What ointment is good for leg pain? A Pharmacological Guide

October 12, 2025 •

5 min read

According to the American College of Physicians, topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are a recommended first-line treatment for acute musculoskeletal injuries like sprains and strains. When wondering what ointment is good for leg pain, the best choice depends heavily on the source of the discomfort, whether it's arthritis, a muscle strain, or nerve-related pain.

Quick Summary

Different topical treatments offer relief for leg pain, including anti-inflammatory NSAID gels, counterirritants, and numbing agents. The best product depends on the cause of the pain, such as joint inflammation or muscle soreness, and should be applied following specific safety precautions for maximum efficacy.

Key Points

Topical NSAIDs reduce inflammation: Diclofenac gel (Voltaren®) is a key example that targets joint pain caused by arthritis with minimal systemic absorption.
Counterirritants mask pain: Ingredients like menthol and methyl salicylate provide cooling and warming sensations that distract the brain from muscle and joint aches.
Capsaicin desensitizes nerves: Derived from chili peppers, this ingredient reduces pain signals over time but may cause an initial burning sensation.
Lidocaine numbs the area: As a local anesthetic, lidocaine blocks nerve signals for immediate, targeted relief of minor pain.
Avoid heat and broken skin: Never apply heat sources or tight bandages over treated areas, as this can increase the risk of serious skin burns.
Check the product's purpose: Choose an ointment based on the type of pain (e.g., inflammation, nerve pain, or muscle soreness) for the most effective relief.

Understanding the Cause of Your Leg Pain

Before reaching for an ointment, it's essential to understand the cause of your leg pain. Topical treatments work most effectively for localized, superficial issues affecting muscles and joints near the skin's surface, such as the knees, ankles, and feet. Deeper pain or pain radiating from a more serious condition requires a proper medical diagnosis. Common causes of leg pain that can be addressed topically include:

Osteoarthritis: Chronic joint pain, often in the knees, where topical NSAIDs can provide targeted relief.
Muscle Strains and Sprains: Acute injuries to muscles and ligaments benefit from anti-inflammatory and counterirritant effects.
Nerve Pain (Neuropathy): Conditions like diabetic neuropathy or postherpetic neuralgia may respond to specific nerve-blocking or desensitizing agents.
General Muscle Soreness: Aches and pains from overuse or exercise can be soothed with cooling or warming counterirritants.

Types of Topical Pain Relievers and Their Mechanisms

Several classes of active ingredients are available in over-the-counter (OTC) and prescription topical products. Their mechanisms of action vary, making some more suitable for certain types of leg pain than others.

Topical NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

Topical NSAIDs deliver an anti-inflammatory medication directly to the site of pain, resulting in lower systemic absorption and reduced risk of side effects compared to oral versions. Diclofenac gel (Voltaren®) is a prominent example available OTC. It works by inhibiting enzymes responsible for producing inflammatory chemicals, thereby reducing both pain and swelling. Voltaren is FDA-approved for treating arthritis pain in the knees, ankles, and feet and can also be effective for other localized inflammatory conditions.

Counterirritants (Warming and Cooling Agents)

These products, which include ingredients like menthol, camphor, and methyl salicylate, work by distracting the brain from the pain signals.

Menthol: Provides an intense cooling sensation that overpowers the perception of pain. It is a common ingredient in many muscle rubs (e.g., Biofreeze®, Icy Hot®) and is often used for immediate, temporary relief of muscle soreness and minor aches.
Methyl Salicylate: Also known as wintergreen oil, it acts as a warming counterirritant. It is often combined with menthol to create a hot-and-cold sensation that distracts from deeper aches in muscles and joints. Some products combine these for a dual-action effect.

Capsaicin Creams

Derived from chili peppers, capsaicin provides pain relief by first stimulating, then desensitizing, nerve endings. With repeated application over several days, capsaicin depletes a chemical (substance P) that transmits pain signals, resulting in long-term relief. This can be particularly useful for certain types of chronic nerve pain or osteoarthritis. However, it is known to cause a burning sensation upon initial application, which usually subsides with consistent use. It is crucial to wash hands thoroughly after applying to avoid spreading it to sensitive areas like the eyes.

Topical Anesthetics

Lidocaine is a local anesthetic that numbs the area by blocking nerve signals. It is available in creams, gels, and patches (e.g., Aspercreme with Lidocaine®, Lidocare®) and provides effective relief for minor skin irritation and localized pain. While it doesn't address the underlying inflammation, its numbing effect can be a powerful tool for pain management, especially for strains and sprains.

Other Herbal and Natural Ingredients

Arnica: A homeopathic remedy often used for bruising and swelling, though evidence for its effectiveness is limited. Some studies suggest it may provide similar pain relief to topical ibuprofen for osteoarthritis.
Turmeric and Boswellia: Some gels incorporate these natural anti-inflammatory ingredients, which are commonly used in herbal medicine.

Comparison of Common Topical Pain Relievers


Feature	Topical NSAID (Diclofenac)	Counterirritant (Menthol/Methyl Salicylate)	Capsaicin Cream	Lidocaine Cream/Patch
Primary Mechanism	Reduces inflammation by blocking enzymes.	Masks pain with cooling/warming sensations.	Desensitizes nerve endings over time.	Numbing agent; blocks nerve signals.
Primary Uses	Arthritis, sprains, strains, general musculoskeletal pain.	Muscle soreness, sprains, strains, minor joint pain.	Chronic nerve pain, osteoarthritis.	Minor aches, strains, muscle pain.
Onset of Relief	May take days for full effect, but can provide relief sooner.	Immediate cooling or warming sensation.	May take up to two weeks of regular use.	Fast-acting numbing effect.
Initial Sensation	Minimal skin sensation.	Cooling, warming, or alternating sensation.	Burning or tingling, which decreases with use.	Numbing sensation.
Systemic Risk	Very low compared to oral NSAIDs.	Minimal systemic risk.	Minimal systemic risk.	Minimal systemic risk when used as directed.
Best For	Chronic inflammation and joint pain.	Acute muscle aches and strains.	Long-term pain desensitization.	Immediate, localized numbing relief.

How to Choose and Apply an Ointment for Leg Pain

Identify the Pain Type: Is the pain from inflammation, nerve irritation, or a simple muscle ache? For arthritis, a topical NSAID may be best. For temporary muscle soreness, a counterirritant could suffice. For nerve pain, capsaicin or lidocaine might be appropriate.
Start with OTC Options: Many effective options like menthol-based rubs or diclofenac gel are available without a prescription.
Consult a Doctor for Prescription-Strength or Chronic Issues: For severe, persistent, or nerve-related pain, a healthcare provider might recommend a stronger, prescription-grade product or patch.
Follow Directions Strictly: Adhere to dosage and frequency guidelines on the packaging or from your doctor. Do not apply to broken or irritated skin.
Wash Hands Thoroughly: Always wash your hands immediately after application, especially with products containing capsaicin, to prevent transferring the product to eyes or other sensitive areas.
Avoid Heat: Do not apply heating pads, electric blankets, or tight bandages over the treated area, as this can increase absorption and risk burns.

Conclusion

When it comes to finding what ointment is good for leg pain, the best solution depends on the underlying cause and severity. For localized inflammation due to arthritis, over-the-counter topical NSAIDs like diclofenac are a highly effective option with low systemic risk. For immediate relief from muscle strains or soreness, counterirritants with menthol or methyl salicylate can provide a powerful distraction. Capsaicin offers a long-term desensitizing effect for chronic nerve pain, while lidocaine delivers rapid numbing. Always start with the least aggressive option and consult a healthcare provider for severe or persistent pain, or before using multiple products simultaneously. Choosing the right product, understanding its mechanism, and using it correctly will help manage leg pain effectively and safely.

For more detailed information on a range of topical analgesics for different conditions, see the comprehensive Cochrane Review on the topic.

Frequently Asked Questions

Topical pain relievers are absorbed through the skin to act locally at the site of pain in nerves, muscles, or joints. Some reduce inflammation, while others distract from or block pain signals.

Yes, topical NSAIDs generally have fewer systemic side effects, such as stomach irritation, because they result in much lower systemic exposure compared to their oral counterparts. This makes them a preferred option for localized pain.

No, you should not use a heating pad or tight bandage over the treated area. Doing so, especially with products containing counterirritants or capsaicin, can increase drug absorption and may lead to serious skin burns.

Cooling ointments, typically containing menthol, provide a cold sensation that distracts from pain. Warming ointments, with ingredients like capsaicin or methyl salicylate, irritate nerve endings to create a warm feeling, also helping to mask deeper pain.

The onset of relief varies. Counterirritants provide an immediate sensation, while anti-inflammatory and numbing agents like topical diclofenac and lidocaine can work within 15-30 minutes. However, capsaicin requires consistent application over several days or weeks for its full effect.

No, it is not recommended to use multiple topical pain products on the same area unless specifically instructed by a doctor. This can increase the risk of skin irritation, burns, or other adverse reactions.

For nerve-related leg pain, capsaicin cream can be a good option because it works by desensitizing nerve endings over time. For temporary relief, a product containing lidocaine can help numb the area by blocking nerve signals.