• Adedeji Olusanya, Aaron Yearsley, Nicholas Brown, Samantha Braun, Corey Hayes, Evon Rose, Brian Connolly, Madeline Dicks, Colby Beal, Brett Helmonds, Wesley Peace, Bryce Kirkman, Christina Nguyen, Jacob Erickson, Gabby Nguyen, Esha Lukose, Wouter Koek, Ameet S Nagpal, and Michelle Trbovich.
• The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
• Pain Med. 2023 Jan 4; 24 (1): 717871-78.

BackgroundNeuropathic pain (NP) after spinal cord injury (SCI) exacerbates disability, decreases quality of life (QOL), and is often refractory to available therapies. Patients report willingness to trade potential recovery of strength, bowel, bladder, or sexual function for pain relief. One proposed mechanism causing NP is up-regulation of transient receptor potential vanilloid 1 (TRPV 1) proteins in uninjured C fibers and dorsal root ganglia causing neuronal excitability. Recent studies have found up-regulation of TRPV 1 proteins after SCI.ObjectiveWe hypothesize the application of capsaicin 8% patch (C8P), FDA approved for NP in diabetic peripheral neuropathy and post-herpetic neuralgia, will improve pain, function and QOL in persons with SCI.MethodsRandomized single-blind crossover design in which 11 persons with SCI and NP refractory to two oral pain medications received C8P or a control low dose Capsaicin 0.025% patch (CON) over two 12-week periods. Pain (VAS, MPI-SCI), quality of life (WHO-QOL), and functional status (SCIM) were measured at 2-4-week intervals.ResultsThere was a main treatment effect of C8P over CON on VAS and MPI-SCI outcomes with pain reduction of 35% and 29% at weeks 2 and 4, respectively. C8P also demonstrated a main treatment effect over CON on the SCIM mobility subscale. WHO-QOL scores did not improve with C8P.ConclusionsC8P improves pain and mobility for patients with SCI and refractory NP. Larger studies should be performed to evaluate impact of repeat applications and QOL outcomes.© The Author(s) 2022. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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