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  • Flexotone However, the downside is the overwhelming smell and the fact that it does not provide long lasting relief of pain. Pain Cream Containing Capsaicin Capsaicin is the active ingredient in chili peppers and can also be found in certain topical pain creams. Zostrix is an example of an over the counter pain cream that uses capsaicin. This type of cream can be effective for fibromyalgia, joint and muscle pain as well as back aches. Pain cream containing capsaicin works by depleting the body of substance P (a chemical that transmits pain). Th