Topical capsaicin for chronic neck pain. A pilot study

Substance P is thought to be the principle neurotransmitter of
nociceptive impulses in type C sensory neurons. Prolonged
repeated applications of capsaicin cream depletes the sensory
C-fibers of substance P. In an open-labeled prospective pilot
study, 23 patients with chronic neck pain (greater than 3 mo)
completed the study. Patients applied topical capsaicin
(0.025%) cream four times a day to painful areas in the neck
and shoulder girdle for a 5-wk treatment period. One patient
dropped out because of intolerable burning. Statistically
significant improvement was obtained in two primary outcome
variables, the visual analog pain scale (P = 0.00013) and the
pain relief scale (P = 0.002). Paired t tests failed to show a
significant improvement in the McGill Pain Questionnaire. This
study demonstrated that topically applied capsaicin cream may
decrease subjective neck pain. A double-blind,
placebo-controlled trial is needed to confirm this treatment

Mathias BJ, Dillingham TR, Zeigler DN, Chang AS, Belandres PV

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