How to Use Capsaicin (Pepper Creams) for Joint Pain

The active ingredient in so-called "hot pepper" creams is capsaicin - which indeed comes from hot pepper plants. It is marketed under such brand names as Zostrix and Capzasin-P. It can help people with arthritis-related joint pain in several ways.

Initially, it causes a warm tingling or burning sensation - which distracts you from the underlying pain. Some find this uncomfortable, but some find this lessens their pain. After a few weeks of use, the burning sensation is often less of an issue and deeper pain-relieving benefits grow. Capsaicin appears to reduce a chemical - substance P - that sends pain signals to the brain. It often takes a week or two, therefore, to get maximal benefit.

Here's how to use it:

First, try the mid-strength, which is 0.075% capsaicin.

• If you find the burning too much to cope with, go for the milder strength, which is 0.025%. With time, as the uncomfortable sensations decrease, you may be able to build back up to the stronger dose
  
  
• If you don't get enough relief with the mid-strength, try the strongest dose, which is 0.25% -- but don't use that dose first.
  
  
• Wash your hands well after use. Make absolutely sure that the cream or fingers that have touched the cream do not touch your eyes, your genitals, or inside your nose - lest you get hit with the same wild burning that would occur if you touched them after chopping up a hot pepper.
  
  
• Apply capsaicin after a work-out or shower rather than before. Warm water or sweat hitting an area of your body where you have used capsaicin may cause a marked increase in burning sensation.
  
  
• Give capsaicin a full trial - three times daily for two weeks. If you don't have an improvement by then - or if you feel worse at any time or just can't stand the burning - just stop using it. However, if the lower dose doesn't work but you tolerate it, a higher dose (see above) may work.