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Transdermal capsaicin has long been utilized for pain management, primarily in low-dose formulations for over-the-counter use; however, recent interest has shifted toward high-dose transdermal capsaicin therapies, including both prescription-strength products and investigational formulations designed for localized neuropathic pain. WasabiRub, a topical analgesic developed by SportsPharm, combines pure, undiluted capsaicin with methyl salicylate and menthol to create a multi-mechanistic, athlete-oriented formulation aimed at rapid and sustained relief. This literature review examines the pharmacologic rationale for each active ingredient, explores their mechanisms of action in pain modulation, and evaluates emerging polymer-enhanced capsaicin delivery systems—such as nanoemulgels and nanocrystal-loaded gels—for their relevance to future iterations of WasabiRub. By comparing these novel technologies to traditional formulations, this review outlines the potential clinical value of combining high-dose capsaicin with functional excipients. Taken together, current findings suggest that WasabiRub may offer a practical, non-opioid option for localized pain relief in sports and rehabilitation settings, with opportunities for further optimization through nanotechnological enhancement. Additional clinical studies are warranted to confirm long-term safety, tolerability, and therapeutic efficacy.