This information is for people who have osteoarthritis. It tells you about creams and gels containing capsaicin, a treatment used for osteoarthritis. It is based on the best and most up-to-date research.
Does it work?
Yes, probably. There's some evidence that capsaicin cream may be helpful if you have osteoarthritis in your hands. But the research is quite old, so we can't rely on it completely.
What is it?
Capsaicin comes from capsicum, the pepper plant. It's one of the chemicals that makes chillis hot. Capsaicin is also used to treat other conditions. It is used to help people with diabetes cope with the pain from nerve problems, for example.
Doctors can prescribe creams and gels that contain capsaicin. These include Axsain and Zacin.
Creams or gels that you rub into your joint may be more useful for osteoarthritis in the fingers, thumb or knee than in the hip, where the joint is deeper.
How can it help?
Creams or gels containing capsaicin can reduce pain in the short term and, if used regularly, their effect can build up. After a week of rubbing in a little bit of capsaicin three or four times a day, up to two-thirds of people who used it for osteoarthritis said it had eased their pain.   
How does it work?
Capsaicin acts on the nerve endings in the skin that feel pain. These nerve endings produce a chemical called substance P that's partly responsible for making you feel pain. Capsaicin reduces the nerve endings' supply of substance P and stops you from feeling so much pain from your joint. 
Can it be harmful?
Creams or gels with capsaicin often irritate the skin, giving a burning feeling. Nearly half of the people who use them get this irritation, but it's mild.  You should wash your hands after applying the cream or gel and make sure you keep it away from your eyes, broken skin and mucous membranes (delicate parts of your body that are covered in mucus, like the inside of your nose).
How good is the research on capsaicin creams and gels?
There is some evidence that capsaicin creams can help ease the pain of osteoarthritis in the hands. But the studies are quite old and we need more research to be certain that they work.
We didn't find any good-quality studies looking at capsaicin for osteoarthritis of the knee or hip.
Diabetes is a condition that causes too much sugar (glucose) to circulate in the blood. It happens when the body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).
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