TOPICAL CAPSAICIN FOR CHRONIC NECK PAIN - A PILOT-STUDY

Substance P is thought to be the principle neurotransmitter of nocicep tive impulses in type C sensory neurons. Prolonged repeated applicatio ns of capsaicin cream depletes the sensory C-fibers of substance P. In an open-labeled prospective pilot study, 23 patients with chronic nec k pain (greater than 3 mo) completed the study. Patients applied topic al capsaicin (0.025%) cream four times a day to painful areas in the n eck and shoulder girdle; for a 5-wk treatment period. One patient drop ped out because of intolerable burning. Statistically significant impr ovement was obtained in two primary outcome variables, the visual anal og pain scale (P = 0.00013) and the pain relief scale (P = 0.002). Pai red t tests failed to show a significant improvement in the McGill Pai n Questionnaire. This study demonstrated that topically applied capsai cin cream may decrease subjective neck pain. A double-blind, placebo-c ontrolled trial is needed to confirm this treatment effect.