[Use of topical capsaicin for pain management: Review and evidence-based indications]

Topical capsaicin is a medication that has been used for years in the treatment of pain, whose effectiveness is based on its ability to cause permanent partial denervation of the superficial terminal nerve fibers, in spite of the fact that it must be used at high doses and for a period of time to perform this effect. The use of capsaicin in the treatment of neuropathic pain currently has a high level of evidence, and the use of casaicin 8% can be recommended as a second choice medication in the treatment of these pathologies. Capsaicin has actually a good level of evidence in knee osteoarthritis and rheumatoid arthritis. However, although its use is spreading in the treatment of painful osteotendinous syndromes, there are currently no studies that analyze its effect, so we must be cautious when we indicate capsaicin in these pathologies.