling relief that helps reduce muscle pain and the formula contains no anti-inflammatory drugs (NSAIDs) or parabens. In addition, it slows blood flow and cools your skin, the latter of which can potentially distract from pain, Dr. Ochiai adds.

Because menthol is the active ingredient in Biofreeze, it has a light scent but it isn't overpowering and fades quickly. I can feel it working within roughly two minutes and have noticed the effects last for hours.

It isn't greasy, doesn't stain clothing, and a little bit goes a long way. I particularly like the roll-on, mess-free design. The applicator itself, which utilizes a rollie ball, gives a massaging effect, too.

For deep aches and chronic pain, Sombra's Warm Therapy Pain Relieving Gel offers gentle warmth to help relieve pain. It massages into your skin quickly, and within a few minutes, you can feel its warming effects.

Chase says warming agents help increase blood flow to the area, relaxing muscles, soothing stiffness, and reducing discomfort.

I discovered this muscle rub when I was looking for a product to relieve tension in my wrists from past injuries. It offers comfortable warmth rather than burning heat. Ingredients, including menthol, camphor, and witch hazel, give this gel a mild scent, but it may be too strong for some. 

Dr. Sayman's Wonder Rub contains a trio of potent ingredients offering numbing, cooling, and anti-inflammatory properties for comprehensive pain relief. Lidocaine 4%, the maximum strength available without a prescription, acts as an anesthetic, helping to numb the area and reduce pain, Dr. Ochiai says.

A 2021 study in Drug Design, Development and Therapy reports topical lidocaine can help reduce pain for diabetic peripheral neuropathy, carpal tunnel syndrome, chronic lower back pain, and osteoarthritis

It's also not greasy and has no odor. The 4-ounce tube goes a long way since you only need a bit for each application. The rub is easy to massage into your skin and because it's unscented, you can apply it anytime.

Application type

There isn't much of a difference in efficacy among application types, says Dr. Ochiai. So really, it comes down to personal preference. But Chase says there are pros and cons to each type:

• Roll-ons: Great for targeted relief on-the-go without getting your hands messy. They're also perfect for small areas like the neck or temples.
• Balms: Thick and wax-based, balms provide for prolonged relief, especially in localized areas like joints or knuckles, Chase says. This makes them ideal for deep massages and dry climates.
• Gels: Lightweight and fast-absorbing, gels are great for broad muscle coverage or post-workout recovery. Plus, they don't leave a greasy residue.
• Salves: Lighter and moisturizing, salves are good for larger areas like the back or thighs, offering quick application without stickiness.

Key ingredients

Chase suggests avoiding products with preservatives, parabens, or artificial dyes if you have sensitive skin. Always patch-test first. Here are effective ingredients that you want to see in a good muscle rub.

• Diclofenac & Ketoprofen (NSAIDs): Research shows these NSAIDs are helpful for localized arthritis and muscle strains, which Dr. Ochiai says is because they decrease inflammation through COX-2 inhibition.
• Arnica: An effective natural anti-inflammatory to minimize soreness and swelling.
• Capsaicin: The other main effective natural ingredient, Dr. Ochiai says, this chemical, found in hot peppers, blocks pain signals, and offers a warming sensation for chronic pain or stiffness.
• Menthol: Provides a cooling effect that reduces swelling and numbs acute pain, Chase explains.
• Essential Oils: Peppermint, eucalyptus, and lavender can reduce muscle tension and inflammation, Chase says. (Just make sure they're 100% pure.)

Fragrance

Scented muscle rubs can sometimes enhance the experience but also may irritate sensitive skin. Consider these points:

• Artificial fragrance: This is the most likely to irritate your skin and doesn't add any pain-relieving benefits, so always opt for a product without artificial fragrances added.
• Cooling Scents: Menthol and peppermint have an invigorating aroma that comes along with physical cooling effects, which some people may enjoy.
• Relaxing Scents: Lavender and eucalyptus promote a calming environment, making them perfect for post-workout recovery.
• Fragrance-free options: If you have very sensitive skin or don't like the smell of fragrances, choose a product without essential oils, menthol, or camphor.