Is Icy Hot Effective At Relieving Back Pain?

Icy Hot Topical Cream Icy Hot Topical Cream

Icy Hot is one of the most popular pain-relieving brands in the world today, selling over $270 million worth of products each year. The brand offers a wide variety of creams, sleeves, sprays and patches that claim to dull your pain by cooling down the affected area and then “relax it away” through heating properties.

With their steady popularity, Icy Hot and similar topical products have piqued the interest of people who struggle from frequent back pain. Icy Hot has even created some commercials that target that demographic specifically.

But do the actual benefits of the product really live up to all the marketing hype?

In this unbiased, clinical review, we’re going to look at the research and science behind Icy Hot and determine if it actually has any merit for people who deal with back pain.

First off, let’s begin by determining exactly what IcyHot is.

What is Icy Hot?

Icy Hot products are made up of a combination of active ingredients including menthol, methyl salicylate, and capsaicin (a compound found in chili peppers). Menthol and methyl salicylate cool the skin and then capsaicin irritates it on a minor level, causing it to feel warm.

The exact dosage of the chemicals depends on the product you purchase varying anywhere from 2.5% menthol to 30% methyl salicylate. Typically, the “stronger” the relief, the higher the concentration of menthol and methyl salicylate.

Let’s break down these chemicals a little bit to see exactly what they’re doing when they’re applied to your skin.


Menthol is one of the most common chemicals used in topical pain relief. It’s a compound derived from peppermint, eucalyptus and pennyroyal herbs which gives it its trademark “cooling” properties.

The reason that menthol feels cold when applied to the skin is not because the chemical actually lowers the temperature of your body, but because it activates a protein called TRPM8.

TRPM8 is a cold-sensing receptor protein that allows our bodies to naturally detect change in temperature. When the protein detects that the temperature of a certain area is dropping, it changes its shape to allow calcium ions to flow into the nerve cells, allowing you to “feel” the cold.

Menthol is one of the few chemicals that naturally activate TRPM8 and gives a unique cooling sensation, making it a popular compound to include in mints and gum. Additionally, the cooling properties of menthol have been shown to be anesthetic, which means they help prevent pain, especially in the throat and on the skin. This is the reason you often see menthol as a key ingredient in cough drops and topical creams, like Icy Hot.

Methyl Salicylate

Methyl salicylate is an organic chemical compound that is derived naturally from several plant species, most commonly the wintergreen.

The compound is occasionally used in topical creams to help treat minor aches and pains and works through a process called “counterirritation”, which we’ll discuss in detail below. In a nutshell, however, it irritates the skin just enough to help block pain signals coming from a different area of the body, say a pulled muscle, providing temporary relief.


Like methyl salicylate, capsaicin is a counterirritant that helps relieve pain by irritating the skin.

Capsaicin is the active component of chili peppers and is what gives them their fiery “kick” and produces a burning sensation in just about everything that it touches. In large doses, like taking a bite out of chili pepper, this burning is uncomfortable and painful. But in smaller quantities, it can produce a heating sensation that is pain-relieving.

The compound is what gives Icy Hot its heating properties.  

How does Icy Hot Relieve Pain?

Icy Hot is known as a counterirritant, which means that its purpose is to create minor inflammation or irritation in one area in order to block pain signals coming from another area. To accomplish this, chemicals like menthol and capsaicin change the temperature of the skin which distracts the pain coming elsewhere in the body.

Counterirritation is a common method of pain relief both in healthcare and in our daily lives. As a matter of fact, it’s probably something that you’ve done before.

Counterirritants employ what is known as the Gate Control Theory which essentially suggests that non-painful and painful input cannot be registered by the brain at the same time. According to this theory, there is a gating mechanism that works at the base of the brain to control the stimuli that is received from the central nervous system and that certain inputs can control the action of this “gate.”

By default, if there is no input from the nervous system, that gate remains closed. However, when we experience pain, small nerve fibers (the nerves that can sense pain) synapse onto projection cells which travel to the brain. If there is more small fiber stimulation than typical, painless input, the gate will open and the brain will sense the pain.

On the other hand, large fibers (the nerves that sense general stimulation) also work the same way. However, if there is more large nerve fiber stimulation, it will close the gate to the brain blocking out all signals, including pain. 

For example, have you ever taken a hot bath or shower when you had a bad case of poison ivy or a itchy rash?

That’s counterirritation at a very basic form. The bath, in and of itself, isn’t necessarily “healing” your rash, but the heat is stimulating the nerves around the skin and blocking the pain/itch signals that are going to your brain, bringing you some short-term relief.

Is Icy Hot Effective in Relieving Back Pain?

In short, the chemical properties of Icy Hot cannot penetrate deep enough into your muscles to cause any substantial healing, but they can provide a temporary relief by stimulating the nerves near your skin and blocking pain signals.

It’s important to remember that most back pain is caused by damaged muscles or joints that support the spine, not from the bone structure itself. This being the case, Icy Hot can be an effective relief from a short term strain or tweak.  

It’s not that Icy Hot is actually providing any real healing properties to the muscle or joint. Rather it is simply blocking or distracting you from the pain long enough for your body to heal and restore the damaged structure which, for many people, is all they need.

However, for people who are suffering from chronic back pain or a symptomatic spinal condition, the benefits of Icy Hot or another topical cream will likely be minimal. Depending on the severity of the pain, it may block the sensation for a couple of hours, but when it wears off, you’ll still be experiencing the same amount of pain as before.

What Does Science Say About Icy Hot?

In truth, science doesn’t actually say a lot about the efficacy of Icy Hot. Studies have been so minimal and inconclusive over the years that it’s led many professionals to simply believe that the “pain relieving” sensation is nothing more than a placebo effect.

With the chemical properties of Icy Hot it’s impossible for anyone to deny that they “feel something” when they apply the topical cream. But is what they’re feeling really doing them any physiological good?

Likely not.

As we’ve mentioned before, the chemical properties in most Icy Hot products are not designed to penetrate deep into your muscle tissue and often don’t contain properties that promote healing. Some over the counter topical creams may include compounds that help reduce inflammation, but nearly anything that you can buy without a prescription simply doesn’t have the strength to delve far enough into your body to do any good.

Additionally, when it comes to conditions that stem from a problem within the structure of the spine itself, like a pinched nerve, chemicals of almost any type are going to be almost completely ineffective at healing your chronic back pain.

Icy Hot can’t fix a herniated disc or reverse spinal stenosis. Obviously, the product doesn’t claim to do any of that, but people who have undiagnosed spinal conditions may fall into the trap of believing that it can do something that it simply cannot.

For spinal conditions that are causing daily back pain, it’s vital for you to visit a spinal specialist and diagnose what’s actually occurring. Icy Hot may help dull your pain for a little while, but it will not make it go away.

Now, does this mean that Icy Hot is a sham and worthless in pain treatment? Absolutely not.

We’re big proponents of finding a pain-relief system that works for you and your specific needs. Often that includes a consistent exercise regimen, a healthy diet, plenty of sleep and potentially anti-inflammatory medication. But if you find that Icy Hot helps you find relief, even for a short time, we absolutely think you should continue using it, as long as it isn’t replacing other pain-fighting activities in your life.

However, we also believe that knowledge is power. Finding out what’s plaguing your spine, whether big or small, puts you in control of your treatment. 

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Atlantic Brain and Spine A graduate of both Yale and Stanford, Dr. Jae Lim is a board-certified spine surgeon who specializes in minimally invasive spine surgery and robotic spine surgery, significantly reducing surgical impact and recovery times. (703) 876-4270
8501 Arlington Blvd. Suite 330
United States
Jae Y. Lim Ben L. Nguyen