Menthol-Based Topical Analgesic Induces Similar Upper and Lower Body Pain Pressure Threshold Values: A Randomized Trial

J Sport Rehabil. 2022 Jan 1;31(1):24-30. doi: 10.1123/jsr.2021-0144. Epub 2021 Sep 22.


Context: Both health professionals and consumers use menthol-based topical analgesics extensively for the temporary relief of pain from musculoskeletal ailments or injury. However, there are no reports of differences in the pain pressure threshold (PPT) or the relative effectiveness of topical analgesics to reduce pain in the upper and lower body muscles and tendons. The objective of this study was to investigate whether differences existed in PPT and relative pain attenuation associated with a menthol-based topical analgesic over a variety of upper and lower body muscles and tendons.

Design: Randomized allocation, controlled, intervention study.

Methods: Sixteen participants (10 females and 6 males) were tested on their dominant or nondominant side. The order of specific muscle/tendon testing was also randomized, which included upper body (middle deltoid, biceps brachii, and lateral epicondylar tendon) and lower body locations (quadriceps, hamstrings, gastrocnemius, lumbosacral erector spinae muscles, and patellar and Achilles tendons). The PPT was monitored before and 15 minutes following the application of a menthol-based topical analgesic.

Results: A menthol-based topical analgesic increased PPT (decreased pain sensitivity) overall (P = .05; 11.6% [2.4%]; d = 1.05) and PPT was higher (P < .0001; 31.5%-44.2%; d = 1.03-1.8) for lower versus upper body locations.

Conclusions: Health professionals and the public can be assured of similar reductions in pain sensitivity independent of the location of application of a menthol-based topical analgesic.

Keywords: lower back; musculoskeletal; tendons.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Achilles Tendon*
  • Analgesics / pharmacology
  • Analgesics / therapeutic use
  • Female
  • Humans
  • Male
  • Menthol* / pharmacology
  • Pain
  • Pain Threshold


  • Analgesics
  • Menthol