Routine Rheumatology Heats Up as Compounding Pharmacies Turn to Capsaicin for Summer Joint Pain
Now that summer — also known as “trauma season” to hospital workers — is upon us, joint pain is on the rise. Maintenance projects that have been waiting around the house all year are finally getting some attention. Part-time athletes are getting out on the weekends, taking advantage of temperate days to hit up the driving ranges or courts. One doesn’t need to be savvy with a club or a racquet to develop “golfer’s elbow” or “tennis elbow,” however, which leaves a large portion of the population suffering from joint pain every summer. Luckily, chili pepper extract capsaicin is a valuable pharmaceutical resource this time of year, particularly in topical ointments for pain management.
“Golfer’s Elbow” and “Tennis Elbow” Cause Racquet in the Summer
They may have goofy monikers, but golfer’s elbow and tennis elbow are both serious issues that can leave people on the sidelines, unable to participate in their everyday activities. Both medial epicondylitis and lateral epicondylitis are common ailments that can result from active overexertion, which is usually exacerbated during the warm days of summer.
Similar to tendonitis, the most common symptoms of medial epicondylitis are joint pain on the inner elbow and pain in the front of the forearm whenever something is lifted with the palm facing upward, such as a golf club (hence the name). Medial epicondylitis is one of the most frequently reported summertime issues for men and is the most common overall cause of pain on the inner elbow.1
On the flip side (so to speak), lateral epicondylitis is symptomized by pain on the outer elbow. It is caused by overuse of the forearm muscles during repetitive actions, such as twisting a screwdriver or swinging a tennis racquet. For most people suffering from this affliction, pain only occurs when using the forearm and wrist for twisting movements, such as opening a jar; however, the joint pain can be constant and so severe that, for some, it even affects sleep and the ability to hold a fork.2
Putt the Pills Back on the Shelf
If you conduct a quick Google search of “how to treat joint pain,” the first unsponsored link that appears (at this time of writing) touts the use of pills for pain management, such as ibuprofen tablets, oral NSAIDs, acetaminophen tablets, opioids, muscle relaxants, antidepressants, and AEDs. These treatments may be more readily available, but they also come with a set of potential side effects, including nausea, gastrointestinal bleeding, and constipation.
Topical treatments are far more efficient for treating joint pain than oral medications because they don’t require time for absorption post-consumption and they can zero in on the source of the pain. They also spare the digestive tract, unlike pills and tablets, which may simply provide patients with a new source of discomfort. It makes more sense to turn to a topical ointment as a star player in the fight against pain.
Chili Pepper Joins the Team…and Improves the Other Players’ Performance
As a pharmacist, it’s important that you talk to physicians about how capsaicin works in topical treatments so they can better advise their patients on how to manage joint pain. When combined with other ingredients (such as menthol), capsaicin can create an effective analgesic blend that utilizes hot and cold sensations to alleviate pain.
Given that capsaicin is chili peppers’ naturally spicy deterrent against herbivores, it does burn upon contact with the skin as it bonds to heat-sensitive channel receptor TRPV1.3 However, studies show that topical administration of capsaicin is most effective. It reaches maximum concentration most quickly, yielding faster results than oral or in vitro administration.4
Some generic creams contain capsaicin alone and can provide analgesic relief. However, capsaicin is doubly beneficial when it is combined with other pain-killing ingredients because it also improves blood circulation, which means it boosts the effectiveness of any other ingredient with which it’s combined.5 Methyl salicylate and menthol are just two examples of herbs that complement capsaicin and are commonly used in topical ointments. For osteoarthritis, the analgesic effects of topical capsaicin are enhanced when combined with glyceryl trinitrate.6 Topical cayenne cream also proves to be all the more effective for arthritic pain when combined with capsaicin.
Brand-name ointments aren’t the best place to find capsaicin because they lean more heavily towards other ingredients. Icy Hot Cream contains menthol and methyl salicylate; BenGay contains camphor, menthol, and methyl salicylate; and Tiger Balm contains camphor and menthol. While teaming analgesic menthol up with counterirritant methyl salicylate is definitely a good start to the fight against joint pain, why leave capsaicin warming the bench? Unlike the camphor listed above, it does more than just serve as another analgesic or counterirritant added to the mix.
Compounding Pharmacies Can Serve Up Pain Relief with Capsaicin
Talk to physicians about using topical treatments as a first line of defense to alleviate joint pain. For common ailments like golfer’s elbow or tennis elbow, look towards combinations of ingredients that might not be readily available on the pharmacy shelf. Add capsaicin when compounding in-office to increase the effectiveness of analgesic topical blends you already prepare and look for premade analgesic blends containing capsaicin.
Pharmaceutica North America offers Medrox, a line of OTC topical analgesics for temporary relief of muscle, joint, and nerve pain that is delivered transdermally via ointment or patch. Medrox contains Capsaicin, Menthol, and Methyl Salicylate. Please contact us today to learn more about how we can provide your pharmacy with safe, high-quality topical medications.
- “Summertime is ‘Trauma Season’ for Hospital ERs,” 2014, http://www.post-gazette.com/news/health/2014/05/09/Hospital-fun-in-the-summertime-Summertime-means-weathering-more-injuries/stories/201405090080 ↩
- “Tennis Elbow,” 2015, http://patient.info/health/tennis-elbow-leaflet ↩
- “The Capsaicin Molecule,” 2015, http://www.scienceofcooking.com/capsaicin.htm ↩
- “Chemical and Pharmacological Aspects of Capsaicin,” 2011, www.mdpi.com/1420-3049/16/2/1253/pdf ↩
- “Cayenne and Capsaicin,” 2014, http://www.organiclifestylemagazine.com/cayenne-and-capsaicin-natures-miracle-medicine/ ↩
- “The analgesic efficacy of topical capsaicin is enhanced by glyceryl trinitrate in painful osteoarthritis: a randomized, double blind, placebo controlled study,” 2000,