CFS & Fibromyalgia Integrative Therapies Capsaicin for Fibromyalgia and Chronic Fatigue Syndrome By Adrienne Dellwo Updated on March 03, 2022 Medically reviewed by David Ozeri, MD Print Table of Contents View All Table of Contents General Health Benefits Fibromyalgia and ME/CFS Research Risks and Side Effects Capsaicin is derived from spicy peppers and is what gives peppers their heat. As a topical medication, it's used for a wide variety of medicinal purposes, including pain. It might sound strange that the hot stuff in peppers can relieve pain, especially if you're not a fan of eating spicy food. Why would something that causes burning on contact with your tongue help alleviate pain? It sounds contradictory. However, it's precisely that immediate burning sensation that's behind capsaicin's effectiveness. This drug is classified as a counterirritant, which means that it causes pain in order to defeat it. Here's one theory of how that works: everyone's cells contain something called substance P. It's a neurochemical that transmits pain signals to your brain. Capsaicin forces the cells in the tissue it touches to release all of their substance P, and that's the burning pain you feel. Once the substance P is gone, those cells can no longer send pain messages. Capsaicin takes away their postage stamps. Or, so I don't sound like an old fogey, it crashes their wi-fi. Another possibility is that it actually desensitizes the peripheral nerves, which tend to be hypersensitive in us. Banar Fil Ardhi / EyeEm / Getty Images General Health Benefits A fair amount of research has been done on capsaicin for a variety of conditions. Some research supports the topical use for: Neuropathy and other nerve pains Rheumatoid arthritis and osteoarthritis Back pain Muscle pain Post-surgical pain Cluster headaches (when taken as a nasal spray) Capsaicin also has some non-pain-related uses, including: Psoriasis (a skin condition) Mouth sores stemming from radiation or chemotherapy For Fibromyalgia and ME/CFS So far, we have no research specifically on capsaicin for chronic fatigue syndrome. However, because this disease can have some of the same pain types as fibromyalgia, the following studies may be relevant. In a 2013 study of severe cases of fibromyalgia (Casanueva), researchers reported significant short-term changes in: Pain Depression (possibly as a result of lower pain levels) Role limitations due to emotional problems Fatigue severity Pressure pain threshold Measures of overall well-being and illness impact However, this study only involved 70 people in the treatment group. Those people continued with their regular medical treatment and added capsaicin. The 60 people in the control group also continued their regular treatments but were not given a placebo. We need larger, placebo-controlled trials to replicate these results before we can put a lot of faith in the results. Pain Studies Some research has been done on types of pain rather than on specific conditions. Some of these pain types are involved in fibromyalgia and may be part of chronic fatigue syndrome as well. Nociceptive Hypersensitivity At least a portion of the pain involved in these conditions is believed to be from overactive nociceptors — specialized nerve endings in your skin that gather information about pain, temperature, and other environmental factors. A 2015 study in Molecular Pain suggests that a single dose of topical capsaicin may alleviate nociceptive hypersensitivity. It also it also helped in pain inhibition, which is when your brain prepares for or adjusts to painful stimuli. Pain inhibition is believed to be dysregulated in fibromyalgia. Neuropathy Fibromyalgia is also believed to involve a type of pain called neuropathy, which results from damaged or dysfunctional nerves. While we don't have evidence of neuropathy in chronic fatigue syndrome, at least one study (Anderson) suggest that chronic fatigue syndrome may share underlying biology, and therefore a significant overlap with, conditions involving neuropathy. Multiple studies show that capsaicin may be effective against neuropathy, generally in combination with other medications. Possibly making these studies more relevant is a 2015 study in the European Journal of Pain showing that capsaicin is more effective in people with hyperalgesia, which is pain amplification by the nervous system. Hyperalgesia is believed to be a factor in both fibromyalgia and chronic fatigue syndrome. Usage, Risks, and Side Effects Some benefits of capsaicin include: It's relatively inexpensiveIt's available over the counter at most grocery and drug storesIt won't interact negatively with your other medications As with all treatments, you'll need to weigh the risks and benefits to determine whether capsaicin is right for you. Talk to your healthcare provider or pharmacist about any questions or concerns. When you use topical capsaicin, it's important to remember that it works because it burns. However, while the burning sensation is normal, not everyone can tolerate it. Also, some people may experience side effects. Capsaicin is available as a cream or in liquid form. The liquid is generally in an applicator that's similar to a roll-on deodorant or bingo dauber. Make sure you read and follow direction on the package. When handling capsaicin, be sure to: Wear glovesDon't expose the skin to heat, such as from a heating pad or when your skin is heated up from a shower or bathKeep away from eyes and flush eyes with water if it gets in themDon't use it on broken or irritated skinAvoid sensitive areas and wash them with soap and water if they're exposed Common capsaicin side effects include: Redness of the skinIf dried residue is inhaled, coughing, sneezing, watery eyes, and sore throat can occur Higher doses can result in additional side effects. Stop use and notify your healthcare provider if you experience: Increased pain (beyond the initial burning sensation)BlisteringInflammation of the skin It's also possible to be allergic to capsaicin. Avoid this medication if you're allergic to peppers. Get immediate medical attention if you have symptoms of a serious allergic reaction, which include: RashItchingSwelling of the face, tongue, or throatTrouble breathingSevere dizziness Don't use capsaicin if you're pregnant, trying to become pregnant, or breastfeeding. 5 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Sharma SK, Vij AS, Sharma M. Mechanisms and clinical uses of capsaicin. European Journal of Pharmacology. 2013;720(1-3):55-62. doi:10.1016/j.ejphar.2013.10.053 O’Neill J, Brock C, Olesen AE, Andresen T, Nilsson M, Dickenson AH. Unravelling the mystery of capsaicin: a tool to understand and treat pain. Dolphin AC, ed. Pharmacology Review. 2012;64(4):939-971. doi:10.1124/pr.112.006163 Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (High concentration) for chronic neuropathic pain in adults. Cochrane Pain, Palliative and Supportive Care Group, ed. Cochrane Database of Systematic Reviews. 2017;2021(7). doi:10.1002/14651858.CD007393.pub4 Tamburini N, Bollini G, Volta CA, et al. Capsaicin patch for persistent postoperative pain after thoracoscopic surgery, report of two cases. Journal of Visualized Surgery. 2018;4:51-51. doi:10.21037/jovs.2018.02.06 Casanueva B, Rodero B, Quintial C, Llorca J, González-Gay MA. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatology International. 2013;33(10):2665-2670. doi:10.1007/s00296-012-2490-5 Additional Reading Javed S, Alam U, Malik RA. Diabetes, obesity & metabolism. 2015 Dec;17(12):1115-25. doi:10.1111/dom.12535 Burning through the pain: treatments for diabetic neuropathy. Mainka T, et al. European journal of pain. 2016 Jan;20(1):116-29. doi: 10.1002/ejp.703. Presence of hyperalgesia predicts analgesic efficacy of topically applied capsaicin 8% in patients with peripheral neuropathic pain. Casanueva B, et al. Rheumatology international. 2013 Oct;33(10):2665-70. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Ma XL, et al. Molecular pain. 2015 Apr 22;11:22. Experimental evidence for alleviating nociceptive hypersensitivity by single application of capsaicin. Schug SA, Goddard C. Annals of palliative medicine. 2014 Oct;3(4):263-75. Recent advances in the pharmacological management of acute and chronic pain. By Adrienne Dellwo Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit