- What are the evidence-based guidelines regarding over-the-counter capsaicin products for the treatment of acute and chronic non-cancer pain?
Seven relevant publications were identified, these comprised two systematic reviews of guidelines, and two individual guideline reports on osteoarthritis (OA); and three individual guideline reports on neuropathic pain (NP). There appears to be some variability in the recommendations for use of capsaicin for the management of pain in patients with OA. The two systematic reviews found that capsaicin was recommended for OA (two guidelines), hand OA (two guidelines), knee OA (three guidelines), and hip OA (one guideline); and capsaicin was not recommended for OA (one guideline). According to one guideline report, capsaicin is recommended for knee OA but not for hand OA (conditional recommendation); and the other guideline report does not recommend for or against use of capsaicin for treating glenohumeral joint OA (due to absence of reliable evidence). For treatment of patients with NP, one guideline recommends high concentration capsaicin patch (weak recommendation); and two guidelines recommend capsaicin (8%) patch as second-line treatment (strength of recommendation: weak according to one guideline and based on high level evidence according to another guideline).Findings need to be interpreted in the light of limitations (such as limited available evidence, and variability in the reported recommendations).