Treatment of painful radiculopathies with capsaicin 8% cutaneous patch

Baron, Ralf; Treede, R.‐D.; Birklein, Frank; Cegla, Thomas; Freynhagen, Rainer; Heskamp, ML; Kern, Kai-Uwe; Maier, Christoph; Rolke, Roman; Seddigh, Susann; Sommer, Claudia; Ständer, Sonja; Maihöfner, Christian

doi:10.1080/03007995.2017.1322569

Cited by 13 publications

(12 citation statements)

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“…The authors have suggested that scores of ≤12 indicate unlikely , 13–18 uncertain and ≥19 likely presence of NP. A likely neuropathic component was reported in 16–68% of patients with low back‐related leg pain (Morsø et al., ; Uher and Bob, ; Baron et al., ; Mathieson et al., ), and in 12–38% of patients with low back pain only (Freynhagen et al., , ; Schmidt et al., ; Förster et al., ; O'Sullivan et al., ; Hiyama et al., ; Reimer et al., ).…”

Section: Introductionmentioning

confidence: 99%

Assessing neuropathic pain in patients with low back‐related leg pain: Comparing the painDETECT Questionnaire with the 2016 NeuPSIG grading system

Hasvik

Haugen

Gjerstad

et al. 2018

European Journal of Pain

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Section: Introductionmentioning

confidence: 99%

Assessing neuropathic pain in patients with low back‐related leg pain: Comparing the painDETECT Questionnaire with the 2016 NeuPSIG grading system

Hasvik

Haugen

Gjerstad

et al. 2018

European Journal of Pain

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“…14,20,21 For example, a single application of highly concentrated capsaicin (8%) had an analgesic effect in subgroups of patients with different etiologies of neuropathic pain (ie, postherpetic neuralgia, HIV polyneuropathy, and painful radiculopathy). 2,5,51,52 Highly concentrated capsaicin induces reversible degeneration of capsaicin-sensitive nociceptive endings in the epidermis. However, only in a subset of patients treated with high-dosage capsaicin (8%) an analgesic effect could be achieved.…”

Section: Discussionmentioning

confidence: 99%

Sensitized vasoactive C-nociceptors: key fibers in peripheral neuropathic pain

Forstenpointner

Naleschinski

Wasner

et al. 2019

PR9

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Introduction:Multiple mechanisms are involved in the development and persistence of neuropathic pain. Some patients with nerve damage will remain painless and develop a “loss of function” phenotype, whereas others develop painful neuropathies.Objectives:The aim of this study is to investigate the role of a peripheral nervous system sensitization by analyzing patients with and without pain.Methods:The topical application of capsaicin was investigated in peripheral nociceptors. Two groups of patients (painful vs painless) with length-dependent neuropathies and small-fiber impairment were tested. Quantitative sensory testing was assessed before and after topical application of 0.6% capsaicin in the affected skin. In addition, blood perfusion measurements and an axon reflex flare assessment were performed.Results:Quantitative testing revealed that heat hyperalgesia was induced in all patients and volunteers (P < 0.01) without observing any significant differences between patient groups. By contrast, the extent of the axon reflex flare reaction (P < 0.01) as well as the blood perfusion (P < 0.05) was significantly greater in patients with pain than in neuropathy patients not experiencing pain.Conclusion:Hyperexcitable vasoactive nociceptive C fibers might contribute to pain in peripheral neuropathies and therefore may serve as a key player in separating into a painless or painful condition.

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“…A randomized controlled trial by Castro et al from 2017 found 3.6% over-the-counter lidocaine combined with 1.25% menthol was just as efficacious in reducing chronic lower back pain as 5% lidocaine patches. These results lead to the theorization that menthol improves skin permeability to lidocaine, and this combination serves as a more affordable option to patients [53].…”

Section: Lidocainementioning

confidence: 93%

A Comprehensive Review of Over the Counter Treatment for Chronic Low Back Pain

et al. 2020

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Purpose of the Review: Chronic low back pain (CLBP) is a major contributor to societal disease burden and years lived with disability. Nonspecific low back pain (LBP) is attributed to physical and psychosocial factors, including lifestyle factors, obesity, and depression. Mechanical low back pain occurs related to repeated trauma to or overuse of the spine, intervertebral disks, and surrounding tissues. This causes disc herniation, vertebral compression fractures, lumbar spondylosis, spondylolisthesis, and lumbosacral muscle strain. Recent Findings: A systematic review of relevant literature was conducted. CENTRAL, MEDLINE, EMBASE, PubMed, and two clinical trials registry databases up to 24 June 2015 were included in this review. Search terms included: low back pain, over the counter, non-steroidal anti-inflammatory (NSAID), CLBP, ibuprofen, naproxen, acetaminophen, disk herniation, lumbar spondylosis, vertebral compression fractures, spondylolisthesis, and lumbosacral muscle strain. Over-the-counter analgesics are the most frequently used first-line medication for LBP, and current guidelines indicate that over-the-counter medications should be the first prescribed treatment for non-specific LBP. Current literature suggests that NSAIDs and acetaminophen as well as antidepressants, muscle relaxants, and opioids are effective treatments for CLBP. Recent randomized controlled trials also evaluate the benefit of buprenorphine, tramadol, and strong opioids such as oxycodone.

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Treatment of painful radiculopathies with capsaicin 8% cutaneous patch

Abstract: Effective neuropathic pain relief was observed after patch application within the innervation territories of both dorsal and ventral branches of the spinal nerve. Further controlled randomized trials are indicated.

Cited by 13 publications

References 50 publications

Assessing neuropathic pain in patients with low back‐related leg pain: Comparing the painDETECT Questionnaire with the 2016 NeuPSIG grading system

Assessing neuropathic pain in patients with low back‐related leg pain: Comparing the painDETECT Questionnaire with the 2016 NeuPSIG grading system

Sensitized vasoactive C-nociceptors: key fibers in peripheral neuropathic pain

A Comprehensive Review of Over the Counter Treatment for Chronic Low Back Pain

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