Patches and Ointments and Oils, Oh My! The Best (And Worst) Pain Topicals
Updated: Oct 2
Ice hockey players are great guinea pigs to test pain topicals. They’re always getting smashed against the boards, hip checked in the open ice, and punched between whistles. It’s a tough game, and players collect bruises, sprains, and broken bones, and are always eager to show off their battle scars in the locker room. And speaking of locker rooms, Every dank locker room from here to Moscow reeks of Icy Hot, Bengay, Mineral Ice and Tiger Balm, and I’ve tried them all with some success, but wasn’t totally satisfied with topicals until I found some of the tried and true topicals made with Chinese herbs.
“When there’s no movement, there’s pain. When there’s movement, there’s no pain.”
This is the central principle to treating pain in Chinese medicine, therefore, I really don’t
advocate topicals that numb your pain or freeze it (sorry, Biofreeze) unless you are at a 10/10
pain level. This concept of cold vs heat is also central to treating pain from a Chinese
standpoint, because cold causes constriction (no movement), which may numb the pain, but
won’t lead to a thorough recovery.
This is a review of some of the top topicals from drugstores and some of the Chinese products I’ve discovered over the years. I’ll factor in price, skin irritation, naturalness of ingredients and messiness. I will not factor in which one is the best to prank your teammate’s athletic supporter with… until the end.
Patches are good to cover wide areas without messing up your clothes. They also medicate for longer (generally).The downsides are that they tend to stick on for too long and can be painful to take off.
Why do I have so many of these at the clinic?
Because the box looks legit.
Hua Tuo, The righteous Chinese dude on the box is the most famous Chinese physician in history. This guy didn't mess around; he reportedly performed the world’s first brain surgery, using a marijuana herbal infusion as an anesthetic. A whole set of acupuncture points along the spine are named after him, too.
So any product with his legendary likeness must kick butt, right?
Well, when it comes to presentation over substance, I would say that it’s the Milli Vanilli of pain patches, but that’s really not fair to Milli Vanilli (RIP Vanilli). After all, the chest bumping and
What stinks about it? First off, it’s so weak that you can’t even tell it’s on; nevermind the “Extra Strength” label. But that’s not the worst part. No, the worst part is that the adhesive is stronger than the medicine! It won’t come off in the shower, and if you have any low back hair, you’ll be smooth as silk once you rip it off and dry the blood.
There are probably less painful ways to prep for that sweet lower back butterfly tattoo you always wanted. Trust me, I know from experience, dude.
The blue box (狗皮膏- Dog skin plaster) is worse than the Hua Tuo, because it doesn't do much but also does not stay on. I doubt it’s actually made from dog skin, but you never know when it comes from China.
I hate to sound like a hipster, but I learned about this and other “magical Japanese pain topicals” before it was cool. In fact, My wife and I loaded our suitcases with it when we first went to Japan. This and other products came in sprays, speedstick-like roll ons, and patches. What was in them, however, was completely unknown. My Japanese friend couldn’t even tell me what the ingredients said.
Here's what the box says:Camphor, Menthol,Methyl salicylate, mineral oils, perfume, polyisobutylene, styrene-isoprene-styrene block copolymer, synthetic aluminum silicate, terpine resin, titanium dioxide
Methyl salicylate is the key here; it’s an NSAID (like ibuprofin). What that means is, not only does it mask the pain (as opposed to promoting recovery), it has all the side effects and warnings that go along with NSAIDS, like stomach bleeding and danger for those with heart conditions or high blood pressure.
A lot of baggage to sooth pain, wouldn't you say?
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I envisioned this to be the pain patch equivalent of a prime, chiseled Arnold, standing slowly from a lightning storm and bouncing his man-pecs before he crushes some mohawked punks’ skulls.
Nope, it’s not that exciting.
-But it’s an “infrared” patch!
Sure, and I have some chakra balancing sand from my backyard to sell you, too.
But seriously, the ingredients are a who’s who in the Chinese herbal pharmacopeia;
frankinsense, myrrh, et al. I discovered it at a booth several years back at a Colorado wellness conference, and I was psyched to try it. And I wanted to love it. However, despite having the makings of a star, it’s just lacking that X-factor and will remain Mr. Meh. Sort of like Ryan Reynolds.
一條根 / Tong Luo
I got these in Chinatown a while back and assumed that the high price would mean better results. I do like them; they have a great, herby smell and feel ok on your pain, but I feel they just don’t move the blood quickly enough to justify the price.
辣椒膏 “Chili Pepper Plaster”
My wife and I brought 6 boxes of this back from Taiwan because it works so well.
I threw my back out in acupuncture school doing something stupid (that’s for another post) and this spicy vixen sat on my back and made it allllll right.
I tried every other pain patch in our medical university pharmacy, including famous brands like Yunnan Bai Yao (meh, btw). I’m telling you, chili plasters were the only ones that got me back to….oh, I almost revealed my secret.
Now, imagine my dismay when I graduated and eagerly shopped around to fill my own
pharmacy and couldn’t find them on the market! There are other chili brands (Salonpas has one), but they’re not as good as this. The kind I carry not only has chili, but a cornucopia of studly Chinese herbs to assist the pleasant, picante peppers.
Capsaicin is the active agent in chili peppers, and is clinically proven to reduce pain signals, either by completely depleting substance P (a pain transmitter) from the area, or by causing healing via irritation; prompting your body send in Seal Team 6 to the spicy site. Either way, it’s like inviting Uncle Rico to a house party that you want to disperse.
These patches do indeed burn, but not too much- yet they are very easy to take off if the heat gets too intense. You can feel it working for at least 8 hours.
Oils and Balms:
Generic Capsaicin Oil
I expected more from you, generic spice oil!
Look how it burned the crap out of my neck! I may have been born and raised in Idaho, but I’m not THAT much of a redneck!
Capsaicin Oil burnt my neck (Reviews by SLO Wave Acupuncture)Capsaicin Oil burnt my neck (Reviews by SLO Wave Acupuncture)
Capsaicin Oil burnt my neck
If you want to char your skin, but still keep your muscular pain, this is the topical for you! But remember, if you put this in your teammate's jock, you'll probably go to jail.
I really did take 2 showers to get this off and it only stopped burning when I applied:
Ching Wan Hung
This is the topical that I used to heal the pain inflicted by the Capsaicin topical. Seriously.
This is used for burns (physical, not witty insults), and I’d been told about it’s legendary powers for years. But since my old man was a fireman, I’ve always had this weird paranoia around getting burned and literally never had to treat one until I found this Capsaicin crap.
Anyway, it cooled the raging burn down pretty quickly and I put it back in my first aid kit, where my teachers all told me to put it. It works, you should get some.CBD Oils
I’m gonna get a lot of crap for this, because I know these are all the rage now. The best way to sound progressive is to push CBD products. But I always have to ask anyone who promotes them, "You’re making them in your garage and selling them, aren’t you?" And chances are, the answer is "Yes!"
And just in case you’re going to accuse me of being a narc, I’ll go right ahead and say, “smoke it, don’t rub it!” It'll work way better.
It just isn’t worth the price in topicals. Look, many of these CBD oils and balms are ok, but I would argue that the menthol, camphor and other ingredients mixed with the CBD do more than the CBD. There really isn’t any research suggesting otherwise, either. It might help, but the industry standards are blurry and there is no quality control. Again, if it were cheaper it may very well be worth it.
Bob’s Medicated Oil
Ingredients: Peppermint oil, tea oil, cinnamon oil, Sanguis Draconis (Xue jie), Radix Scutellariae, Baicalensis (Huang Qin), Licorice Gan Cao
This is a modern take on the classic “Po Sum On” oil that we all learned about in acupuncture school. I included this over Po Sum On because it really works better, and Bob Flaws is a trustworthy character and is known to use quality ingredients.
It works well on pain, and has a very medicated odor and feel. In fact, some patients report that it is very cool (from the peppermint) while others report that it is hot (Cinnamon); I know, that’s a curious phenomenon. But regardless, when it’s on there’s no mistaking that there’s medicine on your wound.
I deduct points because you have to wash your hands very thoroughly after application (so as not to get it in your eyes), and it can be slightly irritating to the skin.
The classic! Unbeknownst to me, this was the first Chinese medicine I ever took. I always kept a jar of this, Icy Hot, and Mineral Ice in my hockey bag at all times. All three of these are ok, but of the three, Tiger Balm is the best because it’s hot and moving, but not irritating.
It gets docked a few points because it will stain your clothes (and don’t buy the colorless one; it isn’t hot enough). Also, 8 bucks for a tiny jar just doesn’t fly, Captain.
Zheng Gu Shui
(Jung Goo Shuey)
Sang to the melody of Steve Miller’s “Jungle Love”:
I met you at somebody's herb shop
I thought I smelled you before
I threw my back out at Crossfit
And writhed in pain on the floor
Zheng Gu Shui, it's helping my back
It's healing my neck pain, neck pain
Zheng Gu Shui, it's helping my back
It’s healing my neck pain~
This magical Juju juice comes in a red spray bottle and can be used on all kinds of pain. It was introduced to me by my most beloved teacher and I have used it daily on patients’ backs, shoulders, necks and ankles ever since. Patients usually come back the next time and ask if they can buy a bottle. I carry it because I believe in it, not the other way around!
It’s good for arthritis, bruises, and expedites healing for breaks and sprains.
This is different from many of the other topicals because it's more neutral in temperature. This is a plus for people who easily burn from the more heating oils.
What can I say, it works without giving you too strong of a medicated odor or burning on the skin. In Chinese it means “correct the bone water,” and it really does seem to go to the deep levels of your tissues quite subtly, yet powerfully.
...And to answer the question from the beginning, Icy Hot ruined some friendships and made others stronger.