Capsaicin (CapS) is a topical pain medication that is helpful for some people with arthritis or neuropathic nerve pain. Unfortunately, many people think that is causes more pain than it relieves.
This compound is found in all types of peppers such as habanero and jalapeno peppers. It is responsible for the burning mouth and red face that is associated with eating those peppers.
It is that same burning sensation that makes it helpful for some people with certain types of pain.
There is debate about exactly how and why it helps, and some people question whether or not it really does anything to relieve pain.
Some of the theories about why it works:
•CapS blocks pain by depleting your body’s supply of Substance P.
•The burning sensation triggers the release of endorphins.
•The Gateway theory of pain control.
Image thanks to Hans Braxmeier via Wikimedia Commons
Depletes Substance P
Substance P is a primary neurotransmitter involved in sending the pain signal to your brain.
The constant stimulation by CapS is thought to use up all of the available Substance P which prevents the pain signal from reaching the brain.
Unfortunately, it may take 2 weeks to deplete your Substance P and begin blocking the pain.
The sensation that some people describe as "burning pain" and others describe as "stimulation" triggers the release of endorphins from your central nervous system and your pituitary gland.
Endorphins are those magic little molecules that bind to the same receptors in your brain as morphine. They are produced in response to pain, stress, and strenuous physical exercise.
They can help to relieve pain and produce the "runner's high" that marathon runners talk about.
The Gateway Theory
The Gateway Theory of pain control states that you can only feel one pain or one sensation at a time. The stimulation of some nerves can partially block the sensory input from other nerves.
That is why you rub your hand after slamming it in the door. The sensation of rubbing it blocks the sensation of pain.
The stimulation that you feel from the capsaicin may block your perception of the pain that you are trying to treat.
The people who support the use of CapS talk about the "temporary stimulation" that you feel when you first apply it to your skin. They reported after a short period they feel a sensation of numbness.
The other group complains that the "burning pain" they feel from capsaicin is worse than the pain they were trying to get rid of.
There is always the risk of an allergic reaction anytime you start a new medication but that is not common with OTC CapS.
Some people do experience dermatitis and small blisters with over the counter preparations. Rarely, CapS can cause severe burns.
Formulations that are sold over the counter are generally well tolerated except for the skin "stimulation" discussed above.
There is a stronger preparation available by prescription that is a patch that must be applied in your doctor's office. The response of people to this medication is widely variable and some people find it completely intolerable due to increased pain from the treatment or due to severe skin irritation.
If you are living with pain, especially neuropathic pain, which is not well controlled with other methods CapS may be worth a short term trial. You could try a small amount of one of the over the counter preparations to check your response.
If it helps to block the pain, and does not cause any skin problems or other reactions, you may consider trying to treat a larger area. If you find that over the counter treatments are well tolerated and seem to help control your pain; you could discuss with your doctor a trial of the stronger formulations available by prescription.