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Methyl salicylate – pain relief

Online doctors at Just Health Experts have served an amazing role helping individuals remotely. Here’s a response to a frequent inquiry by users of the service.

Runners experience many injuries such as muscle cramps, leg pain, foot pain, and even joint pain. With the growing opioid epidemic and people seeking more natural remedies, what are some ways to reduce pain? Are there pain relieving options without taking pain medications like Tylenol or ibuprofen? This article will go into detail about methyl salicylate combinations, an alternative medicine option for pain relief.

What is methyl salicylate?

Methyl salicylate comes from wintergreen oil or sweet birch oil. It is not used as a single product. Rather, it is marketed as a combination product with menthol or camphor. These are also natural pain reducing ingredients.1

The US Food and Drug Administration has approved certain combination products containing methyl salicylate.2 Specifically, it is approved for treatment of mild to moderate pain.2

How does it work?

Methyl salicylate is a counterirritant. A counterirritant works by using a less severe pain to counter a stronger one. In other words, it has a contradictory pain-relieving effect.1

Also, methyl salicylate is a counterirritant because it increases blood flow. It makes the blood vessels bigger. More blood flow increases skin temperature at the area, producing a counterirritant effect. As a result, it produces the “hot” sensation.1

Other ingredients in combination with methyl salicylate include camphor and menthol. They naturally come from plants like the camphor tree and peppermint. Also, these ingredients cause the “cool” sensation.1

Why is it a good alternative medicine?

  • Methyl salicylate in a combination product is applied as a patch, gel, or cream. This makes the product easier to apply and use.1
  • Opioids, prescription NSAIDs, and over the counter medications like Tylenol or ibuprofen have risks of systemic toxicities. In other words, they work all over the body. Methyl salicylate works only at the pain site.3
  • Methyl salicylate products work longer for pain relief than medications taken by mouth. For example, it can work up to 12 hours compared to oral medications. Oral medications usually work every 4-8 hours, depending on the drug.4
  • Methyl salicylate also helps reduce dependence on oral pain-relieving medications.1
  • In a study testing the efficacy and safety of methyl salicylate containing patches compared to placebo, patients had significant pain relief. However, it was only tested in patients with mild to moderate pain.2

Methyl salicylate products should only be used three to four times a day for up to seven days. If pain is still persistent after seven days, patients should consult their primary care provider.1

Are there any drug interactions or precautions?1

  • There may be potential drug interactions with warfarin. It may increase risk of clots.
  • Do not use products with methyl salicylate if you are allergic to aspirin or other NSAIDs.
  • Do not use the product on the face or on top of rashes.
  • Be careful and do not use in children less than 12 years old. In fact, there was increased risk of death when ingested by children less than 6 years old.
  • Some methyl salicylate containing products can be cut but read the directions or talk to your primary care provider if you are unsure.
  • Many patches are only for one-time use.

What are the side effects?

If not used correctly, there are potential side effects. For example, if you are allergic to aspirin or nonsteroidal anti-inflammatory drugs, do not use products containing methyl salicylate.1

In addition, there is potential for severe burning, pain, swelling, or blistering of the skin. If any of the serious side effects occur, seek medical attention right away.4

Other less serious side effects may be a mild warming or cold sensation. This is due to the way that it naturally works.1

Nonpharmacologic Therapy

Properly warming up and having enough time to prepare can prevent injuries. This includes stretching, adequate hydration, and wearing appropriate shoes. Also, sweating causes loss in electrolytes. In this case, patients should rehydrate and supplement the loss with sports drinks or enhanced waters.1

Another strategy is RICE therapy. It stands for rest, ice, compress, and elevate. This method helps naturally promote healing. Also, it reduces swelling and inflammation. However, only ice the area for 15-20 minutes at a time. Icing for too long delays healing time.1


Western cultures are becoming more interested in alternative medicines that are less harsh and more natural. For example, there are alternatives that lessen pain at the site directly without taking oral medications. An option is methyl salicylate containing products. Methyl salicylate is a natural ingredient from wintergreen or sweet birch oil that does not affect other parts of the body. It acts only on the application site. It is well-tolerated and also lasts longer than oral NSAIDs. Furthermore, methyl salicylate is used in combination with other naturally deriving ingredients. It produces a “hot and cold” effect on the pain area. In addition to using methyl salicylate containing products for pain, there are nonpharmacological therapies that are effective. For more information about this topic and other useful dietary supplements, please visit Natures Reveal.


  1. Olenak, Julie. “7. Musculoskeletal Injuries and Disorders.” Handbook of Nonprescription Drugs, by Daniel Krinsky et al., American Pharmacists Association, 2017.
  2. Higashi, Yoshinobu et al. “Efficacy and safety profile of a topical methyl salicylate and menthol patch in adult patients with mild to moderate muscle strain: a randomized, double-blind, parallel-group, placebo-controlled, multicenter study.” Clinical therapeutics 32,1 (2010): 34-43. doi:10.1016/j.clinthera.2010.01.016
  3. Gudin, Jeffrey A et al. “Improvement of Pain and Function After Use of a Topical Pain Relieving Patch: Results of the RELIEF Study.” Journal of pain research 13 1557-1568. 26 Jun. 2020, doi:10.2147/JPR.S258883
  4. Salonpas Pain Relief Patches. Hisamitsu, 2020,

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