Capsaicin

Capsaicin is a potential alternative for osteoarthritis (OA) pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications. Capsaicin may be effective in those who have OA in only one or two joints, such as the knee or hand. Capsaicin may also be tried in combination with oral medications when OA pain relief is not adequate. 

Capsaicin may be used in addition to disease-modifying anti-rheumatic drugs (DMARDs) or biologics to treat the pain of inflammatory arthritis; however, capsaicin is not routinely used in the treatment of inflammatory arthritis.

Capsaicin is found naturally in hot peppers and is available in topical creams that may be applied directly to the skin over a joint to help lessen the pain of osteoarthritis (OA). Capsaicin is a potential alternative for OA pain not relieved with acetaminophen or for people who cannot tolerate or are reluctant to use oral medications. Capsaicin may be effective in those who have OA in only one or two joints, such as the knee or hand. Capsaicin may also be tried in combination with oral medications when OA pain relief is not adequate.

Capsaicin may be used in addition to disease-modifying anti-rheumatic drugs (DMARDs) or biologics to treat the pain of inflammatory arthritis; however, capsaicin is not routinely used in the treatment of inflammatory arthritis.

Apply sparingly three or four times daily and massage into the affected area.

Capsaicin works by reducing substance P, which plays a role in transmitting pain signals in the body. 

Capsaicin does not provide immediate relief to pain; pain relief may take up to two weeks with daily administration. Maximal effect can take up to four weeks.

Do not use capsaicin topical preparations if you have had a previous allergic reaction to the medication. Capsaicin should not be used on raw, broken or irritated skin.

Capsaicin products are for external use only. If rash occurs, discontinue use. If condition worsens or symptoms persist, discontinue use and contact your healthcare provider.

Avoid contact with eyes. After application, wash hands thoroughly to prevent spreading the product to eyes and mouth. Flush with water if contact does occur. 

The application of external heat, such as an electric heating pad, a hot water bottle or sweating through exercise, may result in excessive skin irritation or burn.

Skin irritation, local burning, stinging or redness may be most prominent during the first week of treatment. These side effects often prevent long-term use.

Apply topical capsaicin products as recommended and contact your healthcare provider if you have any concerns while using the medication.  

Skin irritation diminishes or disappears with continued use at the recommended dose. If capsaicin is applied less frequently than recommended or used intermittently, the burning effect may persist.

On occasion, you may need blood work while using topical capsaicin. Your healthcare provider may meet with you regularly to ensure that your pain is adequately controlled.

Store this medication at room temperature (15 to 30 degrees Celsius) and keep it out of reach of children.