Natural Medicines Newsletter

Volume 1, Issue 14, 04/23/2009

Question

Part 2: If the primary mechanism for pain relief is not substance P depletion, as commonly thought, then what is the mechanism by which continued use of topical capsaicin results in pain relief and when does this relief normally begin?

Answer

In part 1, the mechanism by which topical capsaicin initially causes the patient to experience and perceive greater pain or burning prior to the onset of analgesia was discussed.(1) This would obviously make topical capsaicin problematic for some patients.  Unfortunately, topical capsaicin must be consistently applied to the area of desired pain relief at least.........
 
......It is apparent from this series on the mechanism of action of topical capsaicin that capsaicin's analgesic effect undergoes various phases of action on nerve fibers and, unlike any other analgesics, causes initial discomfort before any relevant pain relief is experienced.  If prescribed and used appropriately, this treatment can offer benefits to patients not able to tolerate additional systemic medications due to other comorbidities or medications.  In fact, topical capsaicin is recommended by the American Pain Society as an effective adjunct to chronic pain management in patients with arthritic pain.(12) 
 
Other keywords found in this issue: glutamate, Ca, Na, mitochondria, mechanism of action, neurotoxic
 
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