Several double-blind trials have shown that topical use of cayenne extract creams containing 0.025 to 0.075% capsaicin reduces pain and tenderness caused by OA. These creams are typically applied four times daily for two to four weeks, after which twice daily application may be sufficient. Products containing capsicum oleoresin rather than purified capsaicin may not be as effective.
Willow has anti-inflammatory and pain-relieving properties. Although pain relief from willow supplementation may be slow in coming, it may last longer than pain relief from aspirin. One double-blind trial found that a product containing willow along with black cohosh, guaiac (Guaiacum officinale, G. sanctum), sarsaparilla, and aspen (Populus spp.) bark effectively reduced OA pain compared to placebo. Another trial found that 1,360 mg of willow bark extract per day (delivering 240 mg of salicin) was somewhat effective in treating pain associated with knee and/or hip OA.
Stinging nettle has historically been used for joint pain. Topical application with the intent of causing stings to relieve joint pain has been assessed in preliminary and double-blind trials. The results found intentional nettle stings to be safe and effective for relieving the pain of OA. The only reported adverse effect is a sometimes painful or numbing rash that lasts 6 to 24 hours...
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