A Case for Capsaicin
Complex regional pain syndrome type one (CRPS I) is a serious condition that has often eluded doctors' efforts to solve it. The syndrome involves pain and other factors, such as swelling or blood flow changes in the skin, after an injury. The pain often seems out-of-portion to the medical condition and is not easily explained. No particular treatment has been widely accepted, though many combinations of medicine, physical therapy, and psychological counseling have been used.
One recent case of CRPS I was successfully solved with the help of capsaicin. Capsaicin comes from red hot chili peppers and is applied directly on the skin. It is a common ingredient in pain relievers for osteoarthritis and neuralgia (sharp nerve pain). However, capsaicin has not been studied as a treatment for CRPS I.
The patient was a 26-year-old man who had been run over by a fork-lift truck. His left arm had been amputated, and his left leg suffered a tricky fracture. After three months, the fracture hadn't healed. The leg was casted, and the patient was told to avoid putting weight on the leg. After being in the cast for six weeks, the patient's foot and foreleg were swollen, warm to the touch, and painful enough to limit walking. The patient was diagnosed with CRPS I.
Capsaicin (.075 percent) was applied twice per day. The patient was permitted to start gradually putting his foot down with more pressure while he was up and walking. His treatment sessions were closely monitored. If he had too much pain or showed signs of swelling or nerve irritation, he was required to immediately reduce the pressure he was placing on his foot. No other treatments were given for the CRPS I.
After three weeks of these treatments, the man's pain and swelling were decreased. After six weeks, pain and swelling were gone, and other factors in his condition were improved as well. He was able to leave the hospital.
This result led the doctor on the case to suggest that capsaicin might warrant further study for use against CRPS I. Used for this challenging medical condition, capsaicin may help patients better tolerate physical therapy treatments, lower their pain sensitivity, and keep them from having long-term problems.
Gerard M. Ribbers, MD, et al. Complex Regional Pain Syndrome Type I Treated with Topical Capsaicin: A Case Report. In Archives of Physical Medicine and Rehabilitation. June 2001. Vol. 82. No. 6. Pp. 851-852.