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Pain Management

Topical Capsaicin

Capsaicin is an active alkaloid in hot peppers. It has been successfully used to reduce pain in herpes zoster, diabetic neuropathy and post-mastectomy pain syndrome (Sandford & Benes 2000). It works as an inhibitor of substance P.

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Methods Outcome
Sandford & Benes 2000USA

Case Series


Population: SCI: Age=18-66 yr; Gender: males=6, females=2; Level of injury: C6-L5; Severity of injury: complete=4, incomplete=4; Cause of injury: MVA=3, GSW=3, fall=1, aneurysm repair=1; Type of pain=nociceptive (radicular).Treatment: Patients who underwent topical capsaicin therapy to reduce pain were retrospectively reviewed.

Outcome Measures: Reduction in pain.

1.     Patients showed improvement in pain in 1-2 wk of topical capsaicin therapy.2.     Two patients showed long-term efficacy for over 2 yr.


Topical capsaicin was used to treat radicular post-SCI pain for 1-2 weeks (Sandford & Benes 2000). Patients showed improvement in pain and 2 of the 8 patients were still improved for over two years.


There is level 4 evidence (from one case series study: Sandford & Benes 2000) that topical capsaicin reduces post-SCI radicular pain.

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