Reumatol Clin. 2018;14(1):40–45 ww w . r eumatologiaclinica.org Review Article Topical capsaicin for pain in osteoarthritis: A literature review Vânia Guedes a,* , João Paulo Castro b,c , Iva Brito d,e a Family Medicine, Unidade de Saúde Familiar Faria Guimarães, Porto, Portugal b Physical Medicine and Rehabilitation Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal c Department of Anatomy, Faculty of Medicine of Porto University, Porto, Portugal d Rheumatology Department, Centro Hospitalar São João, Porto, Portugal e Department of Medicine, Faculty of Medicine of Porto University, Porto, Portugal a r t i c l e i n f o Article history: Received 17 April 2016 Accepted 31 July 2016 Available online 27 August 2016 Keywords: Capsaicin Osteoarthritis Pain a b s t r a c t Osteoarthritis is the most common joint disorder worldwide. The predominant symptom, pain, is usually treated with acetaminophen or oral non-steroidal anti-inflammatory drugs, although they are associated with a significant risk of side effects. Topical capsaicin may represent an effective and safe alternative. The aim of this review is to examine the evidence for the efficacy and safety profile of topical capsaicin in the management of pain caused by osteoarthritis. Databases were searched for articles published between 2004 and 2016, in Portuguese, English or Spanish, using the search terms “capsaicin” and “osteoarthritis”. When compared to placebo, it was found that topical capsaicin has a good safety profile and efficacy in reducing osteoarthritis pain of the hand, knee, hip or shoulder. However, the studies have significant limitations, the most important the difficulty of blinding. It is attributed to this review the strength of recommendation B. © 2016 Elsevier Espa ˜ na, S.L.U. and Sociedad Espa ˜ nola de Reumatolog´ ıa y Colegio Mexicano de Reumatolog´ ıa. All rights reserved. Capsaicina tópica para el dolor de la osteoartritis: una revisión de la literatura Palabras clave: Capsaicina Osteoartritis Dolor r e s u m e n La osteoartritis es la enfermedad articular más común mundialmente. El síntoma predominante, el dolor, se trata generalmente con paracetamol oral o antiinflamatorios no esteroideos, a pesar de que están asociados con un riesgo significativo de efectos secundarios. Capsaicina tópica puede representar una alternativa eficaz y segura. El objetivo de esta revisión es examinar la evidencia disponible acerca de la eficacia y del perfil de seguri- dad de la capsaicina en el tratamiento del dolor. Se realizaron búsquedas en bases de datos de artículos publicados entre 2004 y 2016, en portugués, inglés o espa ˜ nol, utilizando los términos «capsaicina» y «osteoartritis». En comparación con el placebo, la capsaicina tiene un buen perfil de seguridad y eficacia en la reducción del dolor de la osteoartritis de la mano, la rodilla, la cadera o el hombro. Sin embargo, los estudios tienen limitaciones significativas, principalmente la dificultad de cegamiento. Se atribuye a esta revisión una fuerza de recomendación B. © 2016 Elsevier Espa ˜ na, S.L.U. y Sociedad Espa ˜ nola de Reumatolog´ ıa y Colegio Mexicano de Reumatolog´ ıa. Todos los derechos reservados. * Corresponding author. E-mail address: vaniapoguedes@gmail.com (V. Guedes). Introduction Osteoarthritis (OA) is the most common joint disorder worldwide. 1 It is estimated that approximately 18% of women and 10% of men above 60 years old have symptomatic OA and that more than 50% of people over the age of 65 have radiological evidence https://doi.org/10.1016/j.reuma.2016.07.008 1699-258X/© 2016 Elsevier Espa ˜ na, S.L.U. and Sociedad Espa ˜ nola de Reumatolog´ ıa y Colegio Mexicano de Reumatolog´ ıa. All rights reserved.