Reviewed guidance
Topical capsaicin can reduce knee osteoarthritis pain for some people when used regularly, although local burning or stinging is common and benefit varies between individuals.
Adjunctive relief of pain from established knee osteoarthritis using a labeled topical capsaicin cream; not a claim for oral cayenne, chili-containing food, supplements, essential oils, or homemade rubs.
How to use it: Use only a labeled topical capsaicin product and follow its directions. A commonly studied regimen was 0.025% cream applied four times daily for four weeks, but product labeling should control actual use. Wash hands after application and avoid eyes, mucosa, broken skin, and external heat.
Transient burning, stinging, or warmth is common. Stop for severe irritation. Do not apply to broken or inflamed skin or combine with heating pads or other intense heat. Avoid transferring residue to eyes or mucous membranes.
Get medical care for symptoms that are severe, last longer than expected, get worse, or otherwise concern you.
Practical ways to use the ingredient may not provide the same form or amount discussed in the evidence.
Evidence transparency
American College of Rheumatology / Arthritis Foundation
Supports conditional topical capsaicin use while keeping exercise and established OA care central.
Rheumatology
Supports variable individual response to topical capsaicin versus topical ibuprofen.
NHS
Controls urgent hot-swollen-joint, fever, trauma, and inability-to-bear-weight boundaries.
National Center for Complementary and Integrative Health
Supports reviewed-not-promoted turmeric/curcumin posture because formulation and bioavailability remain unresolved and liver injury has been reported with highly bioavailable products.
Clinical Therapeutics
Supports preparation-specific use of 0.025% topical cream and documents local burning.