Topical Capsaicin Versus Diclofenac for Chronic Temporomandibular Joint-Related Pain

NCT07598994 — Not applicable, Completed, 50 participants, Istanbul University

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Topical Capsaicin Versus Diclofenac for Chronic Temporomandibular Joint-Related Pain: A Randomized, Prospective, Single-Blind Clinical Trial

RegistryNCT07598994
StatusCompleted
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: single, treatment
Enrollment50 (Actual)
SponsorIstanbul University (Other); collaborators: The Scientific and Technological Research Council of Turkey
ConditionsTemporomandibular Disorders (TMD), Temporomandibular Pain
InterventionsCapsaicin Topical Cream, Diclofenac 1% Topical (Drug)
Datesstart 2025-08-28, primary completion 2026-04-06, completion 2026-04-06, first posted 2026-05-20, last updated 2026-07-01
Locations1 site in Turkey (Türkiye)

Related Papers Related Patents Related Grants Related Experts
All trials for Temporomandibular Disorders (TMD) All trials for Temporomandibular Pain All trials of Capsaicin Topical Cream All trials of Diclofenac 1% Topical

-Summary

The goal of this clinical trial is to compare the effectiveness and safety of topical capsaicin cream and topical diclofenac gel in women with chronic temporomandibular joint-related pain. The main questions it aims to answer are:

* Does topical capsaicin reduce pain intensity more effectively than topical diclofenac?
* Do the treatments improve jaw function, pressure pain threshold, and neuropathic pain symptoms?

Researchers will compare topical capsaicin cream with topical diclofenac gel to evaluate differences in pain relief and functional improvement.

Participants will:

* Apply the assigned topical medication four times daily for 7 days
* Attend clinical examinations and pain assessments at baseline, Day 8, and Month 1
* Complete pain-related questionnaires and functional jaw measurements during follow-up visits

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+Detailed description

This randomized prospective single-blind clinical trial was designed to evaluate the efficacy and safety of topical capsaicin cream compared with topical diclofenac diethylammonium gel in female patients with chronic temporomandibular joint-related pain. Fifty women aged between 18 and 65 years diagnosed with temporomandibular disorders were randomly assigned to either the capsaicin group or the diclofenac group.

Participants in the capsaicin group applied 0.075% topical capsaicin cream, while participants in the diclofenac group applied 1% diclofenac diethylammonium gel. Both medications were applied four times daily over the temporomandibular joint lateral pole region for 7 days. Existing occlusal splint therapy was continued throughout the study period.

Clinical evaluations were performed at baseline, Day 8, and Month 1. Outcome measures included pain intensity assessed with a visual analog scale, multidimensional pain assessment using the McGill Pain Questionnaire, neuropathic pain evaluation using the DN4 questionnaire, pressure pain threshold measurements, maximum mouth opening, lateral mandibular movements, clinician global impression of change, and adverse effects.

The study was approved by the Istanbul University Faculty of Dentistry Clinical Research Ethics Committee and conducted in accordance with the Declaration of Helsinki.

+Arms and interventions

ArmTypeInterventionsDescription
Capsaicin GroupExperimentalDrug: Capsaicin Topical CreamParticipants received 0.075% topical capsaicin cream applied four times daily over the temporomandibular joint lateral pole region for 7 days.
Diclofenac GroupActive comparatorDrug: Diclofenac 1% TopicalParticipants received 1% diclofenac diethylammonium gel applied four times daily over the temporomandibular joint lateral pole region for 7 days.
  • Capsaicin Topical Cream (Drug), also known as Capsaicin 0.075% Cream: Topical capsaicin cream applied four times daily over the temporomandibular joint region for 7 days.
  • Diclofenac 1% Topical (Drug), also known as Diclofenac Diethylammonium 1% Gel: Topical diclofenac diethylammonium gel applied four times daily over the temporomandibular joint region for 7 days.

+Outcome measures

Primary outcomes

  • Change in pain intensity measured by Visual Analog Scale (VAS) [Baseline, Day 8, and 1 Month]: Pain intensity was evaluated using a 10-cm Visual Analog Scale (VAS) in patients with temporomandibular disorder-related pain. Changes in VAS scores were compared between the capsaicin and diclofenac

Secondary outcomes

  • Pressure Pain Threshold [Baseline, Day 8, and 1 Month]: Pressure pain threshold over the temporomandibular joint lateral pole measured using a dolorimeter.
  • Maximum Mouth Opening [Baseline, Day 8, and 1 Month]: Maximum interincisal mouth opening measured in millimeters.
  • McGill Pain Questionnaire Scores [Baseline, Day 8, and 1 Month]: Pain severity assessed using the McGill Pain Questionnaire.
  • DN4 Neuropathic Pain Scores [Baseline, Day 8, and 1 Month]: Neuropathic pain symptoms assessed using the DN4 questionnaire.
  • Lateral Excursion Measurements [Baseline, Day 8, and 1 Month]: Right and left mandibular lateral excursion movements measured in millimeters.
  • Clinician Global Impression of Change (CGIC) [Day 8, and 1 Month]: Clinical improvement assessed using the Clinician Global Impression of Change scale.

+Eligibility

Sex: Female, ages: 18 Years to 65 Years

Inclusion Criteria:

* Female participants aged between 18 and 65 years
* Diagnosis of temporomandibular disorder (TMD)-related pain
* Presence of pain for at least 3 months
* Baseline pain intensity sufficient to require treatment
* Willingness to comply with study procedures and follow-up visits
* Signed informed consent form

Exclusion Criteria:

* Pregnancy or breastfeeding
* History of allergy or hypersensitivity to capsaicin or diclofenac
* Presence of systemic inflammatory or neurological disease
* Use of systemic analgesics, corticosteroids, or muscle relaxants during the study period
* Active skin lesions or dermatologic disease in the application area
* Previous temporomandibular joint surgery
* Participation in another clinical trial within the last 30 days
* Inability to comply with study procedures

+Locations (1)

FacilityCityCountryStatus
Istanbul University Faculty of DentistryIstanbul, IstanbulTurkey (Türkiye)

+Publications

  • Mena M, Dalbah L, Levi L, Padilla M, Enciso R. Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis. J Dent Anesth Pain Med. 2020 Dec;20(6):337-356. doi: 10.17245/jdapm.2020.20.6.337. Epub 2020 Dec 28. PMID 33409363
  • Haanpaa M, Treede RD. Capsaicin for neuropathic pain: linking traditional medicine and molecular biology. Eur Neurol. 2012;68(5):264-75. doi: 10.1159/000339944. Epub 2012 Sep 28. PMID 23037991
  • Klinge SA, Sawyer GA. Effectiveness and safety of topical versus oral nonsteroidal anti-inflammatory drugs: a comprehensive review. Phys Sportsmed. 2013 May;41(2):64-74. doi: 10.3810/psm.2013.05.2016. PMID 23703519
  • Alomar X, Medrano J, Cabratosa J, Clavero JA, Lorente M, Serra I, Monill JM, Salvador A. Anatomy of the temporomandibular joint. Semin Ultrasound CT MR. 2007 Jun;28(3):170-83. doi: 10.1053/j.sult.2007.02.002. PMID 17571700
  • Gan TJ. Diclofenac: an update on its mechanism of action and safety profile. Curr Med Res Opin. 2010 Jul;26(7):1715-31. doi: 10.1185/03007995.2010.486301. PMID 20470236
  • Craft RM, Mogil JS, Aloisi AM. Sex differences in pain and analgesia: the role of gonadal hormones. Eur J Pain. 2004 Oct;8(5):397-411. doi: 10.1016/j.ejpain.2004.01.003. PMID 15324772
  • Harper DE, Schrepf A, Clauw DJ. Pain Mechanisms and Centralized Pain in Temporomandibular Disorders. J Dent Res. 2016 Sep;95(10):1102-8. doi: 10.1177/0022034516657070. Epub 2016 Jun 28. PMID 27422858
  • Busse JW, Casassus R, Carrasco-Labra A, Durham J, Mock D, Zakrzewska JM, Palmer C, Samer CF, Coen M, Guevremont B, Hoppe T, Guyatt GH, Crandon HN, Yao L, Sadeghirad B, Vandvik PO, Siemieniuk RAC, Lytvyn L, Hunskaar BS, Agoritsas T. Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline. BMJ. 2023 Dec 15;383:e076227. doi: 10.1136/bmj-2023-076227. PMID 38101929