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Thread: Capsaicin - 10 Things You Should Know

  1. #1
    Veteran Member Katee's Avatar
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    Default Capsaicin - 10 Things You Should Know

    Topical Cream Relieves Arthritis Pain
    By Carol Eustice, About.com Guide
    Updated March 04, 2009

    Capsaicin is an ingredient in many topical skin preparations used to relieve pain. Capsaicin is available as a cream, ointment, stick, pad, gel, liquid, or lotion. It is marketed under many brand names including Zostrix, Icy Hot Arthritis Therapy, Capsagel, and Arthricare for Women.

    Here, 10 things you should know about capsaicin:

    1 - Capsaicin is the active component of chili peppers.
    Capsaicin is actually an irritant to humans, producing a burning sensation in any tissue it touches. Capsaicin works by depleting or interfering with substance P, a chemical involved in transmitting pain impulses to the brain. The properties of capsaicin make it an option for relieving pain associated with osteoarthritis, rheumatoid arthritis, and diabetic neuropathy. Capsaicin is used to relieve muscle pain, joint pain, or nerve pain.

    2 - Capsaicin is available over the counter.
    You do not need a prescription for capsaicin from your doctor. You can find products containing capsaicin in your drugstore for over-the-counter purchase. You should follow the directions given by your doctor or the directions on the label (there are different dosages or strengths of capsaicin available). For pain relief, capsaicin is usually used 3 or 4 times a day. You should rub the capsaicin cream or gel into the painful area until no more cream is visible on the skin.
    Wash hands thoroughly after applying capsaicin to other areas of the body. If the capsaicin was applied for hand pain, however, wash your hands after 30 minutes.

    3 - Don't use extra doses of capsaicin.
    Stick to the directions, but if you should inadvertently miss a dose, use it as soon as you remember -- unless it's close to the time of the next dose.

    4 - Capsaicin has no known drug interactions.
    Though there are no recognized drug interactions with capsaicin, ask your doctor to be sure that you can use capsaicin, and continue to take your current medications. It's important to inform your doctor about any products you are using.

    5 - Capsaicin may cause a burning sensation.
    You will likely experience a warm, burning, stinging sensation when you begin using capsaicin. The sensation, which is expected when beginning use, may actually continue for 2 to 4 weeks. The sensation should lessen the longer you use capsaicin. Reducing the number of daily doses of capsaicin will not reduce the sensation, but it may reduce the pain relief achieved.

    6 - Arthritis pain relief is not immediate.
    Even with regular use of capsaicin, arthritis pain relief will take some time. Pain relief from arthritis typically is evident 1 to 2 weeks after starting capsaicin. To prevent pain from returning, capsaicin must be continued. However, if pain is not better after using capsaicin for 3 or 4 weeks, talk to your doctor. It may not be worth it to continue.

    7 - Capsaicin must be handled with care.
    Be aware of what can happen if you get capsaicin in your eyes or on other sensitive body parts because of the burning sensation it causes. If capsaicin gets in your eyes, immediately flush your eyes with water. To rid other sensitive areas of capsaicin and the burning feeling, wash the areas with warm soapy water. Keep capsaicin out of reach of children.

    8 - Some people should not use capsaicin.
    There are warnings about using capsaicin under certain circumstances. Before using capsaicin, tell your doctor about:
    • broken skin
    • skin irritation
    • previous allergic reactions to capsaicin, hot peppers, other drugs, dyes, foods, preservatives
    • breastfeeding
    • pregnancy or current attempts to become pregnant
    Also, be aware that capsaicin should not be used by children under 2 years of age.

    9 - Research supports use of capsaicin for osteoarthritis and rheumatoid arthritis.
    A study from 1991 involved 70 osteoarthritis patients and 31 rheumatoid arthritis patients. Patients were instructed to apply 0.025% capsaicin or placebo to painful knees, four times a day. Results revealed that 80% of patients treated with capsaicin experienced pain reduction following two weeks of treatment.

    10 - Research also supports the use of capsaicin for osteoarthritis of the hands.
    Capsaicin 0.075% was evaluated for osteoarthritis and rheumatoid arthritis in a 4-week study, published in 1992. All of the study participants had significant hand pain and applied capsaicin to their hands 4 times daily. It was found that capsaicin reduced tenderness and pain in osteoarthritis of the hand patients, but not rheumatoid arthritis patients when compared to placebo.

    http://osteoarthritis.about.com/od/p.../capsaicin.htm

    I'm a big advocate of capsaicin cream. i know i've posted about this before. Capsaicin cream is good on muscle aches and sprains/strains as well as joint pain. I came across this article when doing a search.

    However, i am not comfortable with their recommendation of a cream with .075% capsaicin content. They seem to have fallen prey to "if a little is good, more is better" thinking. My experience is that a cream at this content will be unbearably hot for many, probably most, people.

    The highest dose i recommend (with the exception of for heart issues posted elsewhere here at HH) is .035%. You may need to do several days of "loading dose" of the four times a day recommended in this article, but after about a week using it twice a day should bring relief.

    My favorite form of this cream is in Boswellin Cream; its capsaicin content is .025%. This won't be appropriate for everyone as it contains methyl salicylate made from wintergreen. If scents are an issue, you may not be able to use this formulation. I do find that the scent dissipates before long, but some folks wouldn't be able to tolerate it at all.

    I am only familiar with a couple of the creams (mentioned at the beginning of this article), but the commercially prepared ones sold in the pharmacies (which are also much more expensive than the Boswellin Cream) are unscented. You will have to check the ingredients list to see what else is added.

    Also, i find their recommendation to wash your hands but to wait half an hour is irresponsible. This cream is highly skin permeable, and washing your hands after half an hour will do NOTHING because the active ingredient will already be absorbed into your skin/fingertips. Following this recommendation, every time you touch your eyes or other mucus membranes, you will be touching those sensitive areas with the cream, which will burn and be very uncomfortable.

    I generally apply this cream to large areas, like my leg (or the back of my hands) with my wrists. The palms of your hands will almost certainly never need to have an application, applying it to the back of your hands is the most effective for pain in the hands. Apply some to your wrist and use it to work in the cream.

    If this isn't practical for other areas of the body, then use gloves or a plastic baggie for the application. You really do not want this stuff on your fingertips or palms!

    Number Six is very important!

    I've a large number of success stories from using this cream.
    Briefly, my own: I have a childhood injury that causes my right leg to rotate laterally. Over time this has created tight muscles and my right IT band is very tight. This in turn has created knee pain. I was in so much pain a couple of years ago that it was difficult to function. I began using the Boswellin Cream about 3 times a day. After a couple of days the pain was greatly reduced. I decreased usage to twice a day, in the morning and before bed at night. (I was also doing stretching exercises to help with these areas.)

    Within a couple weeks, the pain was undetectable if i used this regularly, but would return if i missed a few doses. Within a couple of months, i was able to stop using this and return to normal (for me) functioning. However, that pain will flare from time to time. Since that regular usage a couple of years ago, it only takes a couple of doses before the pain resolves itself.

    Thursday this week i was in quite a lot of pain again. I applied one dose to my leg that night at bedtime, and the pain has not returned. After regular use, it appears the body "remembers" and responds to this very well.

    Also, my grandma used to use this on a couple of arthritic joints on her hand. After regular usage, the swelling and inflammation was visibly reduced when this cream was applied.

    I'm very impressed with this cream/compound, and most people i know who have used it have had a positive result.
    Last edited by Islander; 12-18-10 at 03:53 PM.

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    Veteran Member Reesacat's Avatar
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    Default Re: Capsaicin - 10 Things You Should Know

    Thanks, Katee! I had tried a stronger concentration capsaicin cream than you recommend and had quite painful burning/skin irritation. I was hesitant to try another one, but your experience and recommendations make sense.

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    Veteran Member mellowsong's Avatar
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    Default Re: Capsaicin - 10 Things You Should Know

    Katee, I have no idea what strength cream I used when I had my horrible reaction as it was years ago, however, I think I want to try the Boswellin Cream you are suggesting. Thanks.

    Just an FYI, if you were to get the cream in your eyes or other sensitive areas or you were reacting negatively to it, milk will do a much better job of stopping the burn than soap and water. You can flush your eyes with the milk first.

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    Veteran Member Katee's Avatar
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    Default Re: Capsaicin - 10 Things You Should Know

    Update on this post:

    Since some of my clients can't tolerate scent and the Boswellin cream i recommend has Methyl Salicylate from wintergreen, i wanted to know what is available at the regular pharmacy these days.

    I stopped by CVS last night. I know that the creams they carry that have capsaicin are unscented. They had both Capzasin and Zostrix on the shelves, both in high potency formulas. They had nothing with a formula less than .075%. Keep in mind that the most i recommend is .035%, and my preferred choice is .025%. The other formulas they had were .1% and .15% - the last is SIX TIMES my recommended dose.

    The ingredients in the Zostrix cream (besides the capsaicin) are: Benzyl Alcohol, Cetearyl Alcohol, Glyceryl Monostearate, Isopropyl Myristate, PEG 100 Stearate, Water (Purified), Sorbitol Solution, White Petrolatum.

    Zostrix was about $19 for 2 oz (Boswellin cream, by comparison, is about $6-10 for 4 oz).

    That said, if you really cannot tolerate the scent of the Boswellin cream, you probably can tolerate Zostrix - but do not expect to be able to pick it up at your local pharmacy. They do not carry a cream that has a safe dose. I did find it online at original potency - .025%.

    I really can't say enough about this
    capsaicin cream (at original potency). It is really a miracle worker for joint and muscle pain.






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    Veteran Member mellowsong's Avatar
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    Default Re: Capsaicin - 10 Things You Should Know

    Thanks Katee...surprisingly, I can tolerate menthol, wintergreen etc unless it is extremely strong. While the ingredients in the Zostrix are not good, if you wanted to, you could probably use 2/3 coconut oil and 1/3 of the 0.75% Zostrix to get to the dose Katee recommends.

  6. #6
    Pinkpajamas
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    Default Re: Capsaicin - 10 Things You Should Know

    I tried Capzasin cream for the first time yesterday after suffering for a year with terrible burning nerve pain. After two applications I was pain free. This has been a life saver for me after many many prescriptions failed to do anything. My only regret is not finding it sooner.

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    Veteran Member Reesacat's Avatar
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    Default Re: Capsaicin - 10 Things You Should Know

    Welcome, Pinkpajamas! I am so glad the Capsaicin cream helped you. We have a New Member's section in the forum — feel free to introduce yourself.

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