Very common question for people with pain: “Which pain cream do you think I should use for…?”

As a chronic pain sufferer, I have tried quite a few. Recommending a pain cream can be really difficult because everyone’s pain is different. It’s important to get to the reason for the pain in order to determine the correct kind of ingredient(s) to treat it with. In this article, I share some of what I have learned over the years.

You won’t find a bottle of Biofreeze anywhere in my office. It’s weird, I know—it seems like every massage therapist, physical therapist, and/or chiropractor in existence uses or at least sells Biofreeze in their office. Though I have no “beef” with this product, I do not use or recommend it because it did not help me with my low back pain prior to surgery. It would feel disingenuous, telling people to use something that didn’t help me. Biofreeze helps a lot of people—and even more really seem to like it’s light and pleasant smell. If you love Biofreeze, by all means—USE IT. I have no problem using Biofreeze on my patients who want to bring it in with them, though I would prefer to use it at the end of the massage because I don’t like the way it feels to massage with it. Sticky. I absolutely can’t stand sticky. But I know I am not in the majority on this. A lot of people love Biofreeze—and that’s the thing—sometimes you have to try a few things in order to find the right one. Biofreeze is a good place to start, it is a good product with a lot of good ingredients. It just wasn’t the pain cream for my nerve pain. (Performance Health, please don’t sue me! Your product is loved by millions—with reason.)

So, if I am not using Biofreeze in my practice—what am I going to recommend to you?

“Where are you going after your massage?”

Weird question, right? I often ask my patients this before applying anything that has an odor during their massage. As a rule of thumb, the stinkier the pain cream—the better it helps with muscular pain. This is because of the menthol or other derivatives that frequently show up in these concoctions. Menthol, found in peppermint and other natural oils, is an analgesic (pain reliever) anti-inflammatory ingredient that produces a cooling sensation by blocking the calcium current along the nerves responsible for detecting temperature. This makes it a great carrier for other ingredients, since it penetrates deep below the skin’s surface.

Arnicare is by far the pain cream I recommend most often. Arnica Montana, the main ingredient in Arnicare, is a flower known for its anti-inflammatory properties. Oftentimes surgeons will ask patients to take a regimen of arnica tablets for a few days prior to surgery. I use Arnicare every day that I work before I start to stave off soreness in my hands. Arnicare is usually marketed for bruising, and it does a great job lessening the length of time and severity of bruising—but I use it because it has no odor. If anything, it has a slight pleasant flowery smell that disappears almost immediately. I will often recommend Arnicare for patients who suffer from inflammatory conditions or do not like the smell of menthol or other ingredients. Arnicare is also indicated for patients who cannot use other anti-inflammatory NSAIDS due to health conditions. Arnicare can be found online and in drugstores—and I do carry the larger size in my office.

One unique product I recommend is Muay Cream, a white strongly-scented pain cream from Thailand that was first used by Muay Thai Boxers. Yes, you read that right—it is a pain cream designed for MMA fighters. The list of active ingredients in Muay Cream is pretty simple: Menthol (mentioned above, analgesic), Eugenol (Oil of Clove)—an antiseptic, analgesic, anti-inflammatory agent, and Methyl Salicilate. Methyl Salicilate is hands-down my favorite pain relieving ingredient because it carries other pain relievers deep into the body. However, Methyl Salicilate is an NSAID—so please use caution if you cannot risk exposure. I use and recommend Muay Cream for patients who have pulled, strained, or overworked muscles. The only ways I currently have for finding Muay Cream are to search for it online. I do try to keep a few tubes on hand in my office for patients who have a hard time locating it.

Last—but certainly not least—I recommend a product called TerraFreeze for my patients who suffer from nerve pain. As I said earlier, Biofreeze (along with a whole host of other pain creams) did not touch my nerve pain when I suffered with herniated discs. The only product I found that would even make a dent in my pain no longer exists: Maximum Strength Blue Emu. Blue Emu, a decent blue anti-inflammatory cream whose main ingredient is emu oil, does still exist—only now without the Methyl Salicilate needed to carry it deep enough to affect the nerves. I was actually ANGRY when I saw Max Strength Blue Emu clearanced out online and in stores. I was telling all of my patients about it—knowing it would help with everything from muscular pain to inflammation to disc issues. It was the best topical analgesic cream on the market. BLUE EMU!! WHY DID YOU GET RID OF IT???!!! (Can you tell I am still emotional about it? HA!) In response, I did two things way back when: 1. I wrote the company a deeply and (wayyy too) emotional letter begging them to reconsider 2. I bought 20 tubes of it. Yes, I actually bought 20 tubes of it. NFI, the company that makes the Blue Emu line of products, must have read my letter and felt sorry for me—because they sent me a case of my beloved Max Strength (along with some really great lip balms. HIGHLY recommend them) and a letter explaining that it wasn’t selling as well as the normal Odor-Free Blue Emu due to the strong menthol (wintergreen lifesaver) smell. I put two tubes of my beloved cream aside for myself and then one-by-one gave away the rest. When a patient would walk into my office with nerve pain associated with disc issues, there wasn’t a whole lot that I could do for them—so I would gently work the muscles surrounding the disc problem and send them home with a bottle of my beloved cream to be applied up to four times a day. This box (and my 18 purchased bottles) didn’t last all that long—and I was sad to see them go. Afterward, I searched high and low (Side Note: Can you tell I take my pain cream research very seriously?) for a similar product. I dabbled with a few other creams, such as Pain Terminator (decent cream-but that name?!) and Blue Goo—which had a menthol “kicker” instead of Methyl Salicilate—but it just wasn’t the same. I am a little embarrassed to admit this—but I even tried a few horse liniments. Don’t do this, it can be really dangerous for you. DMSO—a common horse liniment ingredient—is WAY too powerful for human application, as well as possibly damaging to your kidneys. My advice—leave the liniment for the horses that need it. Anyway, I tried a LOT of things in my effort to recreate the magic of Max Strength Blue Emu. Nothing worked.

Until…

TerraFreeze came into my life thanks to an Amazon search. I decided to search for my own personal Perfect Pain Cream, searching for “Arnica Emu Oil Methyl Salicilate”. Only one product showed up: a terribly expensive, small jar of something called TerraFreeze. A quick look at the Amazon listing showed that not only was it Emu Oil blended with my dear Methyl Salicilate—but it ALSO had my other favorite, Arnica Montana. Bonus! I ordered two jars, one for me to try out and another for my friend Jack—who suffers with nerve pain/neuropathy. Jack was just about as zealous as I used to be with finding his Perfect Pain Cream, and I knew he would tell me the truth if it turned out to be garbage. But it wasn’t. Jack ended up ordering his own jars from the TerraFreeze website—and I ended up buying a whole bunch on a Buy One, Get One Free special so I could stock some in my office. The rest is history. TerraFreeze is perfect for all kinds of pain. It has the arnica needed to handle bruising and inflammation, the menthol needed for muscular pain, and the Emu/Methyl Salicilate needed to ease nerve pain. In my opinion, TerraFreeze is the “Mac Daddy”—I love it more than even my beloved Max Strength Blue Emu. It is on the pricier side at $25, but I really believe it is worth it’s weight in gold.

Now you know my passion for finding the Perfect Pain Cream. While TerraFreeze is in my opinion the BEST option currently on the market, Arnicare is a very close second (and possibly first for those who do not suffer with nerve issues). Muay Cream is an excellent option for those with purely muscular pain, and it comes in at only $10. If you have made it this far into this week’s blog post, I truly appreciate you. You are an AllStar. Please, as always, let me know if you have any questions about anything I have discussed. Thank you so much for supporting this blog!

—Stephanie

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