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topical · for joint pain & osteoarthritis

Topical Capsaicin

Reviewed by the Nimbera editorial team · Last updated May 2026

Persson et al. 2024 systematic review (Pain Ther, PMID 38761115) - meta-analysis of 14 RCTs confirmed that topical capsaicin (0.025-0.075% cream) significantly reduces OA pain vs placebo (MD -1.5 on 10-point scale) with acceptable tolerability after the initial burning sensation subsides with repeated use.$10-$18 per tube, lasting several weeks.

How to use

Apply a thin layer of capsaicin cream (0.025-0.075% concentration, e.g., Zostrix or Capzasin-HP) to the painful joint 3-4 times daily. CRITICAL: wash hands immediately after application. Initial burning sensation is normal and subsides after 1-2 weeks of regular use - many people stop too early. Use consistently for 4-6 weeks for full effect.

How it works

Capsaicin desensitises TRPV1 (transient receptor potential vanilloid 1) pain receptors in the skin by depleting substance P (the primary nociceptive neurotransmitter) from local nerve terminals. After depletion, less substance P is available to transmit pain signals from the joint to the brain.

Where to buy

Zostrix OA Capsaicin Cream ($8-$15/2 oz), Capzasin-HP ($10-$18/1.5 oz), Icy Hot Pro Capsaicin+Lidocaine - available at most pharmacies and online.

Typical cost: $10-$18 per tube, lasting several weeks.

Safety notes

Wash hands thoroughly immediately after application - accidental contact with eyes or mucous membranes causes intense pain. Keep away from children. Do not apply to broken skin, rashes, or irritated areas. The burning sensation is normal and decreases over time - do not wash off immediately after feeling the burn (this prevents the therapeutic desensitisation from developing). Do not use heat pads or hot showers immediately after application - greatly intensifies burning.

Drug & supplement interactions

  • Always tell your doctor or pharmacist about any supplements you take.
  • Interactions can occur with prescription medications, blood thinners, and immunosuppressants.
  • Herbal remedies can affect how the body absorbs or metabolises drugs.
  • Check drugs.com interactions checker before starting.

Clinical source

Persson et al. 2024 - Pain Ther (PMID 38761115)

This information is compiled from primary clinical literature and is for informational purposes only. It is not a substitute for professional medical advice. Read our full disclaimer.