Red hot chile peppers are becoming popular for more than spicing
  up foods and making funky music.
     A chemical derived from peppers is being used to help soothe
  arthritis pain and reduce headaches.
     Think back to the last time you set your mouth ablaze with green
  jalapenos or the hottest peppers of all, orange-red habaneros. Your
  eyes watered; your nose ran.
     But those who regularly put away peppers may be less affected.
  Scientists think the chemical capsaicin causes nerve endings in the
  mouth to release a neurotransmitter called substance P, which lets
  the brain know that something painful is going on. Capsaicin can
  stimulate an increase in the amount of substance P released.
  Eventually, this can deplete the substance P supply and reduce
  further releases from the nerve endings. This desensitization could
  reduce the fire of eating peppers.
     Knowing that, researchers tried using capsaicin in a cream (brand
  name Zostrix) to reduce post-operative pain for mastectomy patients
  and amputees. Prolonged use of the cream has also been found to help
  reduce the itching of dialysis patients, the pain from shingles, or
  herpes zoster, and pain and tingling associated with diabetes
  mellitus.
     The cream's pain-relieving success led rheumatologists to wonder
  if the capsaicin cream might help their arthritis patients.
  Apparently, it can. In a recent 12-week study of 113 osteoarthritis
  patients, 81% who regularly rubbed the cream on aching joints had
  less pain. On average, pain was reduced by half.
     "What's surprising is that it took us so long to figure out (that
  capsaicin could benefit arthritis patients)," says Dr. Roy Altman, a
  University of Miami School of Medicine researcher in the
  multi-center trial. The study appears in the June Seminars in
  Arthritis and Rheumatism.
     Repeated uses of this cream (containing a small amount, 0.025%,
  of purified capsaicin) apparently countered the production of
  substance P in the joint, hence less pain.
     Reducing substance P also helps the joint in another way, by
  fighting long-term inflammation. Substance P seems to prolong
  inflammation. That's bad because if joints stay inflamed, cartilage
  may break down.
     About half of the patients had mild to moderate burning and
  stinging where they rubbed the cream, but affects resolved in most
  patients.
     The study that Altman and others conducted had findings similar
  to those of a 1991 study done at Case Western Reserve University,
  Cleveland. However, most arthritis patients in the newer study,
  unlike the previous one, were also kept off non-steroidal
  anti-inflammatory drugs, or NSAIDs, such as ibuprofen.
     Physicians prefer offering  patients a topical pain reliever over
  an internal one. Those taken internally "have much more risk than
  this," Altman says. Regular use of NSAIDs has been linked to
  increased risk of ulcers in the stomach and intestines.
     Altman, who has made the cream part of his treatment for
  osteoarthritis patients, adds one warning about using the cream,
  which can be bought over the counter: Always wash your hands after
  rubbing it on.
     Should you rub your eyes with the cream on your hands, there's
  enough capsaicin to make your eyes water and burn much worse than if
  you'd just eaten some peppers.
     Elsewhere, Yale University researchers reported Monday that a
  taffy candy made with capsaicin eases mouth pain in cancer patients.
     Other researchers have had success at alleviating painful cluster
  headaches with Zostrix. Patients use a swab to apply a small amount
  of the cream once or twice daily into the nostril on the affected
  side.
     Cluster headaches usually affect one half of the head. They may
  hit for an hour every day for four to six weeks, then disappear for
  a year, says Dr. Alan Rapoport, director of The New England Center
  for Headache, Stamford, Conn.
     The headaches, which affect men 5-1 over women, are associated
  with a red or tearing eye, stuffy and running nostrils. "They're so
  severe that some patients have described it as though a hot poker is
  being thrust into the eye and twirled," he says.
     Thus, the slight burning sensation  patients noticed when using
  the cream for a week, in a small study Rapoport worked on, seemed
  small compared with reduced headaches they had during the second
  week.
     Among  17 patients using the cream or a placebo (which included
  an ingredient to cause a capsaicin-like affect), in the second week,
  the burning subsided and headaches began to improve "not in
  everybody, but significantly," Rapoport says.
     That makes sense, he says, because once the substance P is
  depleted from nerve fibers in the area "you should hurt less,
  because the substance P is no longer there."
     The possibilities with capsaicin are heating up. Rapoport says
  researchers think that it might work on migraines. "That would have
  even more application," he says. Migraines affect 12% of the
  population vs. 1% for cluster headaches.
     Elsewhere, researchers are looking into capsaicin's abilities to:
     -- Desensitize nasal nerves to offset non-allergic rhinitis, a
  year-round condition of overly sensitive nostrils.
     -- Prevent herpes flare-ups.
     -- Reduce pain after burns.
     -- Treat psoriasis.
     "We're seeing more and more people looking into the medical
  benefits of capsaicin," says Dave DeWitt, editor of the bimonthly
  magazine Chile Pepper and co-author of The Whole Chile Pepper Book
  (Little, $17.95) with Nancy Gerlach.
     Chiles have long been thought to have medicinal properties and
  ancient drugs containing peppers have been identified by
  researchers. The long-used muscle-treating salve HEET has capsaicin
  in it, too. In fact, the standards used to determine the heat in
  peppers, Scoville Heat Units, is named after Wilbur L. Scoville, a
  pharmacologist for the company that developed the rub.
     Even today, self-administered experiments hint at peppers'
  recuperative powers. "If you have a respiratory problem or the flu,
  some people say try chicken soup. Well, I'd say put a little pepper
  in it," says Vincent W. Zucchero, of 1Mark, a Las Vegas company that
  sells BodyGuard Plus, a self-defense pepper spray.
     Law enforcement agencies use the spray, sold on TV and in
  department stores. It is made of two pepper compounds, one derived
  from hot peppers called oleoresin capsicum.
     That chiles can be used as a food, a drug, and a defense device
  is "amazing," Zucchero says. "It's a magical fruit."
  Pepper cream lessens pain
  Pain in the joint causes release of the neurotransmitter, substance
  P, from nerve endings. This stimulates the release of pain signals
  to sensory nerves that carry those impulses to the brain.
  Pain signals reach the brain through peripheral sensory nerves and
  nerve pathways in the spinal cord.
  Topically applied Zostrix cream contains capsaicin, a chemical
  derived from red hot chile peppers.
  Capsaicin stimulates the release of substance P ...
  and may eventually deplete supply and prevent further release ...
  resulting in fewer pain signals to the brain.
  With less substance P in the joint, some patients have increased
  mobility and less pain after two weeks.
  Less than half of the patients had a temporary burning sensation on
  the skin that lessened as they continued the four-times-daily
  applications.


Copyright 1994, USA TODAY, a division of Gannett Co., Inc.