Capsaicin for neuropathic pain
Level of evidence: B
Capsaicin likely has little to no impact on neuropathic pain.
A systematic review «Soliman N, Moisset X, Ferraro MC, et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. Lancet Neurol 2025;24(5):413-428 »1measured effectiveness of single dose Capsaisin 8 % patches for 30-90 minutes on neuropathic pain including seven randomized trials with continuous outcomes. A reanalysis of these trials suggested a mean 0.36 points decrease (95% CI -0.53 to -0.19) in average pain at 2-12 weeks follow up, translating to about 8 % decrease in pain (95% CI -11 % to -4 %).
The same systematic review found RD of 0.0 % for withdrawals due to side effects (95% CI -1 to 1 %), suggesting that capsaicin has little side effects. However, local skin symptoms are possible.
The quality of evidence was downgraded due to imprecision.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Soliman N, Moisset X, Ferraro MC, et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. Lancet Neurol 2025;24(5):413-428 »1 | SR/MA | Adult patients with neuropathic pain | Capsaisin medications vs placebo | Decrease in average pain | Low |
| Reference | Comments |
|---|---|
| «Soliman N, Moisset X, Ferraro MC, et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. Lancet Neurol 2025;24(5):413-428 »1 | The systematic review included also other treatments for neuropathic pain. The trials had low risk of bias. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: Moderate The quality of evidence was downgraded one time due to imprecision. *We calculated the effect size by using the data provided by the systematic review. We used random effects meta-analysis. I= intervention; C=comparison; CI=confidence interval | |||||
| «Soliman N, Moisset X, Ferraro MC, et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. Lancet Neurol 2025;24(5):413-428 »1 | 7 trials, 2078 patients | 2-12 weeks | Not reported | 4,66 | -0.36 (-0.53 to -0.19)* Relative effect: -8 % (-11 % to -4 %) |
References
- Soliman N, Moisset X, Ferraro MC, et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. Lancet Neurol 2025;24(5):413-428 «PMID: 40252663»PubMed