Methods and compositions for treatment of pain using capsaicin

A method of attenuating transient burning sensation due to injection of capsaicin into a human osteoarthritic knee joint, comprising:

• a. applying for a duration of about 15 minutes a cooling article to an exterior surface of a human patient's knee presenting with osteoarthritic knee joint pain, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the exterior surface of said knee;
• then
• b. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount ranging from about 0.1 g to about 0.5 g;
• then
• c. applying for a duration of about 30 minutes a cooling article to an exterior surface of said knee, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the exterior surface of said knee;
• then
• d. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. applying a cooling article to an exterior surface of said knee for a duration of at least about 30 minutes, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the exterior surface of said knee;
• to thereby attenuate transient burning sensation due to injection of capsaicin.

A method of ameliorating osteoarthritic knee joint pain in a human patient, comprising:

• a. applying a cooling article to an exterior surface of a human patient's knee presenting with osteoarthritic knee joint pain;
• then
• b. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount of about 0.1 g to about 0.5 g;
• then
• c. applying a cooling article to an exterior surface of said knee to achieve a temperature in the range of from about 26° C. to about 33° C. for fluid in the intra-articular space of the joint of said knee;
• then
• d. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. applying a cooling article to an exterior surface of said knee;
• to thereby ameliorate osteoarthritic knee joint pain in the human patient.

A method of attenuating transient burning sensation due to injection of capsaicin into a human osteoarthritic knee joint, comprising:

• a. applying a cooling article to an exterior surface of a human patient's knee presenting with osteoarthritic knee joint pain;
• then
• b. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount of ranging from about 0.1 g to about 0.5 g;
• then
• c. applying a cooling article to an exterior surface of said knee to achieve a temperature in the range of from about 26° C. to about 33° C. for fluid in the intra-articular space of the joint of said knee;
• then
• d. administering by injection into the intra-articular space of the joint of said knee a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. applying a cooling article to an exterior surface of said knee;
• to thereby attenuate transient burning sensation due to injection of capsaicin.

A method of ameliorating joint pain in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• then
• b. optionally administering a local anesthetic agent into said joint;
• then
• c. applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of from about 0.01 mg to about 4 mg;
• and then
• e. optionally applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• to thereby ameliorate joint pain in the human patient.

A method of attenuating transient burning sensation due to injection of capsaicin into a joint in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• b. optionally administering a local anesthetic agent into said joint;
• c. applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of from about 0.01 mg to about 4 mg;
• and then
• e. optionally applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• to thereby attenuate transient burning sensation due to injection of capsaicin.

A method of ameliorating joint pain in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• then
• b. optionally administering a local anesthetic agent into said joint;
• then
• c. applying a cooling article to the patient's skin in proximity to said joint to achieve a temperature in the range of from about 20° C. to about 33° C. for tissue or fluid in the interior of the joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of from about 0.01 mg to about 4 mg;
• and then
• e. optionally applying a cooling article to the patient's skin in proximity to said joint;
• to thereby ameliorate joint pain in the human patient.

A method of attenuating transient burning sensation due to injection of capsaicin into a joint in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• b. optionally administering a local anesthetic agent into said joint;
• c. applying a cooling article to the patient's skin in proximity to said joint to achieve a temperature in the range of from about 20° C. to about 33° C. for tissue or fluid in the interior of the joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of from about 0.01 mg to about 4 mg;
• and then
• e. optionally applying a cooling article to the patient's skin in proximity to said joint;
• to thereby attenuate transient burning sensation due to injection of capsaicin.

A method of ameliorating joint pain in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• then
• b. optionally administering a local anesthetic agent into said joint;
• then
• c. applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. optionally applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• to thereby ameliorate joint pain in the human patient, wherein the joint pain is osteoarthritic joint pain, and the joint is a knee joint.

A method of attenuating transient burning sensation due to injection of capsaicin into a joint in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• b. optionally administering a local anesthetic agent into said joint;
• c. applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. optionally applying for a duration of at least about 10 minutes a cooling article to the patient's skin in proximity to said joint, wherein the cooling article has an exterior surface temperature in the range of from about 1° C. to about 15° C. for application to the human patient's skin in proximity to said joint;
• to thereby attenuate transient burning sensation due to injection of capsaicin, wherein the joint pain is osteoarthritic joint pain, and the joint is a knee joint.

A method of ameliorating joint pain in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• then
• b. optionally administering a local anesthetic agent into said joint;
• then
• c. applying a cooling article to the patient's skin in proximity to said joint to achieve a temperature in the range of from about 20° C. to about 33° C. for tissue or fluid in the interior of the joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. optionally applying a cooling article to the patient's skin in proximity to said joint;
• to thereby ameliorate joint pain in the human patient, wherein the joint pain is osteoarthritic joint pain, and the joint is a knee joint.

A method of attenuating transient burning sensation due to injection of capsaicin into a joint in a human patient, comprising:

• a. optionally applying a cooling article to a human patient's skin in proximity to a joint in need of pain relief therapy;
• b. optionally administering a local anesthetic agent into said joint;
• c. applying a cooling article to the patient's skin in proximity to said joint to achieve a temperature in the range of from about 20° C. to about 33° C. for tissue or fluid in the interior of the joint;
• then
• d. administering by injection into said joint a pharmaceutical composition comprising capsaicin in order to deliver a dose of capsaicin in an amount of about 1 mg;
• and then
• e. optionally applying a cooling article to the patient's skin in proximity to said joint;
• to thereby attenuate transient burning sensation due to injection of capsaicin, wherein the joint pain is osteoarthritic joint pain, and the joint is a knee joint.

A method of ameliorating nerve pain in a human patient, comprising:

• a. applying for a duration of about 15 minutes a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• then
• b. administering by injection into tissue adjacent to the intermetatarsal neuroma a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount ranging from about 1 mg to about 50 mg;
• c. applying for a duration of about 30 minutes a cooling article to the human patient's skin in proximity to the intermetatarsal neuroma in need of pain relief therapy, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• then
• d. administering by injection into tissue adjacent to the intermetatarsal neuroma capsaicin in an amount of from about 100 μg to 300 μg;
• and then
• e. applying for a duration of at least about 30 minutes a cooling article to the patient's skin in proximity to the intermetatarsal neuroma, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• to thereby ameliorate nerve pain in the human patient.

A method of attenuating transient burning sensation due to injection of capsaicin into tissue adjacent to an intermetatarsal neuroma, comprising:

• a. applying for a duration of about 15 minutes a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• then
• b. administering by injection into tissue adjacent to the intermetatarsal neuroma a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount ranging from about 1 mg to about 50 mg;
• c. applying for a duration of about 30 minutes a cooling article to the human patient's skin in proximity to the intermetatarsal neuroma in need of pain relief therapy, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• then
• d. administering by injection into tissue adjacent to the intermetatarsal neuroma capsaicin in an amount of from about 100 μs to 300 μg;
• and then
• e. applying for a duration of at least about 30 minutes a cooling article to the patient's skin in proximity to the intermetatarsal neuroma, wherein the cooling article has an exterior surface temperature in the range of from about 5° C. to about 15° C. for application to the patient's foot;
• to thereby ameliorate nerve pain in the human patient.

A method of ameliorating nerve pain in a human patient, comprising:

• a. applying a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy;
• then
• b. administering by injection into tissue adjacent to the intermetatarsal neuroma a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount ranging from about 1 mg to about 50 mg;
• c. applying a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy to achieve a temperature in the range of from about 26° C. to about 33° C. for tissue in proximity to the intermetatarsal neuroma;
• d. administering by injection into tissue adjacent to the intermetatarsal neuroma capsaicin in an amount of from about 100 μg to 300 μg;
• and then
• e. applying a cooling article to the human patient's skin in proximity to the intermetatarsal neuroma in need of pain relief therapy;
• to thereby ameliorate nerve pain in the human patient.

A method of attenuating transient burning sensation due to injection of capsaicin into tissue adjacent to an intermetatarsal neuroma, comprising:

• a. applying a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy;
• then
• b. administering by injection into tissue adjacent to the intermetatarsal neuroma a pharmaceutical composition comprising a single pain-relief agent selected from the group consisting of lidocaine and a pharmaceutically acceptable salt thereof, in order to deliver a dose of lidocaine in an amount ranging from about 1 mg to about 50 mg;
• c. applying a cooling article to a human patient's skin in proximity to an intermetatarsal neuroma in need of pain relief therapy to achieve a temperature in the range of from about 26° C. to about 33° C. for tissue in proximity to the intermetatarsal neuroma;
• d. administering by injection into tissue adjacent to the intermetatarsal neuroma capsaicin in an amount of from about 100 μg to 300 μg;
• and then
• e. applying a cooling article to the human patient's skin in proximity to the intermetatarsal neuroma in need of pain relief therapy;
• to thereby attenuate transient burning sensation due to injection of capsaicin into tissue in proximity to an intermetatarsal neuroma.