The use of topical capsaicin in managing arthritis pain: A clinician's perspective

doi:10.1016/S0049-0172(10)80026-5

Seminars in Arthritis and Rheumatism

Volume 23, Issue 6, Supplement 3, June 1994, Pages 48-51

https://doi.org/10.1016/S0049-0172(10)80026-5 Get rights and content

Effective management of pain and maintenance of functional status are issues common to all forms of arthritis. The rationale for the use of topical capsaicin toward achieving this goal is reviewed from a clinician's perspective. In addition to presenting findings from the clinical literature, clinical experience has been considered in addressing issues such as patient selection, dosage, systemic side effects, cost of therapy, and patient education.

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Cited by (9)

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Citation Excerpt :
PHN,39–41 chronic distal painful polyneuropathy,42 oral neuropathic pain,43 surgical neuropathic pain,44 and the pain associated with Guillain-Barré syndrome.45 In the treatment of non-neuropathic pain, capsaicin has a role, with evidence of a pain-relieving effect in osteoarthritis,46–51 and neck pain.52 It appears that capsaicin achieves its pain-relieving effect by reversibly depleting sensory nerve endings of substance P53,54 and by reducing the density of epidermal nerve fibers, also in a reversible fashion.55
Topical analgesic agents
2009, Current Therapy in Pain
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2008, Clinics in Geriatric Medicine
Citation Excerpt :
It is available commercially as a 0.025% and a 0.075% cream. It reduces the pain of diabetic neuropathy [19–22], postherpetic neuralgia [23–25], surgical neuropathic pain [26], chronic distal painful polyneuropathy [27], osteoarthritis [28–33], and neck pain [34]. In practice, repeated application of capsaicin is required before clinical effect may be apparent.
Pain processing and transmission are achieved by a complex interaction of pathways and processes. Those parts of the process with peripheral representation may be amenable to therapeutic intervention by systemic administration to achieve a peripheral effect or by local application, including local topical administration to the skin overlying the painful area. Advantages include high level of patient acceptance, ease of administration, avoidance of systemic side effects, and reduced drug-drug interactions. Those drugs with topical analgesic effects include those with specific topical analgesic indication and others in which no such indication exists but that may offer a chance of pain therapy at reduced risk.
Topical Analgesics
2007, Anesthesiology Clinics
Citation Excerpt :
It has now been shown to reduce the pain associated with painful diabetic neuropathy [35–38], PHN [39–41], chronic distal painful polyneuropathy [42], oral neuropathic pain [43], surgical neuropathic pain [44], and the pain associated with Guillain-Barré syndrome [45]. In the treatment of non-neuropathic pain, capsaicin has a role, with evidence of a pain-relieving effect in osteoarthritis [46–51] and neck pain [52]. It appears that capsaicin achieves its pain-relieving effect by reversibly depleting sensory nerve endings of substance P [53,54] and by reducing the density of epidermal nerve fibers, also in a reversible fashion [55].
Historically, analgesics were applied by the topical route of administration. With the advent of oral formulations of drugs, topical application became less popular among physicians, although patients still rated this method of drug delivery as efficacious and practical. We now appreciate that peripheral mechanisms of actions of a variety of preparations rationalizes their topical application and gives further opportunity to target peripheral receptors and neural pathways that previously required systemic administration to achieve therapeutic effect. Therefore, a peripheral effect can be generated by using locally applied drug and, consequently, systemic concentrations of that drug may not reach the level at which systemic side effects can occur.
Topical Analgesics
2007, Medical Clinics of North America
Citation Excerpt :
It has now been shown to reduce the pain associated with painful diabetic neuropathy [35–38], PHN [39–41], chronic distal painful polyneuropathy [42], oral neuropathic pain [43], surgical neuropathic pain [44], and the pain associated with Guillain-Barré syndrome [45]. In the treatment of non-neuropathic pain, capsaicin has a role, with evidence of a pain-relieving effect in osteoarthritis [46–51] and neck pain [52]. It appears that capsaicin achieves its pain-relieving effect by reversibly depleting sensory nerve endings of substance P [53,54] and by reducing the density of epidermal nerve fibers, also in a reversible fashion [55].
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The use of topical capsaicin in managing arthritis pain: A clinician's perspective

Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy

Diabetes Care

Treatment of painful diabetic neuropathy with topical capsaicin: A multi-center, double-blind, vehicle-controlled study

Arch Intern Med

Treatment of painful diabetic neuropathy with capsaicin 0.075%

J APMA

Topical capsaicin in painful diabetic neuropathy: Controlled study with long-term follow-up

Diabetes Care

Topical capsaicin in painful diabetic neuropathy: Effect on sensory function

Diabetes Care

Topical capsaicin treatment of chronic postherpetic neuralgia

J Am Acad Dermatol

Topical 0.025% capsaicin in chronic post-herpetic neuralgia: Efficacy, predictors of response and long-term course

J Neurol

Post-herpetic neuralgia and topical capsaicin

Pain

A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia

Clin Ther

The postmastectomy pain syndrome and topical capsaicin: A randomized trial

Pain

Treatment of reflex sympathetic dystrophy with topical capsaicin: Case report

Pain