15 februari 2015: Bron: Sci. Signal., 10 February 2015 Vol. 8, Issue 363, p. ra15 DOI: 10.1126/scisignal.2005667

Wetenschappers hebben ontdekt waarom capsaicin, stofje dat Chilipepers heet maakt, pijnstillend werkt. Capsaicin blijkt uitstekend te werken als pijnstiller van neuralgia (pijn door beschadigde zenuwen) neuropathie (zenuwpijnen vaak ook veroorzaakt door bepaalde chemo's), spierpijnen en gewrichtspijnen (reuma, atrose).

Voor leken zal het volgende artikel niet goed te begrijpen zijn, maar wat let u eens wat meer Chilipepers te eten bij uw gewone maaltijd of Capsaicinzalf te gaan gebruiken? Of bestel capsaicin - rode peper capsules? 

https://www.google.nl/?gfe_rd=cr&ei=hMDhVISYK8SwOvq4gMgB&gws_rd=ssl#q=capsaicin+capsules

Chili peppers

En voor artsen, wetenschappers en medisch geschoolden is het interessant deze studie eens te lezen: Activation of TRPV1 channels inhibits mechanosensitive Piezo channel activity by depleting membrane phosphoinositides Het abstract staat onderaan dit artikel.

Nog interessanter is het verklarende artikel in The Scientist: How Hot Peppers Can Ease Pain. Researchers uncover one way capsaicin—the spicy compound found in chili peppers—provides pain relief.

Citaat:

The initial pain-dulling sensation occurs when capsaicin activates heat-sensing transient receptor potential vanilloid 1 (TRPV1) ion channels on sensory neurons. Prolonged stimulation with the compound results in desensitization of these neurons. “This is one of the underlying mechanisms of capsaicin’s numbing effect, but TRPV1 is a heat sensor, so how it affects mechanical pain was not known,” said Tibor Rohacs, an associate professor of pharmacology and physiology at Rutgers New Jersey Medical School, who led the study.

Rohacs and his colleagues uncovered a link between the heat-stimulating function of capsaicin and its ability to relieve mechanical pain including neuralgia (pain from damaged nerves), neuropathy, and muscle and joint pain. Capsaicin’s activation of TRPV1 ion channels in turns inhibits mechanical force-sensing ion channels called Piezo1 and 2 by depleting phospholipid signaling molecules, phosphoinositides, in the cell membrane.

In 2013 publiceerden onderzoekers een reviewstudie naar effecten van hoge concentratie capsaicinzalf met mooie resultaten: Topical capsaicin (high concentration) for chronic neuropathic pain in adults 

AUTHORS' CONCLUSIONS:

High-concentration topical capsaicin used to treat postherpetic neuralgia and HIV-neuropathy generates more participants with high levels of pain relief than does control treatment using a much lower concentration of capsaicin. The additional proportion who benefit over control is not large, but for those who do obtain high levels of pain relief there are additional improvements in sleep, fatigue, depression and an improved quality of life. High-concentration topical capsaicin is therefore similar to other therapies for chronic pain. In this case, the high cost of single and repeated applications suggest that high-concentration topical capsaicin is likely to be used when other available therapies have failed, and that it should probably not be used repeatedly without substantial documented pain relief. Even when efficacy is established, there are unknown risks, especially on epidermal innervation, of repeated application of long periods.

Capsaicin grafiek bij review studie

The Cochane Library publiceerde in 2004 een review van tot dan gepubliceerde placebo gecontroleerde studies naar capsaicinzalf. Dus niet naar capsaicin uit Chilipepers: Systematic review of topical capsaicin for the treatment of chronic pain 

Conclusie daaruit is dat vergeleken met placebo het enig effect gaf (nog altijd 35% vermindering van de pijn tegenover 25% bij placebo) maar dat capsaicinzalf niet wordt aanbevolen. Maar als je de referentielijst bekijkt, zie onderaan artikel, dan lijkt capsaicinzalf toch wel behoorlijk goed te kunnen werken.En afgaande op recente studie lijkt het eten van Chilipepers zeker de moeite waard te proberen.

capsaicin grafiek

Abstracten staan onderaan artikel.

10 april 2006: Bron: J Clin Oncol. 1997 Aug;15(8):2974-80.

Capsaicin zalf, (het stofje capsaicin zit in rode pepers en maakt deze dat pepers als heet/scherp worden ervaren) voorkomt hoog significant neurologische pijn (zenuwpijnen) bij kankerpatiënten die geopereerd worden aan hun kanker. Wij vertaalden voor u het abstact van deze studie, die al in 1997 !!!!! werd gepubliceerd. Zie ook positief effect van gebruik van capsaicin zelf bij prostaatkanker: Capsaicin is een stofje dat veel voorkomt in rode pepers bevordert apoptosis = zelfdoding van prostaatkankercellen.

Fase III placebo-gecontroleerde trial van capsaicin zalf in de behandeling van operatieve neuropathische pijn (zenuwpijn) bij kankerpatiënten.

Ellison N, Loprinzi CL, Kugler J, Hatfield AK, Miser A, Sloan JA, Wender DB, Rowland KM, Molina R, Cascino TL, Vukov AM, Dhaliwal HS, Ghosh C.
Geisinger Clinical Oncology Program, Danville, PA, USA.

DOEL: Een minderheid van kanker overlevenden ontwikkelen postoperatieve (na de operatie) en op lange termijn zenuwpijn. Gebaseerd op het bewijs dat capsaicin, het scherpe/hete ingrediënt in hot chili pepers, nuttig zou kunnen zijn in het behandelen van zenuwpijn, ontwikkelden we deze klinische trial.

PATIENTEN EN METHODEN: 99 geschikte patiënten met postoperatieve zenuwpijn werden toegelaten tot deze studie. Na stratificatie (verdeling in groepen), werden de patiënten 8 weken lang capsaicin zalf gegeven (0.075% capsaicin bevattend) gevolgd door 8 weken van een indentieke placebo zalf, of omgekeerd. De capsaicin/placebo zalf werd vier keer per dag op de pijnlijke plekken gesmeerd. Evaluatie van de behandeling werd uitgevoerd door middel van wekelijkse vragenlijsten die door de patiënten werden ingevuld.

RESULTATEN: Gedurende de eerste 8-weken periode, de capsaicin-zalf toediening werd geassocieerd met substantieel meer huidverbranding, huid roodheid en hoesten (P < .0001 voor lek). Echter de behandeling met capsaicin werd net zo vaak gestopt door de weigering van de patiënt of toxiciteit dan in de placebogroep. De capsaicin zalfgroep had substantieel (statistich significant) meer pijnverlichting (P = .01) na de eerste 8 weken, met een gemiddelde pijnverlichting van 53% tegenover 17%. Na completering van de 16 weken durende studie, werd aan de patiënten gevraagd welke behandelingsperiode het meest profijtelkjik was. Van de reagerende patiënten koos 60% de capsaicin periode, 18% koos de placebo periode, en 22% koos geen enkele periode (P = .001).

CONCLUSIE: Een uitwendige capsaicin zalf vermindert postoperatieve zenuwpijn en ondanks enkele bijwerkingen werd deze capsaicin zalf drie keer zo vaak verkozen door de patiënten boven de placebozalf.

Publication Types:
Clinical Trial
Clinical Trial, Phase III
Randomized Controlled Trial

PMID: 9256142 [PubMed - indexed for MEDLINE]

J Clin Oncol. 1997 Aug;15(8):2974-80

Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients.

Ellison N, Loprinzi CL, Kugler J, Hatfield AK, Miser A, Sloan JA, Wender DB, Rowland KM, Molina R, Cascino TL, Vukov AM, Dhaliwal HS, Ghosh C.
Geisinger Clinical Oncology Program, Danville, PA, USA.

PURPOSE: A minority of cancer survivors develops long-term postsurgical neuropathic pain. Based on evidence that capsaicin, the pungent ingredient in hot chili peppers, might be useful for treating neuropathic pain, we developed the present clinical trial.

PATIENTS AND METHODS: Ninety-nine assessable patients with postsurgical neuropathic pain were entered onto this study. After stratification, patients were to receive 8 weeks of a 0.075% capsaicin cream followed by 8 weeks of an identical-appearing placebo cream, or vice versa. A capsaicin/placebo cream was to be applied to the painful site four times daily. Treatment evaluation was performed by patient-completed weekly questionnaires.

RESULTS: During the first 8-week study period, the capsaicin-cream arm was associated with substantially more skin burning, skin redness, and coughing (P < .0001 for each). Nonetheless, treatment was stopped for patient refusal or toxicity just as often while patients were receiving the placebo as compared with the capsaicin. The capsaicin cream arm had substantially more pain relief (P = .01) after the first 8 weeks, with an average pain reduction of 53% versus 17%. On completion of the 16-week study period, patients were asked which treatment period was most beneficial. Of the responding patients, 60% chose the capsaicin arm, 18% chose the placebo arm, and 22% chose neither (P = .001).

CONCLUSION: A topical capsaicin cream decreases postsurgical neuropathic pain and, despite some toxicities, is preferred by patients over a placebo by a three-to-one margin among those expressing a preference.

Publication Types:
Clinical Trial
Clinical Trial, Phase III
Randomized Controlled Trial

PMID: 9256142 [PubMed - indexed for MEDLINE]

How Hot Peppers Can Ease Pain Researchers uncover one way capsaicin—the spicy compound found in chili peppers—provides pain relief.

Sci. Signal., 10 February 2015
Vol. 8, Issue 363, p. ra15
DOI: 10.1126/scisignal.2005667

Activation of TRPV1 channels inhibits mechanosensitive Piezo channel activity by depleting membrane phosphoinositides

  1. Istvan Borbiro,
  2. Doreen Badheka, and
  3. Tibor Rohacs*

- Author Affiliations

  1. Department of Pharmacology and Physiology, Rutgers New Jersey Medical School, Newark, NJ 07103, USA.
  1. *Corresponding author. E-mail: tibor.rohacs@rutgers.edu

Abstract

Capsaicin is an activator of the heat-sensitive TRPV1 (transient receptor potential vanilloid 1) ion channels and has been used as a local analgesic. We found that activation of TRPV1 channels with capsaicin either in dorsal root ganglion neurons or in a heterologous expression system inhibited the mechanosensitive Piezo1 and Piezo2 channels by depleting phosphatidylinositol 4,5-bisphosphate [PI(4,5)P2] and its precursor phosphatidylinositol 4-phosphate [PI(4)P] from the plasma membrane through Ca2+-induced phospholipase Cδ (PLCδ) activation. Experiments with chemically inducible phosphoinositide phosphatases and receptor-induced activation of PLCβ indicated that inhibition of Piezo channels required depletion of both PI(4)P and PI(4,5)P2. The mechanically activated current amplitudes decreased substantially in the excised inside-out configuration, where the membrane patch containing Piezo1 channels is removed from the cell. PI(4,5)P2 and PI(4)P applied to these excised patches inhibited this decrease. Thus, we concluded that Piezo channel activity requires the presence of phosphoinositides, and the combined depletion of PI(4,5)P2 and PI(4)P reduces channel activity. In addition to revealing a role for distinct membrane lipids in mechanosensitive ion channel regulation, these data suggest that inhibition of Piezo2 channels may contribute to the analgesic effect of capsaicin.

Citation:

I. Borbiro, D. Badheka, and T. Rohacs, Activation of TRPV1 channels inhibits mechanosensitive Piezo channel activity by depleting membrane phosphoinositides. Sci. Signal. 8, ra15 (2015).
Full text: >>>>>>

Although topically applied capsaicin has moderate to poor efficacy in the treatment of chronic musculoskeletal or neuropathic pain, it may be useful as an adjunct or sole therapy for a small number of patients who are unresponsive to, or intolerant of, other treatments.

BMJ. 2004 Apr 24; 328(7446): 991.
PMCID: PMC404499

Systematic review of topical capsaicin for the treatment of chronic pain

Lorna Mason, research associate,1 R Andrew Moore, director of research,1 Sheena Derry, senior researcher,1 Jayne E Edwards, senior researcher,1 and Henry J McQuay, professor of pain relief1

Abstract

Objective To determine the efficacy and safety of topically applied capsaicin for chronic pain from neuropathic or musculoskeletal disorders.

Data sources Cochrane Library, Medline, Embase, PubMed, an in-house database, and contact with manufacturers of topical capsaicin.

Study selection Randomised controlled trials comparing topically applied capsaicin with placebo or another treatment in adults with chronic pain.

Data extraction Primary outcome was dichotomous information for the number of patients with about a 50% reduction in pain. Outcomes were extracted at four weeks for musculoskeletal conditions and eight weeks for neuropathic conditions. Secondary outcomes were adverse events and withdrawals due to adverse events.

Data synthesis Six double blind placebo controlled trials (656 patients) were pooled for analysis of neuropathic conditions. The relative benefit from topical capsaicin 0.075% compared with placebo was 1.4 (95% confidence interval 1.2 to 1.7) and the number needed to treat was 5.7 (4.0 to 10.0). Three double blind placebo controlled trials (368 patients) were pooled for analysis of musculoskeletal conditions. The relative benefit from topical capsaicin 0.025% or plaster compared with placebo was 1.5 (1.1 to 2.0) and the number needed to treat was 8.1 (4.6 to 34). Around one third of patients experienced local adverse events with capsaicin, which would not have been the case with placebo.

Conclusions Although topically applied capsaicin has moderate to poor efficacy in the treatment of chronic musculoskeletal or neuropathic pain, it may be useful as an adjunct or sole therapy for a small number of patients who are unresponsive to, or intolerant of, other treatments.

Read the full text:>>>>>>>>>

References for topical capsaicin in painrelief

1. Nolano M, Simone DA, Wendelschafer-Crabb G, Johnson T, Hazen E, Kennedy WR. Topical capsaicin in humans: parallel loss of epidermal nerve fibres and pain sensation. Pain 1999;81: 135-45.

2. Reynolds JEF ed. Martindale: the extra pharmacopoeia. 32nd edn. London: Royal Pharmaceutical Society, 1999.

3. British Medical Association. Royal Pharmaceutical Society of Great Britain. British national formulary. London: BMA, RPS, 2003. (No 45.)

4. Prescription cost analysis. England 2002. Department of Health, London. 2003 ISBN 1 84182 710 X. www.doh.gov.uk/prescriptionstatistics/index.htm

5. Rains C, Bryson HM. Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs Aging 1995;7: 317-28.

6. Jadad AR, Carroll D, Moore A, McQuay H. Developing a database of published reports of randomised clinical trials in pain research. Pain 1996;66: 239-46.

7. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996;17: 1-12.

8. Smith LA, Oldman AD, McQuay HJ, Moore RA. Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain. Pain 2000;86: 119-32.

9. Moore RA, Tramer MR, Carroll D, Wiffen PJ, McQuay HJ. Quantitative systematic review of topically applied non-steroidal anti-inflammatory drugs. BMJ 1998;316: 333-8. [PMC free article]

10. Cook D, Sackett DL. On the clinically important difference. Ann Intern Med 1992;117: A16-7.

11. Morris JA, Gardner MJ. Calculating confidence intervals for relative risk, odds ratios and standardised ratios and rates. In: Gardner MJ, Altman DG, eds. Statistics with confidence—confidence intervals and statistical guidelines. London: British Medical Journal, 1995: 50-63.

12. Tramer MR, Reynolds DJ, Moore RA, McQuay HJ. Impact of covert duplicate publication on meta-analysis: a case study. BMJ 1997;315: 635-40. [PMC free article]

13. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses. Lancet 1999;354: 1896-900.

14. L'Abbe KA, Detsky AS, O'Rourke K. Meta-analysis in clinical research. Ann Intern Med 1987;107: 224-33.

15. Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. A meta-analysis. Eur J Clin Pharmacol 1994;46: 517-22.

16. The Capsaicin Study Group. Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. Arch Intern Med 1991;151: 2225-9.

17. Chad DA, Aronin N, Lundstrom R, McKeon P, Ross D, Molitch M, et al. Does capsaicin relieve the pain of diabetic neuropathy? Pain 1990;42: 387-8.

18. Deal CL, Schnitzer TJ, Lipstein E, Seibold JR, Stevens RM, Levy MD, et al. Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Ther 1991;13: 383-95.

19. Bernstein JE, Korman NJ, Bickers DR, Dahl MV, Millikan LE. Topical capsaicin treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989;21: 265-70.

20. Watson CP, Evans RJ. The postmastectomy pain syndrome and topical capsaicin: a randomized trial. Pain 1992;51: 375-9.

21. Altman RD, Aven A, Holmburg CE, Pfeifer LM, Sack M, Young GT. Capsaicin cream 0.025% as monotherapy for osteoarthritis: a double-blind study. Semin Arthritis Rheum 1994;23: 25-33.

22. Keitel W, Frerick H, Kuhn U, Schmidt U, Kuhlmann M, Bredehorst A. Capsicum pain plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51: 896-903.

23. Ellison N, Loprinzi CL, Kugler J, Hatfield AK, Miser A, Sloan JA, et al. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients. J Clin Oncol 1997;15: 2974-80.

24. Low PA, Opfer-Gehrking TL, Dyck PJ, Litchy WJ, O'Brien PC. Double-blind, placebo-controlled study of the application of capsaicin cream in chronic distal painful polyneuropathy. Pain 1995;62: 163-8.

25. Watson CP, Tyler KL, Bickers DR, Millikan LE, Smith S, Coleman E. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clin Ther 1993;15: 510-26.

26. Biesbroeck R, Bril V, Hollander P, Kabadi U, Schwartz S, Singh SP, et al. A double-blind comparison of topical capsaicin and oral amitriptyline in painful diabetic neuropathy. Adv Ther 1995;12: 111-20.

27. Schnitzer TJ, Posner M, Lawrence ID. High strength capsaicin cream for osteoarthritis pain: rapid onset of action and improved efficacy with twice daily dosing. J Clin Rheumatol 1995;1: 268-73.

28. Schnitzer T, Morton C, Coker S. Topical capsaicin therapy for osteoarthritis pain: achieving a maintenance regimen. Semin Arthritis Rheum 1994;23: 34-40.

29. Winocur E, Gavish A, Halachmi M, Eli I, Gazit E. Topical application of capsaicin for the treatment of localized pain in the temporomandibular joint area. J Orofac Pain 2000;14: 31-6.

30. McCleane G. Topical application of doxepin hydrochloride, capsaicin and a combination of both produces analgesia in chronic human neuropathic pain: a randomized, double-blind, placebo-controlled study. Br J Clin Pharmacol 2000;49: 574-9. [PMC free article]

31. Paice JA, Ferrans CE, Lashley FR, Shott S, Vizgirda V, Pitrak D. Topical capsaicin in the management of HIV-associated peripheral neuropathy. J Pain Symptom Manage 2000;19: 45-52.

32. Naylor CD, Chen E, Strauss B. Measured enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness? Ann Intern Med 1992;117: 916-21.

33. Moore R, Edwards J, Barden J, McQuay H. Bandolier's little book of pain. Oxford: Oxford University Press, 2003: 238-40.

34. Kalso E, Moore RA. Five easy pieces on evidence-based medicine (2). Eur J Pain 2000;4: 321-4.

35. Song F, Altman DG, Glenny AM, Deeks JJ. Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ 2003;326: 472. [PMC free article]

36. Mason L, Moore RA, Edwards JE, McQuay HJ, Wiffen PJ. Systematic review of efficacy of topical rubefacients containing salicylates for the treatment of acute and chronic pain. BMJ; 2004:doi:10.1136/bmj.38040.607141. [PMC free article]

37. Moore RA, Gavaghan D, Tramer MR, Collins SL, McQuay HJ. Size is everything—large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain 1998;78: 209-16.

38. Gøtzsche PC. Reporting of outcomes in arthritis trials measured on ordinal and interval scales is inadequate in relation to meta-analysis. Ann Rheum Dis 2001;60: 349-52. [PMC free article]

39. Simone DA, Nolano M, Johnson T, Wendelschafer-Crabb G, Kennedy WR. Intradermal injection of capsaicin in humans produces degeneration and subsequent reinnervation of epidermal nerve fibres: correlation with sensory function. J Neurosci 1998;18: 8947-59.

High-concentration topical capsaicin used to treat postherpetic neuralgia and HIV-neuropathy generates more participants with high levels of pain relief than does control treatment using a much lower concentration of capsaicin.

Cochrane Database Syst Rev. 2013 Feb 28;2:CD007393. doi: 10.1002/14651858.CD007393.pub3.

Topical capsaicin (high concentration) for chronic neuropathic pain in adults.

Derry S1, Sven-Rice A, Cole P, Tan T, Moore RA.

Author information

Abstract

BACKGROUND:

Topical creams with capsaicin are used to treat peripheral neuropathic pain. Following application to the skin capsaicin causes enhanced sensitivity, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. High-concentration (8%) capsaicin patches were developed to increase the amount of capsaicin delivered; rapid delivery was thought to improve tolerability because cutaneous nociceptors are 'defunctionalised' quickly. The single application avoids noncompliance. Only the 8% patch formulation of capsaicin is available, with a capsaicin concentration about 100 times greater than conventional creams.High-concentration topical capsaicin is given as a single patch application to the affected part. It must be applied under highly controlled conditions, normally under local anaesthetic, due to the initial intense burning sensation it causes. The benefits are expected to last for about 12 weeks, when another application might be made.

OBJECTIVES:

To review the evidence from controlled trials on the efficacy and tolerability of topically applied, high-concentration (8%) capsaicin in chronic neuropathic pain in adults.

SEARCH METHODS:

We searched CENTRAL, MEDLINE, EMBASE and clinicaltrials.gov to December 2012.

SELECTION CRITERIA:

Randomised, double-blind, placebo-controlled studies of at least six weeks' duration, using topical capsaicin to treat neuropathic pain.

DATA COLLECTION AND ANALYSIS:

Two review authors independently assessed trial quality and validity, and extracted data on numbers of participants with pain relief (clinical improvement) after at least six weeks, and with local skin reactions. We calculated risk ratio and numbers needed to treat to benefit (NNT) and harm (NNH). We sought details of definition of pain relief and specific adverse events.Efficacy outcomes reflecting long-duration pain relief after a single drug application were from the patient global impression of change (PGIC) at specific points, usually eight and 12 weeks. We regarded these outcomes as first-tier evidence. We regarded average pain scores over weeks 2 to 8 and 2 to 12 and the number and/or percentage of participants with pain intensity reduction of at least 30% or at least 50% over baseline as second-tier evidence.

MAIN RESULTS:

We included six studies, involving 2073 participants; they were of generally good reporting quality; the control was 0.04% topical capsaicin to help maintain blinding. Efficacy outcomes were inconsistently reported between studies, however, resulting in analyses for most outcomes being based on less than complete data.Four studies involved 1272 participants with postherpetic neuralgia. All efficacy outcomes were significantly better than control. At both eight and 12 weeks there was a significant benefit for high-concentration over low-concentration topical capsaicin for participants reporting themselves to be much or very much better, with point estimates of the NNTs of 8.8 (95% confidence interval (CI) 5.3 to 26) and 7.0 (95% CI 4.6 to 15) respectively. More participants had average 2 to 8-week and 2 to 12-week pain intensity reductions over baseline of at least 30% and at least 50% with active treatment than control, with NNT values between 10 and 12.Two studies involved 801 participants with painful HIV-neuropathy. In a single study the NNT at 12 weeks for participants to be much or very much better was 5.8 (95% CI 3.8 to 12). Over both studies more participants had average 2 to 12-week pain intensity reductions over baseline of at least 30% with active treatment than control, with an NNT of 11.Local adverse events were common, but not consistently reported. Serious adverse events were no more common with active treatment (4.1%) than control (3.2%). Adverse event withdrawals did not differ between groups, but lack of efficacy withdrawals were somewhat more common with control than active treatment, based on small numbers of events. No deaths were judged to be related to study medication.

AUTHORS' CONCLUSIONS:

High-concentration topical capsaicin used to treat postherpetic neuralgia and HIV-neuropathy generates more participants with high levels of pain relief than does control treatment using a much lower concentration of capsaicin. The additional proportion who benefit over control is not large, but for those who do obtain high levels of pain relief there are additional improvements in sleep, fatigue, depression and an improved quality of life. High-concentration topical capsaicin is therefore similar to other therapies for chronic pain. In this case, the high cost of single and repeated applications suggest that high-concentration topical capsaicin is likely to be used when other available therapies have failed, and that it should probably not be used repeatedly without substantial documented pain relief. Even when efficacy is established, there are unknown risks, especially on epidermal innervation, of repeated application of long periods.

Update of

PMID:
23450576
[PubMed - indexed for MEDLINE]

capsaicin, capsacinzalf, neuropathie, neuralgia, zenuwpijnen, gewrichtspijnen, athrose, reuma, Chilipepers, pijnstilling


Plaats een reactie ...

1 Reactie op "Capsaicin zalf uitwendig aangebracht, vermindert significant neurologische pijn (zenuwpijnen) veroorzaakt door operatieve ingrepen bij kankerpatiënten maar chilipepers met veel capsaicin werken ook goed als pijnstiller."

  • Wilme de Roon :
    02/07/2013
    Op het internet ben ik capsaicinzalf tegen gekomen. In eerste instantie als cayennepeper zalf. Bij mijn apotheek nagevraagd, daar wist wist men in eerste instantie niet wat ik bedoelde. Ik vroeg dit ivm mijn artrose. De apotheker zei dat deze zalf artrose niet genezen kon kon. Maar hij was met mij eens dat het de pijn zou blokkeren. Mijn huisarts kende de zalf ook niet maar heeft het recept uitgeschreven. Ik ben zo benieuwd!
    Comment

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