Pain Relief Options for DOMS


Pain can exert a powerful effect on the human body, from limiting one’s engagement in/enjoyment of physical activities to leaving one frustrated, depressed, and anxious. The experience of DOMS (delayed onset muscle soreness) is one that most routine exercisers come to accept and even appreciate on a regular basis, but for those feeling this form of constant discomfort for the first time, it may be more of a deterrent than a motivator. Ice baths, therapeutic massage, muscle rubs, and foam rolling have all proven effective as tools for recovery from any form of intense exercise. In this article, we highlight several of the more commonly-used products to provide pain relief for muscle soreness and rate their effectiveness.

Topical Pain Relief Resources

This review covers topical analgesics only. While over-the-counter oral pain relievers often prove helpful, the author limits the overview to more homeopathic remedies.

Arnica Gel: Categorized as a member of the sunflower family, the flowers and roots of the Arnica plant have proven beneficial as anti-inflammatory agents. According to a 2019 study that appeared in the journal Medicine & Science in Sports & Exercise, using a topical analgesic like Arnica can reduce the intensity of muscle soreness during the 72 hours following a run. Other over-the-counter topical products have also proven to reduce recovery time, owing to their content of ingredients such as menthol, magnesium and/or aloe. (It’s important to note that arnica is a well-known homeopathic remedy, but not all preparations include diluted ingredients if not labeled “homeopathic”, which is more likely to produce positive results.)

CBD: Cannabidiol, one of over 100 substances called cannabinoids found in hemp, can serve as a plant-based remedy for relief of chronic pain. The hemp plant resides in the same family as marijuana. Topically applied oils or creams consist of CBD plus the addition of hemp seed oil to appropriately dilute the preparation.

Cannabis-based compounds show promise as an anti-inflammatory agent, easing post-exercise muscle soreness. The human body produces its own endocannabinoids, which help regulate a majority of the body’s systems in an effort to maintain homeostasis. If the body overheats, for example, the endocannabinoid system recognizes the need to cool down, thereby triggering the sweat response. The pain response works in a similar fashion. CBD oil acts by stimulating our endocannabinoids to block pain more effectively.

Unlike tetrahydrocannabinol (∆(9) -THC), CBD utilized in this method will not elicit any significant psychotropic effects. Certainly, obtaining your medical marijuana card to address pain relief is an option to be discussed with a licensed medical professional.

BioFreeze: MenThe 3.5% menthol contained in this topical gel serves as enough of a skin irritant sufficient to “confuse” the electrical stimulation to the brain, effectively rerouting the brain’s attention away from pain. The gate control theory of pain describes how non-painful sensations can override and reduce the perception of discomfort. A painful sensation stimulates primary afferent fibers traveling to the brain via transmission cells. Activating these cells results in an increase in perceived pain.

In the gate control theory, a closed gate blocks input to transmission cells, thereby reducing any painful sensation. This theory further asserts that non-painful input (in this case, the cooling sensation created by the menthol) closes the nerve gates to any acute pain, thereby “distracting” the individual long enough to mimic the effect of a temporary analgesic.

ThermaCare Patches: These pain relief patches make use of drug-free heat cell technology, a combination of iron, oxygen, water, and salt. Once applied to bare skin, these heat cells activate a chemical reaction known as iron oxidation. By enabling heat to penetrate the affected tissue, the resulting increase in blood flow accelerates the body’s natural healing process.

Salonpas Patches: This company manufactures a number of pain relieving patch products with different ingredients. Utilizing the process of transdermal penetration, the active ingredients in these patches allow for direct application to the affected area. In bypassing the stomach, the user can avoid potential undue gastric distress which often results from oral pain relievers. Since the patches also contain water, a cooling effect to the skin results from the process of evaporation. Ingredients vary from methyl salicylate (derived from aspirin), levomenthol (sensation of cooling), capsicum (sensation of heat), diclofenac (NSAID), and even lidocaine–a known topical anesthetic. Much like an ice pack, the patches keep the sore area exposed to its effects for 6 hours. Similar to heat therapy, cooling techniques also work wonders for easing sore joints and muscles resulting from overexertion.

Go with the (Blood)Flow

As personal trainers and athletes know, water can make the difference between a successful training session and faltering early. Below we outline a few rarely-considered methods to increase training recovery.

Boosting the Blood Flow: As we frequently explain to our clients, post-workout soreness is thought to result from the byproducts of resistance training’s metabolic stress and micro-tears in the muscle tissue. Increasing blood flow to the affected areas enables a greater amount of oxygen/nutrient-rich blood to assist in repair. Before reaching for the bottle of NSAID’s, try a warm bath containing Epsom salts instead. The warmth increases circulation, while the readily-absorbed magnesium in the Epsom salts can greatly diminish muscle pain.

Hydration: While quenching thirst during a tough workout makes logical sense, insufficient electrolytes in the body can also add to the sore muscle conundrum. Keep in mind that the human blood supply consists of approximately 82% water; as muscles train hard, their demand for oxygen-rich blood increases. Keeping a bottle of coconut water within easy reach accomplishes both hydration and replacement of lost electrolytes. Advise your clients to aim for a volume of water in ounces equivalent to half their body weight in pounds (a 150-pound person would need 75 ounces a day).


Resistance Training course


Foods Can Provide Natural Anti-inflammatory and Pain Relief Aid

Knowing that muscle soreness, both acute and delayed, will accompany a challenging resistance-training session, many seasoned athletes opt for advanced preparedness. By including certain known inflammation-fighting foods/supplements in the diet, we can help thwart the severity of post-workout discomfort.

Turmeric and its main ingredient, curcumin, along with fish oils help to speed post-workout recovery. If fish oils pose a digestive challenge, increasing the quantity of fresh fish in one’s meal plan works just as well.

A few studies have demonstrated that the L-citrulline contained in watermelon can attenuate muscle soreness. A single serving of watermelon juice enriched with L-citrulline not only demonstrated the ability to reduce DOMS, but also lowered blood levels of lactate (often responsible for the sensation of “a stitch in the side”). Watermelon slices/juice also fill the hydration need nicely.

Avoiding Toxicity

Overdosing on some non-prescription oral painkillers, most notably acetaminophen, can bring about liver toxicity and failure over time. Mild forms of toxic hepatitis may not result in any symptoms; often only a doctor-requested blood test reveals this dangerous situation. The following symptoms should alert an athlete to seek immediate medical attention:

  • Jaundice
  • Pain in the upper right quadrant of the abdomen
  • Extreme fatigue
  • Loss of appetite/nausea
  • Dark-colored urine
  • Light-colored stools
  • Swelling of lower extremities

Typically, treatment and cessation of the oral painkiller can reverse the situation. However, life-threatening scenarios may arise if an individual habitually engages in the following behavior in an attempt to ease post-exercise discomfort:

  • Ingesting more acetaminophen than directed on the label
  • Using more than one medicine containing acetaminophen (pay attention to cough/flu formulas)
  • Consuming 3 or more alcoholic drinks while taking acetaminophen

Recovering Safely

Tight, sore muscles need not keep one from pursuing his gym habits and reaching his goals. By adopting the practices mentioned within the body of this article, even die-hard strength training devotees can safely mitigate post-workout soreness. “When in doubt, try the natural route!”



Cathleen Kronemer is an NFPT CEC writer and a member of the NFPT Certification Council Board. Cathleen is an AFAA-Certified Group Exercise Instructor, NSCA-Certified Personal Trainer, ACE-Certified Health Coach, former competitive bodybuilder and freelance writer. She is employed at the Jewish Community Center in St. Louis, MO. Cathleen has been involved in the fitness industry for over three decades. Feel free to contact her at [email protected] She welcomes your feedback and your comments!