Complex Regional Pain Syndrome: Is There a Role for Capsaicin?

Complex regional pain syndrome (CRPS) is a challenging disorder occurring in patients most often after trauma or surgery. Its treatment is very complex, and even then, no treatment is fully effective. Capsaicin is a well-accepted treatment for neuropathic pain. However, its use in CRPS is controversial, with few studies having been published on it. In this case report, we describe the case of a female patient with CPRS type II, whose treatment with topical capsaicin resulted in great functional improvement. The patient was referred to the Pain Medicine Unit due to a CRPS type II due to trauma in her right wrist. She complained of severe pain in the median nerve territory of her dominant hand, associated with hyperalgesia, allodynia, burning, and electric shock sensation, resulting in functional disability. Electromyography was compatible with severe axonal injury of the right median nerve of the wrist. After conventional therapies were tried with no improvement, treatment with a capsaicin 8% patch was proposed. A functional improvement was observed after two applications of the capsaicin treatment, allowing the patient to regain activity in her hand. This shows that although evidence for capsaicin use in CRPS treatment is scarce, it can be a viable alternative for some patients.