Spice of Life

"When I eat, like, something really, really hot, my eyes start crying and kind of a crying and sweating," said Gaby Arriaga, sous-chef, Adobo Grill, 1610 N. Wells, Chicago.

Hot sauce and sizzling chili peppers may not only bring lovers of spicy food to their knees, it could help them get back up again. Capsaicin, the compound that gives hot peppers their punch, is now being tested as a way to relieve knee pain. Think of it as fighting fire with fire.

At age 71, Ron Johnson says his knee is in better shape than it was in his fifties.

"It was constant pain in both knees," he said.

That pain was causing him to limp. And that was limiting in his ability to get around.

The spicy new treatment is part of a study that uses adlea, an ultra-purified form of capsaicin. It's injected right into a patient's knee to relive pain.

"It allows the entry of calcium, which desensitizes the nerve for a prolonged period of time," said Dr. Charles Birbara, rheumatologist, Clinical Pharmacology Study Group.

Doctors say capsaicin binds to specific receptors on nerves responsible for pain. When the cells open, extra calcium enters. The nerves become overwhelmed and shut down, thus numbing the pain from several weeks to months.

"What we are looking at here is a very targeted therapy," said Birbara.

Chili peppers have been used in folk remedies for centuries. And over-the-counter heat inducing capsaicin creams are now a drug store staple for aching joints and muscles. There are even prescription-strength versions. Research on capsaicin is really starting to heat up as doctors learn more about the compound and its ability to target pain sensing cells in a unique way.

"So we don't use capsaicin as the only treatment; we go as an adjunct treatment. We use other modalities first and this if the patient still has pain, we rely on capsaicin," said Dr. Magdalena Anitescu, pain specialist, University of Chicago Medical Center.

At the U of C Medical Center, pain specialists have been prescribing capsaicin for years for diabetic neuropathy. Now it's also being used to treat pain after lung and breast surgery, cluster headaches and even shingles.

"It doesn't work for everyone but when it works, it's really wonderful," said Anitescu.

Doctors say because capsaicin pinpoints the pain, patients are reporting few major side effects, except the initial burning sensation when first injected.

"If you can take it in your stomach, you certainly can put it in a knee joint," said Anitescu.

Doctors are also studying adlea for surgical pain. Initial reports suggest some pain is relieved, and patients may need less pain medication, such as morphine, afterwards. Adlea is not FDA approved, and doctors are still testing to see just how long the treatment is effective.

Don't try this at home. The medications use an ultra purified form of capsaicin you won't find in a typical chili pepper.

Contact: Dr. Magdalena Anitescu
Pain Specialist, University of Chicago Med. Ctr.
(773) 702-1000

Anesiva (maker of Adlea)
Gilbert Wong, MD
Dir. of Clinical Research

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