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By Susane Cho, University of Minnesota College of Pharmacy

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With so many topical pain relief products out there, it can be difficult to decide which one to use. In this article, we will be looking at some of the most common topical over-the-counter (OTC) medicines for pain relief and comparing their similarities and differences.

What are topical pain medications and what are they used for?

Topical pain medications, or topical analgesics, are products that are applied to the skin to relieve pain. They work by acting directly at the site of application or systemically through absorption. Topical analgesics are often formulated as creams, lotions, gels, and patches. There are many topical pain products available, but each medication works via different mechanisms and is used for different conditions. Many of these products are available OTC and contain common ingredients such as NSAIDs, lidocaine, and counterirritants. 

Are Voltaren, Aspercreme, Icy Hot, and Bengay all the same?

Voltaren, Aspercreme, Icy Hot, and Bengay are not the same medications. Each brand may carry formulations that contain similar ingredients, so it is important to check the labeling of each product before purchase. Voltaren (diclofenac gel) treats arthritis-related joint pain of the hands, wrists, elbows, knees, ankles, and feet. Aspercreme Pain Relief Cream contains trolamine salicylate and is used to relieve minor joint pain, backache, muscle strains, sprains, and bruises. There are also many popular Aspercreme formulations that contain lidocaine, which is an anesthetic used to numb pain and irritation of the skin.

Icy Hot and Bengay products encompass various formulations of counterirritants (i.e. menthol, methyl salicylate, camphor, capsaicin). Counterirritants act on pain receptors by creating a cooling/warming sensation and are intended to dull the feeling of pain. Icy Hot and Bengay also offer their own lidocaine product options, as well. 

How does Voltaren Work? 

Voltaren contains diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), which works by inhibiting enzymes that lead to the production of important inflammatory mediators (i.e., prostaglandins and thromboxanes). Blocking this response ultimately results in reduced inflammation, pain, fever, and swelling, making Voltaren effective for the treatment of arthritis-related joint pain. 

How does Aspercreme Work?

Aspercreme contains trolamine salicylate, which is a salicylate that works similar to other NSAIDs by inhibiting enzymes that lead to the production of important inflammatory mediators (i.e., prostaglandins and thromboxanes). Blocking this response ultimately results in reduced inflammation, pain, fever, and swelling. Aspercreme is used to relieve minor joint pain, backaches, muscle soreness, strains, sprains, and bruises. Many popular formulations of Aspercreme also contain lidocaine, which is an anesthetic that is used to numb pain by blocking nerve conduction and interrupting the transmission of pain signals. 

How does Icy Hot Work?

Icy Hot products may contain menthol, methyl salicylate, camphor, and/or capsaicin, which are counterirritants. Counterirritants act on pain receptors by creating a cooling/warming sensation, and are intended to help dull the feeling of pain. Icy Hot is used to relieve minor joint pain, backaches, muscle soreness, strains, sprains, bruises, and cramps. Some formulations of Icy Hot also contain lidocaine, which is an anesthetic that is used to numb pain by blocking nerve conduction and interrupting the transmission of pain signals. 

How does Bengay Work?

Bengay products may contain menthol, methyl salicylate, and/or camphor, which are counterirritants. Counterirritants act on pain receptors by creating a cooling/warming sensation, and are intended to help dull and distract from the feeling of pain. Bengay is used to relieve minor joint pain, backaches, muscle soreness, strains, sprains, bruises, and cramps. Some formulations of Bengay also contain lidocaine, which is an anesthetic that is used to numb pain by blocking nerve conduction and interrupting the transmission of pain signals.  

What are the Key Differences between Voltaren, Aspercreme, Icy Hot, and Bengay?

Voltaren vs Aspercreme vs Icy Hot vs Bengay: Ingredients

Icy Hot and Bengay have various formulations that contain a combination of counterirritants (i.e. menthol, methyl salicylate, camphor, and/or capsaicin). Counterirritants create a cooling/warming sensation at the site of application to desensitize pain receptors, and analgesic effects can be felt within the first few minutes of application. Aspercreme contains trolamine salicylate, which relieves pain by inhibiting the inflammatory response, resulting in reduced pain, fever, and swelling within an hour of application. 

In addition, Icy Hot, Bengay, and Aspercreme each offer their own lidocaine products. Lidocaine relieves pain by blocking nerve signaling, effectively numbing the area of application. Generally, topical lidocaine takes around 30-60 minutes to start working and may last for 1-3 hours. Icy Hot, Bengay, and Aspercreme are not intended to be used for long term pain management, and it is advised to see your healthcare provider if you have persistent pain that lasts greater than 7 days.

Voltaren gel works similarly to Aspercreme in that it inhibits the inflammatory response, but does so with the NSAID diclofenac as its active ingredient. The full effects of diclofenac gel are typically felt within 7 days of applying four times daily (although it is possible to feel some relief within an hour), and may last for 1-2 days after final application. The maximum recommended duration of Voltaren use is 21 days. To learn more about diclofenac versus lidocaine, please read the Curist blog: Diclofenac Gel vs Lidocaine Cream

Voltaren vs Aspercreme vs Icy Hot vs Bengay: Uses

Aspercreme, Icy Hot, and Bengay may all be used to treat minor joint pain, backaches, muscle soreness, strains, sprains, bruises, and nerve pain (in the case of their lidocaine products). In contrast, Voltaren is used to specifically treat joint pain on the hands, wrists, elbows, knees, ankles, and feet. It is not recommended for use in other areas with pain deeper below the surface of the skin, such as the back, hip, or shoulder. 

What is the Best Topical Analgesic for Arthritis Pain: Voltaren vs Aspercreme vs Icy Hot vs Bengay?

Voltaren, Aspercreme, Icy Hot, or Bengay may be used for joint pain - but broadly speaking, diclofenac gel (brand Voltaren) is the best topical cream for treating arthritis pain. NSAIDs are analgesic and anti-inflammatory agents that have shown great efficacy in arthritis, and Voltaren (diclofenac gel) is a topical NSAID that exhibits comparable effectiveness with a lower risk of systemic side effects when compared with oral therapy. This makes diclofenac gel a recommended first-line option for arthritis-related joint pain per the American College of Rheumatology (ACR) OA Treatment Guidelines. 

That said, many patients still find relief with alternative OTC products. However, insufficient data exists to recommend lidocaine or counterirritants (found in Aspercreme, Icy Hot, and Bengay) specifically for arthritis. It should be noted that Voltaren is only recommended for application to the hands, wrists, elbows, knees, ankles, and feet. In contrast, Aspercreme, Icy Hot, and Bengay may also be used to treat backaches and other areas of muscle soreness.

What is the Best Topical Analgesic for Muscle Pain: Aspercreme vs Bengay vs Voltaren vs Icy Hot?

Of the OTC products discussed here, Aspercreme, Icy Hot, and Bengay are the best topical creams for muscle pain. Aspercreme, Icy Hot, and Bengay may all be used to treat backaches, muscle soreness, strains, sprains, and bruises. In contrast, Voltaren is used to specifically treat joint pain on the hands, wrists, elbows, knees, ankles, and feet. Voltaren is not recommended for use in other areas with pain deeper below the surface of the skin, such as the back, hip, or shoulder. 

What is the Best Topical Analgesic for Hemorrhoids: Voltaren vs Aspercreme vs Icy Hot vs Bengay?

Among OTC topical analgesics discussed here, products with lidocaine are often the best for pain and irritation caused by hemorrhoids and other anorectal disorders. Although Aspercreme, Icy Hot, and Bengay carry lidocaine products, they are not marketed or recommended for hemorrhoids. Our best lidocaine product for hemorrhoids is Curist Numbing Relief (Lidocaine 5% Cream)

Lidocaine works to numb anorectal pain by blocking nerve conduction and interrupting the transmission of pain signals. It is important to note that lidocaine cream should not be applied inside the rectum, and should be discontinued if you have rectal bleeding. Lidocaine should not be applied on skin that is broken, infected, swollen, or covered with rash. Discuss pain relief options with your doctor if your symptoms persist.

What is the Best Topical Analgesic for Nerve Pain: Voltaren vs Aspercreme vs Icy Hot vs Bengay?

Of the OTC products discussed here, the OTC products with lidocaine are the best and most effective for nerve pain. Lidocaine is an anesthetic and works by blocking nerve conduction to numb the feeling of pain. This makes the lidocaine versions of Aspercreme, Icy Hot, and Bengay better for nerve pain than Voltaren.

Counterirritants (e.g. menthol, methyl salicylate, capsaicin) may also be used to relieve nerve pain and are sometimes formulated in combination with lidocaine. Capsaicin, an ingredient derived from chili peppers, works by producing a burning sensation and has shown effectiveness in treating neuropathic pain. For some people, these effects of capsaicin may feel uncomfortable.

None of these products should be applied on skin that is broken, infected, swollen, or covered with rash. Discuss pain relief options with your doctor if your symptoms persist.

Can I use Voltaren, Aspercreme, Icy Hot, and Bengay Together?

There may be cases where using topical analgesics together may be effective in managing pain or in conditions such as arthritis. However, using multiple topical creams should be done under the care of a medical professional. Please discuss pain relief options with your doctor before using these medications together. 

Where Can I Buy Diclofenac Gel and Lidocaine Cream Online?

Diclofenac gel and lidocaine cream are available in local pharmacies as well as stores online like Curist, and do not need a prescription.

At Curist, we develop FDA-approved equivalents to big brands in order to provide the same medicine relief but at half the price of the brands. Curist products are sold online and shipped directly to your door. To learn more, please visit:

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This content is for informational use only and does not replace professional medical advice, diagnosis or treatment. It is not a substitute for and should not be relied upon for specific medical recommendations. Please talk with your doctor about any questions or concerns.