Experiment with Capsaicin 0.075% cream used over a 3.5% Menthol application:

Following the success of the Salonpas Capsaicin/Menthol patch used yesterday - where the Menthol prevented the Capsaicin from imparting a burning sensation - both feet are still mostly pain free (1 to 2 level), except for an area not covered by the patch...

Following Mrs D's suggestion concerning Menthol, I have now applied a 3.5% Menthol solution called Biofreeze, both by means of a spray on one part of the left foot and with a roll-on applicator on the other part to test both type of applications, as the roll-on solution appears much thicker...

I have waited some 45 minutes for the Menthol solution to completely dry, before coating over the Menthol with the 0.075% Capsaisin cream and this should hopefully reduce or even prevent the burning sensation experienced by many as the main drawback of Capsaicin, while leaving intact its ability to desensitize the nerve receptors...

Here is the post by Pete on treating the pain symptoms caused by Peripheral Neuropathy with Zostrix, a cream made with 0.075% Capsaicin...

I'm new to the forum but will post this reply for what it's worth.

I have suffered from a Peripheral neuropathy for years and use to have that burning feeling on the tops of my feet, especially in hot weather and more especially after taking a walk. My regular physician told me to use Zostrix Cream (over the counter medication). He said it would take several days to start working but should, in my case, relieve the burning sensation and it did. I know apply enough to the tops of my feet once a day to cover (not too much) and for the past 10+ years I've been pretty much pain free from burning feet. Other than that I get pains in my feet and lower legs (that irritating feeling one gets) that sometimes keeps me from being able to get to sleep at night. I guess my doc knew I wasn't the type of person to take advantage of a medication and so prescribed Percocet. I take 1/2 to 1 tablet, only when needed, about 1/2 to 1 hour before bedtime and am able to get to sleep without any problems. I realize this medication isn't for everyone as it’s a narcotic but in my case it certainly helps and I'm very careful to use this drug in moderation.

I do hope your doctor can prescribe something that may give you some relief; I do know how one can suffer from nerve pain, no fun at all!

Best of luck!

http://neurotalk.psychcentral.com/thread122507.html

Double post deleted...

Some 6 Hours later: TOTAL SUCCESS and final conclusion!...

The prior application of Biofreeze 3.5% Menthol, both in spray and roll-on gel forms totally prevented any burning or stinging when the 0.075% Capsaicin contained in Zostrix was applied 45 minutes later...

Pain level in both feet is still at 1 to 2, instead of the usual 6 to 7, since application of the Capsaicin/Menthol patch yesterday, showing that both methods - cream combination or ready made Capsaicin/Menthol Salonpas patch - work very well to control certain types of Neuropathic pain...

The advantage of the Salonpas patch is that it's quickly applied, requires no gloves, creates no mess and allows the wearing of socks immediately afterward. The drawback is that it creates bulk when used on top and bottom of the foot, making it difficult to fit in a normal size shoe. Also, the patch shape makes it more difficult to cover the entire foot, leaving some uncovered areas still prone to pain, but it's the perfect solution when traveling by air in these days of check-out restrictions...

The combination Menthol/Capsaicin creams, though a bit more messy to apply, is ideal for home use as compounded shapes, such as a foot can easily be 100% coated and they will cost much less than the patches in the long run...

Thank you Qutenza: your clinical study pitting 8% Capsaicin expensive prescription patches against a control 'placebo' 200 times weaker at 0.04% Capsaicin, STILL showing 75% comparative efficacy, truly opened my eyes: sometimes, less is much more..

Note: while 0.04% Capsaicin patches are not currently available commercially, the Salonpas 0.025% Capsaicin/1.25% Menthol patches, available over the counter at $4.81 for 6 pieces have fit the bill very nicely...

Posters/readers who have followed these tests may be interested in a new thread just started to review the merits of TPR 20, a single application topical cream for pain management pain where Capsaicin has been replaced by Lidocaine and no gloves are required...

http://neurotalk.psychcentral.com/thread124981.html

My neck and upper back is so sensitive to the touch am I wondering how I would react to apply biofreeze and then Zostrix.

I know when I put Biofreeze like cream on my back before it made the burning pain worse even though it was a cooling feeling.

Also the instructions for the Zostrix cream says put a pea sized amount on the affected area. My area is large. Its half of teh back of my neck, both my sholder blades and sometimes triceps.

I am concerned about putting too much on.

Hi everyone!

My struggle with pain began many years ago. I was diagnosed with RSD when I was 14 and had 6+ horrible months; couldn't walk, was incredibly drugged, etc. Thankfully because of some wonderful doctors my RSD is in remission.

Now I am dealing with residual nerve damage. After a few years of unsuccessful nerve blocks, lasting only a few days each, and different medications; neurotin, elavil, etc. 5 weeks ago got the qutenza patch. This patch has been some what of a miracle for me. I am finally off the elavil and feeling great but I feel the pain slowly creeping back.

So my question is for anyone who knows or has had the qutenza application. If the pain relief lasted 5 weeks the first time and I need to wait until week 12 for another application will the next application last maybe 6 weeks... I'm not sure if it works like that but it would be wonderful if it did.

Any comments would be appreciated. Thank you!!!

Welcome to NeuroTalk:

I'd ask this question over at RSD forum too.
http://neurotalk.psychcentral.com/forum21.html

The problem with this patch for PNers as I see it, is that we cannot stand Capsaicin in the first place.

The second problem is that our PN is more global, and targeting where the patch should be placed is difficult if not impossible for some of our posters.

As far as lasting quality... drug studies can be deceptive as we have all learned in the past decade. They didn't do them on very many patients for these patches, so those post marketing results may be very different than what the studies suggest.

If doctors knew it was shorter duration for these very expensive patches, they may not be so eager to suggest or prescribe them. So the drug company may not release that data...this is common with other drugs too. That is how the industry works.
Glaxo was forced by the Attorney General of NY state to release ALL of its studies on Paxil several years ago, and that revealed many studies of ineffectiveness.

Also I believe the post herpetic neuralgia is the approved indication for this patch. You used it for an off label purpose, and there may be few if any studies including RSD. That is another question you should ask the manufacturer.

So it is difficult to answer your question. Have you called the manufacturer and asked there? You "may" get a response or not, but it is worth a try, IMO.

FWIW, my daughter had it done in January...needed a LOT of sedation due to the severe pain. Lasted about 1/2 hour, but reduced pain considerable for over a month. Second session was a failure.

I tried capsaicin cream. First application went fine. Second application awoke me 4 hours later in the middle of the night with extreme burning. Caused irritation and redness that lasted several days. If you choose to try it I would start by applying it to a very small area the first week or two.

I would suggest that the severe redness etc, may be a hint that you may be intolerant to Nightshade vegetables.

I found this out myself, that I get lots of burning from potatoes.

Solanine in these veggies (esp potatoes) is an alkaloid suspected of causing much grief. Tomatoes which are also in this family, stimulate histamine release as well, which can show up in the skin.
If you search here : nightshades you will find some interesting links.
Here is my thread so far on histamine reactions and the skin:
http://neurotalk.psychcentral.com/thread161714.html

The nightshades can be problematic for some people. The tomatoes and hot peppers, also have that histamine issue, which the potatoes do not.

So, Clay, you may want to google
1)nightshade vegetable reactions
2) histamine releasing foods
3)histamine containing foods
and see if that may help you.