title: Topical capsaicin for chronic neck pain. A pilot study.
abstract: 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 effect.
authors.affiliation: Physical Medicine and Rehabilitation Service, Brooke Army Medical Center, San Antonio, Texas.
authors.forename: B J
authors.initials: BJ
authors.lastname: Mathias
authors.forename: T R
authors.initials: TR
authors.lastname: Dillingham
authors.forename: D N
authors.initials: DN
authors.lastname: Zeigler
authors.forename: A S
authors.initials: AS
authors.lastname: Chang
authors.forename: P V
authors.initials: PV
authors.lastname: Belandres
mesh_terms: D000287:Administration, Topical; D000704:Analysis of Variance; D002211:Capsaicin / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy; D006801:Humans; D008297:Male; D009209:Myofascial Pain Syndromes / Q000188:drug therapy; D009333:Neck; D009619:Nociceptors / Q000502:physiology*; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D010865:Pilot Projects; D011446:Prospective Studies; D013373:Substance P / Q000378:metabolism*
chemical_list: D013373:Substance P; D002211:Capsaicin