TOPICAL CAPSAICIN AS AN ADJUVANT ANALGESIC

Topical capsaicin has been studied in a variety of conditions by uncon trolled and controlled trials. It is attractive because it is a simple , safe treatment. Although these studies suggest an analgesic effect, even placebo-controlled trials have been impossible to blind due to th e burning sensation induced by the capsaicin. A high placebo response rate in the controlled trials is an interesting observation and may ac count for the apparent salutary effect reported in the studies lacking a control. A careful scrutiny of the results of these trials to date as well as clinical experience indicate at best a modest effect with t he currently available preparations with many patients failing to find relief finding the relief unsatisfactory, or being unable to tolerate the burning sensation. Occasional patients appear to have a very good result, and these unusual cases may not be reflected by clinical tria ls. Topical capsaicin is generally not satisfactory as a sole therapy for chronic painful conditions, although it may serve as an adjuvant t o other approaches.