Systematic review of topical capsaicin for the treatment of chronic pain

Abstract

Objective To determine the efficacy and safety of topically applied capsaicin for chronic pain from neuropathic or musculoskeletal disorders. Data sources Cochrane Library, Medline, Embase, PubMed, an in-house database, and contact with manufacturers of topical capsaicin. Study selection Randomised controlled trials comparing topically applied capsaicin with placebo or another treatment in adults with chronic pain. Data extraction Primary outcome was dichotomous information for the number of patients with about a 50% reduction in pain. Outcomes were extracted at four weeks for musculoskeletal conditions and eight weeks for neuropathic conditions. Secondary outcomes were adverse events and withdrawals due to adverse events. Data synthesis Six double blind placebo controlled trials (656 patients) were pooled for analysis of neuropathic conditions. The relative benefit from topical capsaicin 0.075% compared with placebo was 1.4 (95% confidence interval 1.2 to 1.7) and the number needed to treat was 5.7 (4.0 to 10.0). Three double blind placebo controlled trials (368 patients) were pooled for analysis of musculoskeletal conditions. The relative benefit from topical capsaicin 0.025% or plaster compared with placebo was

Chapter 4 European guidelines for the management of chronic nonspecific low back pain

“…The systematic review (Mason et al 2004) and the one relevant trial it included (Keitel et al 2001) were both of high quality. The additional trial (Frerick et al 2003) was also of high quality.…”

Managing osetoarthritis

“…Reviews of randomised controlled trials found that topical capsaicin is superior to placebo for knee osteoarthritis and reduces pain by 50%. 19,31 In general, a concentration of 0.025% capsaicin was better tolerated than 0.075%. Withdrawal because of an adverse event was more common with capsaicin than with placebo (13% vs 3%).…”

Topical Delivery System for Phytochemicals: Capsaicin and Capsicum Tincture

“…This desensitization is dose-dependent. Capsaicin was found to be very effective in reducing the pain associated with osteoarthritis, diabetic neuropathy, and psoriasis [4,7]. Topical drug application to treat arthritic pain is thought to deliver high local drug concentration with a reduced risk of systemic side effects.…”