Dr. Phil Page recently published an article in PT Products on the use of topical analgesics in practice. Below is an excerpt from his article:

Typically, ice is applied to the skin to create a cold response in order to reduce pain because cold reduces the pain threshold. Menthol creates a chemical action on cold receptors rather than a physical action, resulting in a cold response. Patel and colleagues provide an excellent review of the mechanisms behind menthol. TRPM8 receptors stimulate small-diameter fibers, making the counterirritant mechanism less likely. Similar to ice, topical application of menthol in 3.5% gel reduces blood flow by 35% within 60 seconds of application, and remains ~20% reduced at 10 minutes after application. Recently, Topp and colleagues noted increased blood flow in both lower limbs after application to one limb, suggesting a possible systemic mechanism of typical menthol.

 Read the full article here.

 

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