Topical treatment of chronic low back pain with a capsicum plaster

Abstract

The efficacy and tolerance of a capsicum plaster in non-specific low back pain was investigated in a double-blind, randomised, placebo-controlled multicentre parallel group study. A total of 320 patients were randomly assigned to two groups of n=160 subjects treated by the active or the placebo plaster. The main outcome measures used were a compound pain subscore of the Arhus low back rating scale (continuous variable), and a response criterion of a reduction in pain subscore=30% from baseline to final assessment (secondary, non-continuous variable). In addition, the partial pain scores, disability and mobility restriction subscores, the total score of the Arhus low back rating scale, the global evaluation of efficacy by investigator and patient, adverse events, a patient questionnaire on use of the plaster, and an evaluation of tolerance by investigator and patient were obtained. After 3 weeks treatment with capsicum and placebo plaster respectively, the compound pain subscore was reduced by 42% (capsicum) and 31% (placebo) from values on entry. Responder rate was 67% versus 49% (p=0.002). The investigators rated efficacy as "excellent" or "good" by 74% and 36%; the patient's efficacy rating "symptomfree" or "improved" reached 82% and 50%. Adverse local drug reactions were found in 12 patients (7.5%) on capsicum and 5 (3.1%) on placebo. No systemic side-effects were observed. The superiority of the treatment of chronic non-specific low back pain with capsicum plaster compared to placebo was clinically relevant and highly statistically significant. The capsicum plaster offers a genuine alternative in the treatment of non-specific low back pain.

Pharmacotherapy for Chronic Low Back Pain

“…These results were similar to those obtained with a similar capsaicin 8% patch in a similarly designed trial (Keitel et al, 2001). The most common adverse events were application site warmth or itching, although inflammatory contact eczema, urticaria, small hemorrhagic spots, vesiculation, and dermatitis have been reported in a small number of patients (Frerick et al, 2003;Keitel et al, 2001). Given modest efficacy and generally good tolerability, the capsaicin 8% patch may only be useful as adjunctive therapy or as monotherapy in a small subgroup of patients.…”

“…In a double-blind, randomized trial, 320 patients with chronic low back pain were assigned to apply the capsaicin 8% patch or placebo patch once daily for 3 weeks (Frerick et al, 2003). …”

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

“…individuals in whom pain was reduced by at least 30% of the baseline value) was also significantly higher for the capsicum group (60.8% vs 42.1% in the placebo group; p = 0.0219). A second study from the same group of authors, which involved 320 patients with chronic, nonspecific back pain who were randomly assigned to capsicum plaster (N=160) or placebo plaster (N=160), produced similar results: after three weeks treatment, the compound pain sub-score was reduced by 42% and 31% (p=0.002) for capsicum and placebo plasters respectively, and responder rate was 67% versus 49% (p=0.002) respectively (Frerick et al 2003). The authors claimed that the superiority of the capsicum plaster was highly statistically significant and clinically relevant.…”

Market-Based Instruments for the Conservation of Underutilized Crops: In-Store Experimental Auction of Native Chili Products in Bolivia

“…In situ conservation is formally defined by FAO [9] as "the conservation of ecosystems and natural habitats and the maintenance and recovery of viable populations of species in their natural surroundings and, in the case of domesticated or cultivated species, in the surroundings where they have developed their distinctive properties." Native chili varieties are rich in health-related compounds, such as vitamins and antioxidants [10] and capsaicin, a component used for medicinal applications [11,12]. The great variation in the genetic resources of native chilies has yet to be fully taken advantage of by society [13,14].…”