Capsaicin is an ingredient derived from hot peppers. Topical preparations of capsaicin have been shown to be an effective analgesic for pain originating from osteoarthritis and rheumatoid arthritis. This medicine relieves pain only while it is used regularly. The arthritis pain will return if use is discontinued. Care should be taken when applying topical capsaicin so as not to irritate the skin.
Oral pain medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), are the standard treatment for arthritis pain. One drawback to most oral pain medication is an increased risk of gastrointestinal events. Using topical capsaicin for arthritis pain poses no such risk. In addition, topical capsaicin can be used alone or in conjunction with other pain medications. This medicine is available in both over-the-counter and prescription formulations.
Capsaicin works by decreasing the strength of the pain signals in the body. It does this by lowering the levels of a neurotransmitter named substance P, a chemical that acts as a pain messenger. In one study, 80 percent of the patients using capsaicin for arthritis pain in the knee observed some degree of pain relief. Another study showed capsaicin was effective for relieving the pain of osteoarthritic hands. Capsaicin is effective on both transient and chronic arthritis pain. It has a cumulative effect and works better the longer it is used; however, it may take up to two months to reach full effectiveness.
When using capsaicin for arthritis pain, the topical cream is applied to the affected area several times daily. The cream often causes a temporary, uncomfortable burning sensation. This side effect decreases over time. Capsaicin cream can be applied with bare hands, although some patients may choose to use latex gloves to minimize contact with the medication. After application, the hands should be washed thoroughly with soap or vinegar.
The topical cream should not be applied immediately before or after swimming, bathing, or strenuous activities. While using capsaicin for arthritis pain, the treated area should not be wrapped or bandaged. It is permissible to cover the area lightly. The treated area should not be exposed to heat sources, including heating pads and hot water bottles.
A skin patch test should be performed before beginning regular use of the cream. The medication should be applied to a small area of skin. After 24 hours, the skin is checked for any unusual reactions, such as welts, blisters, or discoloration. Capsaicin cream should not be applied to areas of broken or irritated skin. Patients with high blood pressure should check with their doctors before using capsaicin.