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Can a do-it-yourself treatment involving capsaicin—a chemical in hot peppers—stop severe facial pain? A Nashville-based singer-songwriter decided to find out.

Previously on Painopolis, we brought you the jaw-dropping story of an Australian scientist named Hugh Spencer. He’s come up with daring, do-it-yourself method for treating one of the worst types of pain imaginable: that of trigeminal neuralgia.

“After the ailment took hold, Ruggieri found himself buffeted by more than 200 excruciating jolts of pain in his face every day. It got to where he could barely talk, much less sing.”

Through trial and error, Spencer figured out a way to cure himself of this difficult-to-treat disorder, caused by a facial nerve gone rogue. His secret weapon: capsaicin, the chemical in hot peppers that produces the spicy, burning sensation when you eat them. A neurobiologist by training, Spencer argues that capsaicin can deaden the pain receptors that provoke trigeminal neuralgia while leaving other nerve fibers and healthy tissues intact. Consequently, he insists, capsaicin can relieve the suffering without causing facial numbness or other complications sometimes associated with conventional treatments.

It’s been known for decades that capsaicin applied topically to the skin can help relieve certain types of chronic pain. But Spencer added a daunting new twist: instead of smearing the oily substance on his face, he put it directly inside his mouth on the location of the pain and held it there for 20 minutes before rinsing it out. He then repeated this protocol once a day for a week. After that, his pain was gone. That was more than a dozen years ago, and it’s never come back. Not even a twinge.

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As word spread, trigeminal pain sufferers worldwide contacted Spencer to find out more about his treatment. And of the hundreds of people who’ve tried it and reported back, he says, about half of them found relief.

That got my attention. But I wanted to get an independent assessment about this approach from a trigeminal patient who’s used Spencer’s method and could tell me whether it helped.

To do that, I’d need to find somebody who’s either brave or desperate. That’s because the capsaicin recommended by Spencer is 300 times hotter than Sriracha sauce. In fact, it approaches the intensity of law-enforcement-grade pepper spray.

Well, I tracked down just such a person. His name is JP Ruggieri, and when you hear what he does for a living, you’ll understand why his need for relief was so urgent. Ruggieri is a 33-year-old Nashville-based singer, musician, and songwriter. A while back, he began suffering severe facial pain diagnosed as trigeminal neuralgia.

After the ailment took hold, he found himself buffeted by more than 200 excruciating jolts of pain in his face every day. It got to where he could barely talk, much less sing. He couldn’t even tolerate the sensation of a breeze blowing on his face. Instead of maintaining a busy performance schedule as he once had, Ruggieri spent more and more time indoors. And in agony.

He initially tried a first-line medication. But he had to stop taking it after suffering unpleasant side effects. And he wasn’t too keen on trying Option B: having surgeons cut a hole through his skull in hopes of fixing the problem mechanically. Then he heard about Spencer’s protocol. Compared to those other treatments, placing blisteringly hot capsaicin in his mouth didn’t sound so bad after all—particularly if there was any chance it could stop his pain and rescue his music career.

Today, Ruggieri joins us on the show to recount his battle with trigeminal neuralgia; describe what it’s like to put the chemical equivalent of molten lava inside his mouth; and most importantly, reveal whether the treatment actually worked. Whatever you think the answer might be, I can already assure you, you’re not even close. That’s because, this is a story where reality—and the complexities of chronic pain—prove much more unpredictable than you could possibly imagine.

Interviewee:

JP Ruggieri is a Nashville-based singer, musician, and songwriter. To learn more about him and his music, check out his website.

Hugh Spencer’s capsaicin tutorial:

Hugh Spencer, Ph.D., is the co-founder and director of the Cape Tribulation Tropical Research Station, located in Queensland, Australia. Spencer can be contacted at: hugh@austrop.org.au

In this video, Spencer demonstrates how he used capsaicin to vanquish his trigeminal neuralgia and explains the science behind capsaicin’s ability to dial down the pain:

Straight from the lab:

What’s the evidence for capsaicin’s ability to relieve trigeminal neuralgia and other types of neuropathic pain? And how effective are conventional treatments? Scientists have been asking those same questions. Explore this sampling of their research to date:

• “Fight Fire with Fire: Neurobiology of Capsaicin-Induced Analgesia for Chronic Pain,” Pharmacology & Therapeutics, 2021.

• “8% Capsaicin Patch in Treatment of Peripheral Neuropathic Pain,” Pain Physician, 2020.

•  “Topical Capsaicin (High Concentration) for Chronic Neuropathic Pain in Adults,” Cochrane Library, 2017.

•  “Trigeminal Neuralgia,” American Family Physician, 2016.

•  “Capsaicin: Current Understanding of Its Mechanisms and Therapy of Pain and Other Pre-Clinical and Clinical Uses,” Molecules, 2016.

•  “High-Dose Capsaicin for the Treatment of Neuropathic Pain: What We Know and What We Need to Know,” Pain and Therapy, 2014.

•  “Carbamazepine for Chronic Neuropathic Pain and Fibromyalgia in Adults,” Cochrane Library, 2014.

•  “Capsaicinoids in the Treatment of Neuropathic Pain: A Review,” Therapeutic Advances in Neurological Disorders, 2014.

•  “Natural History and Outcome of 200 Outpatients with Classical Trigeminal Neuralgia Treated with Carbamazepine or Oxcarbazepine in a Tertiary Centre for Neuropathic Pain,” The Journal of Headache and Pain, 2014.

•  “The Capsaicin 8% Patch for Neuropathic Pain in Clinical Practice: A Retrospective Analysis,” Pain Medicine, 2013.

•  “Non-Antiepileptic Drugs for Trigeminal Neuralgia,” Cochrane Library, 2013.

•  “Neurosurgical Interventions for the Treatment of Classical Trigeminal Neuralgia,” Cochrane Library, 2011.

•  “The Treatment of Periocular and Facial Pain with Topical Capsaicin,” Journal of Neuro-Opthalmology, 1998.

•  “Topical Application of Capsaicin for Treatment of Oral Neuropathic Pain and Trigeminal Neuralgia,” Oral Surgery, Oral Medicine, Oral Pathology, 1994.

•  “Analgesic Effect of Capsaicin in Idiopathic Trigeminal Neuralgia,” Anesthesia & Analgesia, 1992.

Explore the show notes for this episode at:

https://painopolis.com/capsaicin-versus-trigeminal-neuralgia-part-2/

Music:

Our theme music is “Gentle Storm,” composed and performed by Betsy Tinney (betsytinney.com).

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