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8 Articles in this Series
8% Capsaicin Patch Effective for Post-surgery and Phantom Limb Pain
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8% Capsaicin Patch Effective for Post-surgery and Phantom Limb Pain

The use of 8% capsaicin patch may be beneficial in managing short-, medium-, and long-term pain in patients with post-radiation/post-surgical neuralgias, as well as those with chronic phantom limb pain, according to 2 case reports, presented by Benjamin Moses, MD, et al, from the US Army in Texas.1,2

The first case involved a 66-year-old woman who presented with a history of Stage 3 breast cancer.1 In September 2001, she underwent bilateral mastectomies and had radiation treatment, followed by resection of 2 left ribs (recurrence suspected). The patient developed radiation plexitis and chronic pain near her surgical scars. Over several years, the patient responded moderately to steroid/anesthetic injections and botulinum toxin A (Botox). Oral analgesics were prescribed, but the patient disliked the side effects. At presentation, the patient reported 6 out of 10 on the pain scale and was taking 1 to 2 acetaminophen and hydrocodone (Vicodin), but requested to be tapered off the opioid.

After initial pretreatment with 5% lidocaine ointment, the patient was treated with two 8% capsaicin patches applied for one-60 minute session. The patient reported significant reduction in pain (1/10 on the pain scale), with results lasting 6 weeks. A second and third application were subsequently administered, the second being done with 2.5% lidocaine and 2.5% prilocaine cream (EMLA cream), which demonstrated no improvement in functionality or pain, and the third again involving 5% lidocaine ointment, which was similar in effect to the first application.

The second case involved a 24-year-old soldier with phantom limb syndrome resulting from amputation of both legs.2 The patient presented with severe burning phantom pain (6/10 on the pain scale) echoing the fire that burned his legs and feet. Unable to tolerate prosthesis and not receiving adequate pain management from acupuncture and botulinum toxin A (Botox), the patient was taking up to 70 mg oxycodone (OxyContin) and transdermal clonidine for pain management.

Treatment included an initial application of 5% lidocaine ointment, followed by the 60-minute application of two 8% capsaicin patches on the distal ends of both residual limbs. After 6 weeks, the patient reported 2 out of 10 on the pain scale, 50% reduction in acetaminophen and oxycodone (Percocet) use, improved sleep duration, and can now tolerate use of a prostheses.

Treatment with an 8% capsaicin patch for patients with post-radiation/post-surgical neuralgias and for those with chronic phantom limb pain may be beneficial for pain management; however, further study is needed, noted the investigator.


  1. Moses BA, Brewer DB, Panula TL, Goff BJ. Eight percent capsaicin patch (Qutenza) for chronic post-mastectomy pain. Pain Med. 2012;13(2):Abstract 231.
  2. Moses BA, Brewer DB, Panula TL, Goff BJ. Eight percent capsaicin patch (Qutenza) for chronic phantom limb pain. Pain Med. 2012;13(2):Abstract 232.
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